Phimosis is the condition where the foreskin is too taut to be pulled back over the head of the penis (glans).
Clinically Phimosis is normal in babies and tots, but in older children, it may be the consequence of a skin condition that has something to worry about. Now, one thing needs to be cleared out is that it isn't generally a problem lest it causes symptoms.
Phimosis isn't usually a problem unless it causes symptoms such as redness, soreness or swelling.
If your child's glans is sore and reddened, they may have balanitis (inflammation of the head of the penis).
There may be a dense discharge under the foreskin. If both the foreskin and glans are inflamed, it's known as balanoposthitis. It is best to consult the doctor at that situation.
Most cases of balanitis can be easily succeeded using a combination of creams or ointments, good hygiene, and avoiding materials that irritate the penis.
Balanoposthitis can also occasionally be treated by following simple hygiene measures, such as keeping the penis clean by regularly washing it with a mild soap or moisturizer and water.
Urine can irritate the glans if it's reserved for long periods under the foreskin. Therefore if possible it is important to withdraw the foreskin to wash the glans.
If balanoposthitis is caused by a fungal or bacterial infection, a course of antibiotics and an antifungal cream may be required.
In adults, phimosis can sporadically be associated with sexually transmitted infections (STIs).
It can also be caused by a number of different skin conditions, counting:
lichen planus- a non-infectious itchy rash that can affect various areas of the body
psoriasis- a skin condition that causes flaky, red, crusty patches of skin covered with silvery scales
eczema - a long-term condition that causes the skin to become red, itchy, dry and cracked.
lichen sclerosus - a damaging condition of the foreskin (and sometimes glans) that are perhaps caused by urinary irritation. This is vulnerable to men and boys
Immediate proper treatment is needed in cases where phimosis causes problems such as difficulty in urinating.
To treat phimosis in the best possible way, a doctor might prescribe a steroid cream that helps the foreskin soften. With time it becomes easier to move back and forth. The cream is characteristically applied to the tip of the foreskin. After a couple of weeks, gentle stretching exercises may start. These exercises should be taught to patients (or parents/guardians) so they can be done accurately.
If the case is ina more serious condition of phimosis, it may require circumcision, a technique in which part or all of the foreskin is surgically detached. If only part of the foreskin is removed, relapse of phimosis is possible.
Paraphimosis, when the foreskin cannot be pulled onward from a retracted position, is possible to be treated manually. Generally, the doctor numbs the area with a local anesthetic before pulling the foreskin forward with his or her hands. It is mandatory to seek expert advice before performing any such act.
Paraphimosis is an emergency and needs immediate medical attention to avoid tissue death.