Caring for your son’s foreskin is pretty much a hands-off job. But knowing what is normal and how your son’s foreskin develops and changes over time is essential for every parent to a boy with an uncircumcised penis.
In the beginning, during infancy, your son’s uncircumcised penis needs no special care. The foreskin is a piece of skin overlying the outside of your son’s penis. You never need to pull the foreskin back or detach it in any way. You clean it just like any other skin surface on his body.
Over the first 5 + years of your son’s life, the foreskin will gradually “retract” or pull away from the head of his penis. This happens without intervention as the connective tissue bonding the foreskin to the head of his penis dissolves on its own. As this happens, you can teach your son to wash the end of his penis with soap and water and rinse it well. Some boys will be able to fully retract or pull back their foreskin by the time they start Kindergarten while others may not fully retract it until puberty. Both are okay.
Never force, pull, or rip the foreskin back for your son–your son is the only one who should move his foreskin.
Once he is able to fully retract the foreskin, keeping it clean is his job. Teach him to gently retract the foreskin, rinse the inside of the foreskin and the head of the penis with warm water, and then allow the foreskin to return to its extended position on its own.
The foreskin should never be stuck back or retracted in a painful way. If your son has swelling, redness, or drainage from his foreskin, call his pediatrician for advice.
Very helpful site about Foreskin Care from Paediatric Society of New Zealand
Images above Courtesy of National Organization of Circumcision
Care For An Uncircumcised Penis
CuriousMom says
My 13-year old uncircumcised son says he can’t fully retract his foreskin yet. Should we be worried about this, or let nature take its course?
Wendy Sue Swanson, MD says
Very unlikely to be a problem. Some boys aren’t able to fully retract the foreskin until mid-puberty. However, when he is getting his next well child appointment/check-up, ask the doctor to check as part of physical exam to give him reassurance that all is healthy and normal.
Ora says
You have such good un-common sense. Kudos!
Viki says
Are foreskins making a comeback? We didn’t circumcise our son and I meet very few uncircumcised boys my son’s age (almost 3). Most moms seem concerned about maintaining the status quo – having their son “match daddy” or not stand out from the other boys at school. Do you hear from tween or teen boys who wish their parts had chosen to circumcise them?
Wendy Sue Swanson, MD says
I have never had a patient tell me they wish they were circumcised but admittedly, I have a much larger group of teenage girls in my practice than boys as one of my partners in the office is male.
Rates of circumcision have dropped. Here’s a quick summary of some stats from 2010.https://well.blogs.nytimes.com/2010/08/17/u-s-circumcision-rates-on-the-decline/
Circumcision remains a hotly debated topic and a bog of ethics, rights, protection, culture, and religon. As you may have heard, there is some data (primarily from research conducted in Africa) that finds circumcision can be somewhat protective against the spread and acquisition of STDs but most organizations remain neutral when asked if boys “should” be circumcised. It’s a post I should write, huh?
Brianna Daily says
Studies released in late 2014 have shown that the Langerhan’s cells found within the male prepuce perform an important function of transporting STIs, including HIV, to immune cells which destroy infection quite quickly! Cut away the normal prepuce of a male and he loses this important immunological function… it is no wonder the United States has some of the highest STI rates in the Western world, on top of extremely high rates of male genital cutting.
https://www.ncbi.nlm.nih.gov/pubmed/25551286
Emma la Margarita says
Thank you so much for your article (and your whole blog, for that matter!) I was just wondering the other day while bathing my 21-month old son if I need to pay attention to his penis or not, and in fact he doesn’t even like it if I try to touch it at all (that’s his toy!!) so I’m glad you give clear information that’s easy to understand quickly. After all, I only have a few minutes at a time when I can do something so revolutionary as read. 🙂 I will let his penis do its thing and I won’t worry!
Michael says
What a great clip! Thank you for addressing parents of intact boys.
As an intact male, I would only suggest that soap not be used under the foreskin. That part of the foreskin is membrane. We never soap membranes (inner eyelids, vagina, nostrils), as it tends to dry them out. When that happens, the surfaces stick together and, in my experience, become hypersensitive.
