Cleaning the Penis with Intact Foreskin

Question

My 19 month-old son was not circumcised at birth at my husband's request. I am the one that gives him his bath, and mostly change his diapers every day but I never do anything specific to clean his penis. I've heard that I'm supposed to but have no idea what to do, and my husband tells me not to do anything specific. I just want to make sure I'm doing the right thing. Do you have any recommendations?
Texas

Dr. Greene`s Answer:

Today in the office, a great mom asked me about her son’s newly acquired habit of licking garden snails. Little boys often have a very different sense of hygiene than their mothers. They delight to splash in muddy water, and think nothing of the trail of mucus running down the nose that prompts many mothers to action. Most little boys will not spontaneously wash their hands or clean their penises. So what to do with a foreskin?

If this conflict weren’t enough, sources of childcare information have very different recommendations for care of uncircumcised penises. Some advocate aggressive wiping using cotton swabs and alcohol to clean under the foreskin. At the other extreme, some authorities suggest doing nothing at all until puberty, saying that the collection of cheesy material under the foreskin is natural and desirable. One popular childcare book even differs from itself, saying in a caption, “The uncircumcised penis requires meticulous hygiene; the circumcised penis … requires no special care,” while the accompanying text says, “Contrary to what was once believed, no special care is needed for the uncircumcised penis.”

I recommend a more moderate approach.

Structurally, the penis consists of two main parts, the shaft and the head (which is called the glans). Urine and semen exit the body through a tiny opening at the tip of the glans. At birth, the shaft and the glans are covered by a single continuous layer of skin. If circumcision is performed, the part of this skin that covers the glans is cut off. Immediately after circumcision the glans appears swollen, tender, and vivid red, since the foreskin was firmly attached to the glans before it was forcibly separated and then cut off.

In uncircumcised boys, the foreskin at first remains firmly attached to the glans, but gradually over time the attachments are broken (mostly by the stretching resulting from repeated normal erections). In 90% of boys the foreskin is loose and mobile by age 2, but the process can sometimes take five or more years. When the foreskin has separated from the glans, the foreskin can easily be retracted, or pulled back, to leave the glans exposed. Throughout life, a cheesy white material called smegma, consisting primarily of dead skin cells and secretions from sebaceous glands, will accumulate underneath it.

In uncircumcised boys, forcibly ripping the foreskin from the glans in the name of hygiene can lead to pain, scarring and adhesions. Do not try to forcibly retract the foreskin or to clean under an adherent foreskin with swabs, antiseptics, or even water. On the other hand, even though doing nothing at all may be considered natural, similar reasoning would lead to not cutting the hair, trimming the nails, washing the hands, or cleaning the bottom after a poop. Gentle hygiene enhances health.

Only the outside of the foreskin needs to be cleaned during the first year. It should be cleaned and bathed with soap and water just like the rest of the diaper area. After his first birthday, you might want to very gently pull back on the skin of the shaft to see if the foreskin retracts. If it doesn’t at all, don’t worry — and don’t force it! There is certainly no rush. If urine can flow freely, the hole in the foreskin is big enough. As long as the foreskin doesn’t easily retract (even in a ten year old), only the outside needs to be washed. If the foreskin retracts a little, it would be okay to gently clean the exposed part of the glans with water (but don’t use soap while the foreskin is still partially attached to the glans, since this can irritate this tender area). After cleaning, always pull the foreskin forward to its usual position. This is very important — otherwise it can get stuck and lead to serious damage.

Once the foreskin has completely separated and retracts freely, begin to teach your son to retract his own and clean underneath it when he bathes, or at least once a week. For most little boys this personal cleaning will not become a habit unless you encourage it. Mentioning it positively and frequently throughout the years can instill an important sense of responsibility, prevention, and health that will benefit him for years to come.

Your bathtimes together are precious now, but the habits you help your son develop might also reduce sexually transmitted diseases and cancer of the penis (and cervix in his partner) when your little boy becomes a man.

Last medical review on: January 13, 2015
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
Get Dr. Greene's Wellness RecommendationsSignup now to get Dr. Greene's healing philosophy, insight into medical trends, parenting tips, seasonal highlights, and health news delivered to your inbox every month.
Showing
10
comments (129 total)
Add your comment

Recent Comments

That is common. By the time he has hit puberty it should retract just fine

I saw the Urologist and he gave me clotrimazole and said to apply it to the tightened foreskin. He said to make sure that the foreskin is dry and clean. I am not sure that I am doing this correctly. Is there a video or other means of showing if I am doing this correctly? I am 80 and try to clean in the shower by putting soap on my little finger and I can in about half way..but still cannot get the foreskin back all the way to clean it properly. Also, I would like to have intercourse , but in trying I get P A.
What can I do . I just started his program today. I want to do it correctly…any advice would be appreciated E L S

My son is 4 year’s old , and uncircumcised the tip of his penis is red and irritated. His foreskin has still not separated and the opening is just big enough for him to urinate . I want to know if there is any over the counter ointments I can apply to the irrigated area. Please respond back. Thank

That is common. By the time he has hit puberty it should retract just fine

Would you like some of your citoris cut away? So why cut off foreskin

my foreskin on penis is hard to pull back when i need to go pee.and it feels like it is a sticky feel when i go! that peeling back the foreskin hurts,and I have torn the foreskin pulling it back to go! I do have Diabetes controlled by food intake. and I would like to know if that’s what causing this? it went away. and know it seems to be healing a little. but, there’s a little hole like look on the side of the head of the penis. I don’t know what it is? it doesn’t hurt. but, just wanted to know what it was? I did show the Doc!! but,went away still concerned!! he said wash it! and put Bacitracin Ointment,USP on it after. please answer back.. thank you!

My 5-year-old is the same. There isn’t a problem, though. Some boys aren’t retractable until puberty or beyond. Unless there’s pain, there isn’t usually a problem. (no one ever treated it as a problem when we were in the UK; it’s just been since moving to the US that some have considered it a problem).

I am 88yrs old an uncircumsized.due to inactivety my penis has retracted into my sack and I can’t get to it to clean it.is this a problem?

I am 80 years old and for the last 7 years have not been sexually active. That’s about to change but when I checked, my foreskin has become attached to the base of the glans preventing me to fully expose it. Is this something I should be concerned about or is there something I can do that will fully expose the glans?

I saw the Urologist and he gave me clotrimazole and said to apply it to the tightened foreskin. He said to make sure that the foreskin is dry and clean. I am not sure that I am doing this correctly. Is there a video or other means of showing if I am doing this correctly? I am 80 and try to clean in the shower by putting soap on my little finger and I can in about half way..but still cannot get the foreskin back all the way to clean it properly. Also, I would like to have intercourse , but in trying I get P A.
What can I do . I just started his program today. I want to do it correctly…any advice would be appreciated E L S

I am 88yrs old an uncircumsized.due to inactivety my penis has retracted into my sack and I can’t get to it to clean it.is this a problem?

My son is 5 year old.his foreskin is not opening at all ,but he urinates without pain.
is there any problem i want your suggestions please

My 5-year-old is the same. There isn’t a problem, though. Some boys aren’t retractable until puberty or beyond. Unless there’s pain, there isn’t usually a problem. (no one ever treated it as a problem when we were in the UK; it’s just been since moving to the US that some have considered it a problem).

My son is one year old and his left testes is undescend should i try to giv pressusure to descend down or anything more.what should i do?