What Phimosis Treatments Are Available?

What is phimosis?

Phimosis is a condition which causes the foreskin of the penis to be un-retractable from the head of the penis (NHS, 2022). The foreskin of an uncircumcised man is usually able to be pulled back to expose the head of the penis, also called the glans. For individuals with phimosis, the foreskin is too tight to be pulled back which can cause great discomfort and other problems.

Key Takeaways

Phimosis is a condition where the foreskin can't be retracted:

Phimosis occurs when the foreskin is too tight to be pulled back over the head of the penis, causing discomfort and potential issues with hygiene, urination, and sexual activity.

Phimosis can be treated with steriod creams or surgery:

Treatment options include corticosteroid creams that soften the foreskin or surgical procedures like circumcision. Non-surgical methods may be effective in milder cases, while more severe cases may require surgery.

Consult a doctor if you experience symptoms:

It's important to see a healthcare provider if you or your child shows signs of phimosis. Proper treatment can relieve symptoms, improve hygiene, and prevent complications like infections or difficulty urinating.

What are the different types of phimosis?

There are two different types of phimosis. They are congenital, which means present at birth, and acquired, which means it is developed later in life. Congenital phimosis is more common in newborns and infants (Stewart, W.; 1887), whereas acquired phimosis is more common in older children and adults (NCBI, 2018).

What are the main symptoms of phimosis?

One of the main symptoms of phimosis is the inability to retract the foreskin. This can cause difficulty with urination as the urine can become trapped under the foreskin, which can cause swelling and discomfort. In severe cases, phimosis can also cause pain and difficulty during sexual intercourse.

According to Medical News Today (2023), Phimosis can also cause symptoms such as:

• Swelling or redness of the penis

• Bleeding or discharge from the penis

• Difficulty maintaining good penis hygiene

• Increased risk of urinary tract infections (UTIs) and other medical complications

What are the risk factors for phimosis?

Age

Phimosis is much more common in younger boys (UCSF Department of Urology, 2024). Most cases resolve on their own by puberty.

Personal hygiene

Poor penis hygiene can increase the risk of infections and inflammation, which can lead to phimosis (Ro et al, 2008).

Sexually transmitted infections

Some sexually transmitted infections, including syphilis and gonorrhoea, can cause infections and inflammation of the foreskin which in turn can lead to the development of phimosis (Medical News Today, 2018).

Diabetes

People that suffer from diabetes are more likely to develop infections and are at a higher risk of inflammation (Bromage et al, 2008). These can both increase the risk of phimosis.

What are the potential causes of phimosis?

Congenital factors

Some people are born with a foreskin that is too tight, which can cause phimosis.

Infection or inflammation

Infections and/or inflammation of the foreskin can cause tightness and scarring which can lead to phimosis.

Trauma

Trauma to the foreskin that is caused by injuries or skin tearing can cause scarring and tightness which can lead to phimosis.

Repeated episodes of forceful retraction

If you attempt to forcefully retract the foreskin when it is too tight you can cause irritation and inflammation, and potential infection.

Can phimosis cause other problems?

Yes, phimosis can also lead to other problems. The biggest problem phimosis can cause is perhaps infections of the foreskin and/or glans. When the foreskin is unable to be retracted due to phimosis it can create a warm and moist environment, this is perfect for bacterial growth (). The growth of bacteria can lead to infections in the foreskin and the glans. Infections of this area include balanitis, which is inflammation of the glans, and posthitis which is inflammation of the foreskin. Phimosis can also increase the risk of other conditions such as paraphimosis (Medscape, 2022). Paraphimosis occurs when the foreskin becomes trapped behind the head of the penis. It will mean that the foreskin cannot be pulled back into its original position. When this happens it can cause swelling and discomfort and can become an emergency if it is not treated promptly.

Are there any risks if phimosis is left untreated?

If left untreated, phimosis can lead to several complications with bodily functions (UCSF Department of Urology, 2024). These can include:

Difficulty urinating

If the foreskin is unable to be pulled back it can cause the urine to become trapped. When this happens it can cause swelling and discomfort and can make it very difficult to urinate.