The good people at nocirc.org have a printable pdf that echoes your message and even shares the same graphics at https://nocirc.org/publish/4pam.pdf.
Roland Day says
This is a very good and informative presentation with one exception. The statement that most boys can retract their foreskin by age five is based on erroneous data published by Dr. Gairdner in the British Medical Journal on December 24, 1949. and incorporated without critical examination into every medical textbook on the subject.[1] The statement is inaccurate. Gairdner’s inaccurate statement has been the cause of much needless parental concern for more than 1/2 century and the cause of unnecessary circumcisions.
Newer and better data shows that the average age of first foreskin retraction is 10.4 years and may not occur until the end of puberty in a few cases.[2][3]
References:
1. Hill G. Circumcision for phimosis and other medical indications in Western Australian boys (Letter). Med J Aust 2003;178(11):587. URL: https://www.mja.com.au/public/issues/178_11_020603/matters_arising_020603-1.html
2. Kayaba H, Tamura H, Kitajima S, et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys. J Urol 1996;156(5):1813-5.
3. Thorvaldsen MA, Meyhoff H. Patologisk eller fysiologisk fimose? Ugeskr Læger 2005;167(17):1858-62.
Marilyn Milos, RN says
The average age of foreskin retractability is 10.4 years, so the 13-year-old is well within normal limits. A doctor does not need to check him, which is often embarrassing for a boy going through puberty. If, by the age of 18, 19, or 20, his foreskin is still not retractile and he’d like it to be, he can begin gently pulling his foreskin back over the glans, a little at a time and never to the point of pain! In addition, he can also slip his fingertips inside the opening and gently stretch it outward. Again, he can stretch till the tissue tingles,stop, hold it, and then let it go. If done on a daily basis, it will stretch the tissue to make the foreskin retractable. He can all NOCIRC at 415-488-9883 should he have any questions.
Marilyn Milos, RN says
One more thing…NO soap on the glans or inner lining of the foreskin because the covering of each is mucosal tissue (like the inside of the mouth or underside of the eyelid, and soap would dry the normally moist tissue. All that’s needed is a gentle rinse with warm water and finger tips–no wash cloths or baby wipes, either! Once the boy is old enough to retract his foreskin, it’s simple: Just explain to him that he needs to retract, rinse, and replace his foreskin every so often when he’s in the bath. It’s important for him to pull the foreskin forward to its normal position after it’s been retracted.
Jeremy Davidson says
Marilyn,
With all due respect for all of your much appreciated years of leading the charge to end the nonsense of medical and religious circumcision, you have the “no soap” thing all wrong. What medical/scientific study supports this oft stated, but entirely baseless claim. There is no valid, scientific study to support your claim. This “no soap” thing has taken on a life of it’s own, and gets trotted around like the flawed and fraudulent HIV studies in Africa. It is time to stop saying this garbage opinion.
I am one of the few intact men in my generation in the USA (born in 1952), and I was taught early to “retract, lather, RINSE and replace.” This is all that is needed. Yes it is a mucous membrane inside, but the mouth is too, and nobody is advocating using just water to brush our teeth. If you can provide the science behind your claims of no soap, I am willing to let it get a bit stinky, not any more so than if I skip brushing my teeth and washing my armpits. However, I suspect I will be offending people olfactory senses, by doing so.
Please keep up the good fight, in eliminating circumcision, but let us be VERY careful NOT to fall into the same pit of false claims, as the circumcision sales reps have used for over a hundred years in the USA.
The only rightful owner of a foreskin is the person it is attached to. Some day, I really do hope that social and religious customs will be injected with wisdom, and that eventually, circumcision will become a felony and viewed for what it really is; “sexual assault and battery, upon a minor child.
Marilyn Milos, RN says
Jeremy,
Thank you for your kind comments.
