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Men's health
A tight or irritated foreskin is common, often preventable and usually treatable without circumcision. The foreskin carries nerves and blood vessels that never come back once removed, so we start with the least invasive fix that will work.
Phimosis means the foreskin is too tight to pull back comfortably over the head of the penis, a circumferential tightness. Frenulum breve is different: one short, tight band on the underside that tugs or tears during erections or sex. Paraphimosis is an emergency in which a retracted foreskin gets stuck behind the head and swells; if that happens, seek care immediately.
In adults, most acquired phimosis is preventable. The biggest driver is simply that the foreskin is not pulled back routinely, so moisture and irritation build up underneath, the skin inflames, and scar tissue gradually tightens the opening. Retracting the foreskin before urinating, and cleaning and drying underneath after showering and after sex, prevents much of it.
Recurrent redness and itching under the foreskin are usually a fungal infection. Cleaning and thorough drying are what clear it; a small amount of antifungal cream on the red areas helps stop the growth. See our page on balanitis.
In the early, inflammatory phase, a course of steroid cream with gentle stretching often loosens the foreskin enough to solve the problem. It works best while the opening is still visible when you retract.
A tight frenulum is not a reason for circumcision. In a short office procedure we divide only the tight band and release the tissue around it. Healing takes two to three weeks; keeping the foreskin fully retracted during that time is the single most important step, because it stops the band from re-forming.
When scarring is so advanced that the foreskin cannot be pulled back to clean or to urinate, circumcision is the right operation, and it is better done sooner, before repeated infection makes the tissue harder to work with.
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Often not. Early phimosis frequently responds to steroid cream and stretching, and a tight frenulum is fixed with a frenuloplasty rather than circumcision.
A short, tight band of skin on the underside of the penis that pulls or tears during erections or intercourse. It is corrected by dividing that band.
Retract the foreskin when you urinate and clean and dry underneath it after showering and after sex.
That is paraphimosis, an emergency. Seek care right away so the swelling can be reduced and the foreskin returned.
About two to three weeks without sex or masturbation, and keeping the foreskin fully retracted during healing so the band does not re-form.
Book a men's-health visit at our Manhattan or Forest Hills office — a simple step that's easy to keep putting off.
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