Infections

The warm and moist environment that is created when you are unable to retract the foreskin can increase the risk of infections such as balanitis and posthitis due to bacteria growth.

Paraphimosis

This is a condition in which the foreskin becomes trapped behind the head of the penis, and cannot be pulled back into its original position. Paraphimosis can cause swelling and discomfort and can become serious if it is not treated quickly.

Reduced sexual pleasure

Phimosis can cause pain and discomfort during sexual intercourse. This will in turn lead to a reduced level of sexual pleasure.

Reduced levels of fertility

In severe cases phimosis can cause damage to the foreskin and the glans of the penis which can affect fertility.

Is it dangerous to force my foreskin back if I suffer from phimosis?

It is generally not recommended to force the foreskin back if you have phimosis. If you do force the skin back it can cause pain, swelling, and discomfort. It can even lead to tears in the foreskin and the head of the penis. Forceful retraction can also increase the risk of infections and other complications.

Can good hygiene help with phimosis?

Yes. Ensuring you have good levels of hygiene can help to prevent infections and other complications if you are struggling with phimosis (Harvard Health, 2022). When you have proper hygiene you will be helping to keep the area clean and reduce discomfort.

To maintain good hygiene with phimosis, it is important to:

• Gently clean the area around the foreskin with warm water on a daily basis. Avoid using soap or other harsh cleansers as these can irritate the sensitive skin of the foreskin.

• Avoid forcing the foreskin back when cleaning. This can cause pain, swelling, and tears in the foreskin.

• Avoid using any creams, ointments, or other products on the foreskin without the advice of a doctor or healthcare provider.

• Dry the area thoroughly after washing to prevent bacteria growth and other microorganisms.

Do I need surgery to treat phimosis?

No, surgery is not always necessary to treat phimosis (NCBI, 2018). In some cases, the condition may resolve on its own without treatment. This is especially true when it is in young boys. In some cases, phimosis can be treated without the need for surgical methods. Non-surgical treatment include the use of topical creams to soften the foreskin, or stretching exercises that gradually loosen the foreskin.

In some cases however surgery may be necessary to treat phimosis. This is typically the case when other treatments have not been effective, or, when the tightness of the foreskin is causing significant pain or discomfort.

How can phimosis be treated?

Treatment for phimosis depends on the severity of the condition and the underlying cause.

Phimosis Cream (Corticosteroid Creams)

In mild cases, phimosis may be treated with topical corticosteroid creams. These can help to soften the foreskin and make it more flexible.

How is Corticosteroid Cream used to treat phimosis?

The cream is typically applied to the foreskin once or twice a day for a period of several weeks. The exact dosage and duration of treatment will depend on the cream that is being used, the severity of the phimosis and the response to treatment.

When the foreskin becomes softer and more flexible it may be possible to gently pull it back from the glans of the penis. By doing this, you can help to relieve the symptoms of phimosis such as difficulty with urination and reduced sexual pleasure. It can also help to prevent complications such as infections and paraphimosis.

What Corticosteroid Creams are available to treat phimosis?

There are many different corticosteroid creams available, including Dermovate, Betamethasone, Betnovate, Eumovate and many more. Your prescriber will recommend the most appropriate option for you when you have your consultation.

Circumcision

In more severe cases circumcision, which is the surgical removal of the foreskin, may be necessary to relieve the symptoms of phimosis and prevent complications.

What is circumcision?

Circumcision is a surgical procedure that involves the removal of the foreskin from the penis (Mayo Clinic, 2022). In cases of phimosis, circumcision can be used help to relieve the symptoms by allowing the head of the penis to be exposed. This can help to reduce pain and discomfort, and can also improve urination and hygiene.

What does the circumcision procedure for phimosis involve?

During circumcision, the foreskin is surgically removed from the penis. This is usually done using a scalpel, and local anaesthesia is used to numb the area and reduce discomfort. Circumcision typically takes about 30 minutes to complete and most people can go home the same day.

