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 isn’t pus or dirt, but a natural secretion that helps the foreskin separate.
• You can try to gently retract the foreskin from time to time 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.
• When he is 5 or 6 years old, teach your child how to clean his penis on his own. Encourage him to retract their foreskin and wash the tip of his penis every time he bathes. This should never cause him pain. Remind him to always pull the foreskin back over the tip of his 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 and itching. They can be caused by a bacterial infection, a fungus, or by irritation following the use of a perfumed soap, for example.

What to do Applying an antibiotic ointment as recommended by your pharmacist as soon as inflammation appears often helps to clear up these issues. If the inflammation worsens despite using an antibiotic ointment, or if it does not completely disappear after 4 or 5 days of treatment, it’s best to consult a doctor. They can prescribe the appropriate treatment (e.g., antibiotic or antifungal cream). At any time, if your child’s urine flow is very weak, or if he feels a lot of pain when he urinates, it’s best to consult a doctor.

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 could 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. Jean Turgeon, pediatrician, CHU Sainte-Justine Research and writing: The Naître et grandir Team Updated: November 2018

Photo: iStock.com/johnnyscriv