I don’t know that I’ve read this information in a study. Having done this work for 32+ years, however, I’ve heard from one parent after another who tells me that soaps and shampoos have disturbed the bacterial balance on their sons’ foreskins and caused yeast overgrowth. Of course, other substances, e.g., antibiotics, bubble baths, and chlorinated swimming pools also do the same thing. Once these irritating substances are removed, the health of the foreskin returns. Now, not all boys have this reaction, but, from my experience more do than don’t. Intact males have told me the same thing. When they use soap, their foreskin becomes red, itchy, and it causes stinging with urination. Some males switch from harsh soaps to unscented soap purchased at a natural food store and the problem dissipates. Others just stop using soap and the problem ceases. I’ve talked to the pediatricians, pediatric urologists, and other healthcare professional who have presented at the International Symposia on Circumcision, Genital Integrity, and Human Rights, and in many countries, soap on the foreskin would be an oddity.
Now, as with everything else, there are exceptions to every case and, thankfully, you haven’t suffered any deleterious effects from soap. So, I think we’ll have to acknowledge that there are two stories here. I try to advise the path of least harm, which is why I suggest just warm water.
Thank you for sharing your experience with me. Information is always helpful.
And, lucky you!
Jeremy Davidson says
Marilyn,
Thanks for your response “adjustment” to your understanding of the cleaning care of a foreskin. My “scientific” research is limited to nearly 60 years, and with a study group of one , being myself!
I grew-up with mom diligently rearranging, lathering, RINSING, and replacing my foreskin in my younger years. When mom turned that duty over to the “owner” of my foreskin (me!), she made certain I did so, and there were none of the skin reactions you have listed. I agree, no two foreskins are alike, but I should also ad that my foreskin rinsing step was done in bathwater that already had some suspended soap, already in the water. We only had a nth tub with no shower in our house until I was 16 years old.
As for the “proper ph level inside a foreskin,” I have never read any scientic study that even addresses this, and somewhere not far behind you, I have read extensively on the topic. I know pretty well who started the completely unscientific conjecture about foreskin ph “milieu” (and there is enough of a hint for you to know, too).
And yes, I was one of the VERY fortunate few in my generation in the USA who did not have my sexual capabilities and sensations fraudulently taken away from me. It was my doctor who made that audible change of play call and I never had the opportunity to thank him.
Again, keep up the noble fight for the right of each and every male to determine if HIS “fun skin” stays for a lifetime of enjoyment, or if it is mindlessly amputated, following too many uninformed parents, for way too long!
Jeremy Davidson says
Marilyn,
I am sorry about my hurried state leading to all the typos and iPhone automatic word substitutions in the preceding reply, wherein “retracting” became “rearranging” and some sentence edits I missed on my small screen. I think the general message is still conveyed.
Again, thank you for all you have done in over three decades of effort toward ending the utterly perverse nonsense and medical fraud that is circumcision. Your courage to stand-up and say “NO” in the face of large, medical establishments has yielded significant results.
You can take heart in knowing that your voice, along with many others, over all these many years, has brought about such a significant drop in the circumcision rates. My “unscientific” study group conducted and comprised of my self, noted in the 1960’s that 95% of my local peers had been circumcised. (A rather confounding 66% of my parent’s sons were circumcised.) To read in very recent years, that the USA is now circumcising 55-60% of infants in hospitals, is still an atrocity, but the trend is moving in the right direction. I have influenced the preservation of only about five normal, healthy foreskins over the years, including my son’s. Your preservation count must be a whole lot higher than mine.
Parents need to read, read and read, and do critical thinking when they hear sound bites, opinions, and read fraudulent published studies in medical journals, and wild conclusions, masquerading as nothing more than pseudo-science. Proponents with vested interests thrive on fear mongering in the business of depriving males of their entire penis. Step back from the Kool-Aide, parents! Responsible parenting requires parents to become informed. Only the rightful owner of a foreskin should make this important decision to purchase a circumcision, after he has test-driven HIS foreskin, until he is at least 18! Has there ever been a child circumcised where some involved adult did not have a belief system surrounding circumcision, that is based any differently than believing in The Tooth Fairy? There simply is no truth in circumcision.
ever
Marilyn, your efforts are greatly appreciated. Thank you, on behalf of an increasing number of intact males in the USA!
Jeremy
Marilyn Milos, RN says
Thanks, Jeremy! Yes, we are making a difference. And, now that the circumcision rate has dropped to nearly 50% nationally (and much lower in the western states), we can, for the most part, be sure that the sons of these intact males will be not circumcised either–just as you protected your son. Other parents are becoming educated by their peers who protected their sons. Perseverance furthers and, one day, we will once again become a non-circumcising country!