After circumcision the head of the penis will be exposed, and the remaining skin will be stitched together to cover the area. Over the next few days, the area will heal and the stitches will dissolve. It is very important to keep the area clean and dry during this time, and you will need to avoid sexual activity or any activities that could cause irritation or infection.

What is a partial circumcision?

Partial circumcision, also known as partial foreskin removal, is a surgical procedure that involves removing a portion of the foreskin, as opposed to removing the entire foreskin (Healthline, 2018).

When would a partial circumcision be recommended?

Partial circumcision may be recommended in cases where the foreskin is too tight to be pulled back over the glans of the penis, but is not tight enough to require a full circumcision.

How can partial circumcision treat phimosis?

Partial circumcision can help to relieve the symptoms of phimosis by allowing the head of the penis to be partially exposed. By doing this it will help to reduce pain and discomfort, and can also improve urinary function and hygiene.

What is involved in the partial circumcision procedure to treat phimosis?

During partial circumcision the tightest part of the foreskin is removed and the rest is left in place. Typically, this is done using a scalpel whilst the patient is under local anaesthesia, which is used to numb the area to reduce discomfort. After a partial circumcision the area will heal and the remaining foreskin will gradually stretch over time.

Is circumcision suitable for all cases of phimosis?

No, in some cases, circumcision may not be the best option for treating phimosis. Alternative treatments such as using creams or stretching exercises may be recommended by your healthcare provider. It is always important to discuss the potential benefits and risks of circumcision with a healthcare provider before you make a decision about what treatment you wish to explore.

Is circumcision recommended for children / young boys to prevent phimosis in the future?

It is generally not recommended to perform a circumcision on a child to prevent phimosis in the future. In most cases phimosis is not present at birth and will develop later in life. In younger boys, the condition is typically temporary and will resolve on its own during puberty. For older boys phimosis can be treated using non-surgical methods, such as using creams.

What are the benefits of treating phimosis?

Treatment of phimosis can provide a number of health benefits, including:

Relieving symptoms

Phimosis can cause pain and discomfort during sexual activity or while urinating. Treatment can help to relieve these symptoms and improve the overall quality of life.

Improving urination

Phimosis can cause difficulty urinating or an increased risk of urinary tract infections (UTIs). Treatment can help to improve urinary function and reduce the risk of infections.

Preventing complications

If left untreated, phimosis can lead to irritation, inflammation, and infections of the penis. Treatment can help to prevent these complications and reduce the risk of further health problems.

Improving hygiene

Treatment of phimosis can help to improve the hygiene of the penis by allowing the head of the penis to be exposed. This can also make it easier to clean and maintain proper hygiene.

When should I see a doctor about treating phimosis?

It is important to consult with your doctor if you or your child is showing the symptoms of phimosis (NHS, 2022). Your doctor can assess the severity of the condition and recommend the appropriate treatment. In some cases phimosis may resolve on its own without the need for treatment. It is still important to monitor your own condition and seek medical attention if necessary.

A healthcare provider can provide education and guidance on proper hygiene and care of the penis. This is important for preventing further irritation or infection. They can also answer any questions that you may have about the condition and its treatment. It is always recommended to see a doctor for phimosis so you ensure that the condition is properly managed, as well as to prevent any potential complications.

Where can I buy phimosis treatment creams?

You can purchase phimosis treatment creams such as Dermovate, Betamethasone, Betnovate, Eumovate and more options safely and conveniently online at UK Meds. First, you will need to have an online consultation with a pharmacist-independent prescriber before your order will be supplied. The online consultation will ensure that the corticosteroid cream you wish to purchase is the right medication for your condition.

Sources

• NHS - Phimosis

  Leeds Teaching Hospitals NHS Trust - Tight Foreskin (Phimosis)

  Coventry Rugby GP Gateway - Phimosis

  NHS Wales - Phimosis

  NI Direct - Tight Foreskin (Phimosis) and Paraphimosis

  Wikipedia - Phimosis

  Healthline - Phimosis

  Harvard Health Publishing - Phimosis and Paraphimosis