I often get questions about the function and care of the foreskin. Knowing what is normal and how your son’s foreskin develops and changes over time is important for every parent to a boy with an uncircumcised penis. The foreskin is a piece of loose skin overlying the outside of your son’s penis. It functions primarily to protect the glans (head) of the penis. The foreskin’s inside fold is mucous membrane, like the inside of the mouth, and keeps the surface of the glans soft, moist, and sensitive. The foreskin contains a rich supply of blood vessels and a dense concentration of nerve endings. The frenulum, the fold of tissue on the underside of the penis, secures the foreskin in its forward position. Specialized erogenous tissue, the ridged band, encircles the foreskin where the foreskin’s inside and outside folds meet.
During infancy, your son’s uncircumcised penis needs no special care. You never need to pull the foreskin back or detach it in any way. You clean it (the outside of the foreskin) just like any other skin surface on his body. Over the first 5-10 years of your son’s life, the foreskin will gradually “retract” or pull away from the head of his penis. In some cases, this may not occur fully until the end of puberty. This happens naturally as the connective tissue holding the foreskin to the head of his penis dissolves on its own. Never force, pull, or rip the foreskin back for your son. Your son is the only one who should move his foreskin. Once he is able to fully retract the foreskin, keeping it clean is his job. Teach your son to gently retract the foreskin, rinse the inside of the foreskin and the head of the penis with warm water only. Soap is not necessary and will often irritate the very sensitive membrane on the inside of the foreskin. Soaps and shampoos often disturb the bacterial balance on the foreskin causing redness and itchiness (called balanitis), stinging with urination, and sometimes yeast overgrowth. Other substances, such as antibiotics, bubble baths, and chlorinated swimming pools may also do the same thing. Once these irritating substances are removed, the health of the foreskin returns. After the foreskin has been rinsed, allow it to return to its extended position on its own. The foreskin should never be stuck back or retracted in a painful way. If your son has swelling, redness, or drainage from his foreskin, you should make an appointment with your pediatrician.
When your son it little, you may notice that the head of the penis “balloons” when he is urinating. This is normal and shows that the natural separation of the foreskin from the head of the penis is occurring, but the opening is still narrow. As your son approaches adolescence, he may notice some white matter inside his foreskin. This is called smegma and helps keep the glans moist and facilitates sexual intercourse sexual by acting as a lubricant. Smegma is produced from the mucosal surface of the foreskin, contains fats and proteins, and has a smooth, moist texture. It is perfectly normal and may be rinsed and wiped clean from time to time.
I will leave the very important “circumcise-or-not-to-circumcise” question for another post. Until then, I encourage you to visit this very helpful site Foreskin Care from Paediatric Society of New Zealand. The drawings in this post are from the National Organization of Circumcision .