Anna Mommy says
Dear Doctor. My son’s foreskin was fully retracting at the age of 4 all naturally by himself. I have explained and made sure that he was rinsing inside and everything. Now my boy is nearely eight and suddenly he told me that he can’t open his foreskin. We have tried opening it and it hurts him. I left him alone for few weeks and then asked him to try opening again and it hurt. There are no other issue its not swallen or anything, there were no accidents or pain. He just can’t retract it anymore. Please advise what could that be as my son doesn’t want to go to doctor as he is afraid that doctor will try to open and will hurt him. Thank you.
Marla says
Anna, Mothers should teach their sons to masturbate, which helps to stretch the foreskin. Its important to always be open about discussing their body and health. If he is raised with that openess, he will benefit from your knowledge. Boys tend to masturbate even at a young age, so make sure that he knows its a good thing and it should be done in private.
Brianna Daily says
This is not outside of normal for intact boys. It is quite common for them to retract around the age of 3-5 (a surge of testosterone hits around this time, you will often see pronounced hair growth on legs and arms) and to lose the ability until adolescent years. Retraction is purely a sexual function, so no worries if your son can not retract at the age of 8.
ellen mary says
Thank you! This is a great post! I hope all doctors see it.
Joy Cheng says
Thanks for this very helpful video. I recently found that part of my son’s foreskin is attached to his meatus, which would cause bleeding if he tries to retract the foreskin. And other part of the foreskin is also attached to his glans. My son will turn into 7 this October. Do I need to worry about this situation?
Brianna Daily says
Retraction is purely a sexual function, meant to make sex more pleasurable for a male. There is nothing to worry about at present. Chances are your son will find his foreskin retracts around adolescence.
Jennifer R says
You might want to let whoever is in charge of the main Seattle Children’s Hospital website to update the information on it, because it states for parents to start retracting their intact sons’ penises starting at 1 year old:
https://www.seattlechildrens.org/medical-conditions/symptom-index/foreskin-care-questions/
Wendy Sue Swanson, MD, MBE says
Thanks for your heads up, Jennifer. As you know, there is differing opinions about foreskin care. The content link you reference here is written and licensed by Barton Schmitt (you can see that at the bottom of the page).
I stand by the advice I provided here in this post about leave it alone and not forcing retraction — that a boy himself is the only one who should retract the foreskin outside of keeping it clean in bath/water.
Jennifer R says
To whom should I address my concerns about the content provided by the other doctor?
Wendy Sue Swanson, MD, MBE says
Jennifer,
This is syndicated content. Meaning, Dr Schmitt wrote this and hospitals use it. If you have expertise you want to share, you can contact them directly perhaps.
Patricia says
As the mother of two intact sons, 29 and 24, their pediatrician thought the ratio of circ to intact for their age group would be about 50/50. My uncircumcised father had to be circumcised when he joined the Navy and found it incredibly painful – that made it easy to decide to let my boys decide for themselves.
We recently watched “Adam Ruins Everything” -(available on YouTube or TruTV) – the episode regarding circumcision should be viewed by all non-religious parents contemplating the procedure. And someday perhaps those whose religion demands it will also move for reform…
Jake says
Im 15 and I can’t fully retract my foreskin Should we be worried about this…
Danielle says
Hi I’m Danielle I’m a new mom I just want to know my son is 2 months old and his foreskin doesn’t pull back must I take him to a Dr to be cut ore suld the Dr pull it back I’m very warryd about it they said its not healthi I’m very scard don’t know what to do pleas help
Liam says
I am 13 years old and when I pull my foreskin but it is my actual foreskin that is not wide enough to let all my glands through
Shourya Narula says
I am 18 year old, believe it or not but I recently discovered that I am supposed to pull my foreskin back as I am uncircumcised. The only problem I seem to be having is that when my penis goes semi or even fully erect the foreskin doesn’t come back all the way but when it does the lower part of the tip of the penis starts becoming blue. I have no clue what to do, a little help would be much appreciated.