The skin on your swollen foreskin treatment is so tight that you are unable to pull it down or pull it back. This can be seen in infants and young boys who haven't been circumcised. It usually goes away by itself after age 3.

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There are two types of phimosis: physiological (congenital) and pathological. Physiological phimosis does not require treatment however pathological phimosis requires treatment.


The signs


The phimosis affects the foreskin that covers the penis's head. It may cause pain or swelling when you are urinating. It may also hinder healthy erections and can cause urinary tract infections in adults.



Most children develop phimosis during natural development. It usually resolves between 5-7 years of age however some boys might have a longer time to heal.



There are two types of phimosis: physiologic as well as pathologic. The physiologic type of phimosis is seen in males who are uncircumcised and is caused by the separation of the prepuce from the penis or foreskin over time.



In pathologic phimosis the foreskin can't be separated from the prepuce. This is due to inflammation or scarring. It is more prevalent in older men and may be an indication of balanitis, or other skin conditions, such as eczema or psoriasis or lichen planus.


Diagnosis


A thorough physical examination and medical history is used to identify phimosis. If the doctor suspects that there is an infection and is unsure, he'll take an swab from the skin of the foreskin. The doctor may also request blood tests and urine tests to determine if there is a presence of bacteria.



Symptoms of phimosis are usually mild in children, and will resolve themselves by the time they reach the age of a few years. However should the foreskin become extended and the head of the penis is stuck in that position (paraphimosis) it could be painful and lead to complications.



Pathologic phimosis is a rare condition, but can happen in children or adults who suffer from skin conditions that affect the foreskin or the glans. These include psoriasis, eczema, lichen planus and lichen sclerosis.



The condition is more common in men who are not circumcised and can be treated with daily gentle manual retraction. Smegma is a collection of skin cells that aid to separate the foreskin from the penis' head during retraction.


Treatment


There are many treatments for phimosis. Topical steroid creams or circumcision (which involves removing the skin from the foreskin) are two alternatives.



In many cases, phimosis resolves by itself in children when their foreskin becomes looser and can be pulled back. However when a child is suffering from phimosis that does not clear up, or they have other issues with hygiene or urination it is recommended that they see an expert.



The doctor will examine your son to determine the root of phimosis, and then prescribe the right treatment. For instance, if the cause of phimosis is a bacteria-related infection, your physician might prescribe antifungal ointments or antibiotics.



Some older men and boys are not able to recover on their own. A corrective surgery is required (circumcision). Circumcision can also lower the chance of phimosis recurring in the future. It is essential to keep the wound dry and clean.


The following is a list of preventatives.


The best way to prevent phimosis is to maintain a healthy hygiene, which includes keeping the skin underneath the foreskin free from infection. Washing the penis with warm water gently each day will help to avoid problems.



Topical steroid creams, such as hydrocortisone ointment from 1% to 2,5%, can be used to safely treat physicologic Phimosis. A course of treatment lasting 3 to 6 weeks is usually sufficient.

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If the condition continues to persist, a surgical procedure known as circumcision could be necessary. The surgery can either be a full or partial procedure, or a combination of both.



Circumcision is typically performed on children, however it is also a possibility for older men or those with phimosis that does not improve. It's usually considered a last resort and can result in dangerous complications. Therefore, it's crucial that you consider the risks associated with this procedure before deciding to have it. Before making a final decision it's advisable to talk with your doctor about the pros and cons of circumcision. Regardless, it's always recommended to check regularly for phimosis.