Caring for your child’s foreskin

The foreskin is the small piece of skin that covers the tip of the penis (glans) to protect it. For uncircumcised boys, the penis does not require any special care and can be washed just like any other body part.

Should you pull back your child’s foreskin in the bath?

At birth, the foreskin is attached to the glans. Because of this, you should not try to forcefully retract your baby’s foreskin, as this could hurt him and cause bleeding. In fact, as long as the foreskin is connected to the glans, you should never try to pull it back by force. The foreskin will separate from the glans naturally over time.

This separation generally occurs between the ages of 3 and 6, meaning that the foreskin will easily retract and slide over the glans without resistance. If this does not occur, don’t worry. As long as your child does not have an infection and is not in pain, there isn’t a problem. In some cases, full separation does not occur until puberty.

Good hygiene practices

• If your child’s foreskin is still attached to the glans, simply clean the foreskin with water and then dry it off. You don’t need to use soap on this part of the body, even soaps designed for young children. You can gently pull back the foreskin to clean any discharge that is not visible, but never force it.
• Wipe off any whitish discharge that comes out of the tip of the foreskin, but do not attempt to remove what is under the foreskin. This whitish substance is called smegma. It’s a natural secretion that helps the foreskin separate.
• You can try to gently retract your child’s foreskin in the bath to see if it has separated from the glans.
• When you are able to pull back the foreskin without straining, retract it to remove any secretions that have accumulated there. A buildup of secretions under the foreskin can cause inflammation and may cause the foreskin to tighten. When you’re done, pull the foreskin back over the penis.
• Boys should be taught to clean their penis on their own at age 5 or 6. Encourage your child to retract the foreskin and wash the tip of the penis during bath time. This step should never be painful. Remind your child to always pull the foreskin back over the tip of the penis after washing.

Common problems affecting the foreskin

Posthitis and balanitis

Posthitis is inflammation of the foreskin, while balanitis is inflammation of the glans. When both occur at the same time, the condition is referred to as balanoposthitis.

These inflammations are characterized by redness, swelling of the skin, itching, and sometimes a burning sensation when peeing. Posthitis and balanitis can be caused by a bacterial infection, a fungus, or irritation following the use of a perfumed soap, for example.

What to do

• Apply an antibiotic ointment (e.g., Polysporin®) as recommended by your pharmacist as soon as inflammation appears. This often clears up both issues.
• Consult a doctor if the inflammation worsens despite uses of an antibiotic ointment, or if it does not completely disappear after 4 or 5 days of treatment. They can prescribe the appropriate treatment (e.g., antibiotic or antifungal cream).
• You should also see a doctor if your child’s urine flow is very weak or urinating is very painful.

Phimosis

Phimosis occurs when the opening of the foreskin remains narrow, preventing it from retracting over the glans at all. Some boys are born with a very tight foreskin that does not easily retract.

Phimosis can also be caused by infection, or by tearing caused by forced retraction of the foreskin. The problem manifests as redness at the tip of the penis.

What to do

• Talk to your doctor about prescribing a cortisone cream to soften the foreskin.
• As a last resort, if no treatment works, circumcision may be considered.

Paraphimosis

This problem occurs when the foreskin becomes trapped behind the glans and can no longer move back up to cover it. The foreskin and tip of the penis may become slightly swollen and painful if nothing is done.

What to do

• Compress the glans and foreskin with your fingers to pull the foreskin back into place.
• If this does not work, seek medical attention quickly or the situation will be more difficult to correct.

Things to keep in mind

• Separation of the foreskin usually occurs between the ages of 3 and 6, but sometimes does not happen until puberty.
• Without forcing it, you can try to gently retract your child’s foreskin to see if the glans has separated from the foreskin.
• Clean water is all you need to wash your child’s penis.

Scientific review: Dr. Anne-Claude Bernard-Bonnin, pediatrician Research and writing: The Naître et grandir team Updated: June 2024

Photo: iStock.com/johnnyscriv