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Ask Marilyn—Can a Tight Foreskin be Treated without Circumcision?

by
Ask Marilyn, Blog
September 19, 2022

The penis advice columnDear Marilyn:

I’m a 35-year-old man. I have been having trouble with a very tight foreskin. My doctor says it’s phimosis, and the only treatment is circumcision. Is there any other remedy? I’d really like to keep my foreskin.

—Harold, New Orleans, LA

Dear Harold:

The word phimosis means muzzled, to indicate that the glans (head of the penis) is muzzled by the foreskin. At birth, most babies have “physiological phimosis,” a normal condition because the glans and foreskin have not yet separated. The foreskin separates from the glans over time, usually by adolescence.

Sometimes a retractable foreskin of an adult male will close down; this condition is called “pathological phimosis.” From your letter, I cannot determine why your foreskin has closed down, so I will suggest a number of possible causes and cures.

  1. Exposure to soap, shampoos, and chlorinated water in swimming pools or hot tubs can kill normal, beneficial bacteria on the foreskin, which can result in yeast overgrowth, inflammation, itching, and stinging with urination; it can also make the foreskin close down. This condition can be corrected by eliminating soap and shampoo, or by using barriers creams on the foreskin before swimming. To help the healing process. liquid Acidophilus culture purchased from the health food store or pharmacy can also be applied to the foreskin by pouring some of the liquid into the palm of the hand, dipping the foreskin into the solution, and letting it drip dry; do this six times a day for 3 or 4 days.
  2. Sometimes the foreskin will close down if a male has been too vigorous sexually, which can cause small tears in the foreskin. The opening will become tight while the tissue heals. Time and gentleness are the cure for this.
  3. Pathological phimosis can result from a condition called “lichen sclerosus” (formerly called “BXO”), characterized by the presence of small, shiny, and smooth white patches on the foreskin. These patches may become larger, and the skin may become itchy, thin, and wrinkled, and may tear easily and bleed. A dermatologist can diagnose lichen sclerosus, which is commonly treated with two creams, Clotrimazole and hydrocortisone, both available over-the-counter at your local pharmacy or by prescription, depending upon the desired strength.
  4. Finally, before considering circumcision, ask your urologist about a Y-V- or Z-plasty—a surgery in which small slits are cut in the foreskin, and then they are sewn together in a way that widens the opening. This surgery saves the foreskin and its specialized nerve endings that allow for full sexual sensations and enjoyment.

So, you can see, Harold, that finding the reason for your phimosis is a critical step to solving the problem and avoiding the loss of your foreskin.

—Marilyn

Related Posts

Marilyn

Marilyn Fayre Milos, multiple award winner for her humanitarian work to end routine infant circumcision in the United States and advocating for the rights of infants and children to genital autonomy, has written a warm and compelling memoir of her path to becoming “the founding mother of the intactivist movement.” Needing to support her family as a single mother in the early sixties, Milos taught banjo—having learned to play from Jerry Garcia (later of The Grateful Dead)—and worked as an assistant to comedian and social critic Lenny Bruce, typing out the content of his shows and transcribing court proceedings of his trials for obscenity. After Lenny’s death, she found her voice as an activist as part of the counterculture revolution, living in Haight Ashbury in San Francisco during the 1967 Summer of Love, and honed her organizational skills by creating an alternative education open classroom (still operating) in Marin County. 

After witnessing the pain and trauma of the circumcision of a newborn baby boy when she was a nursing student at Marin College, Milos learned everything she could about why infants were subjected to such brutal surgery. The more she read and discovered, the more convinced she became that circumcision had no medical benefits. As a nurse on the obstetrical unit at Marin General Hospital, she committed to making sure parents understood what circumcision entailed before signing a consent form. Considered an agitator and forced to resign in 1985, she co-founded NOCIRC (National Organization of Circumcision Information Resource Centers) and began organizing international symposia on circumcision, genital autonomy, and human rights. Milos edited and published the proceedings from the above-mentioned symposia and has written numerous articles in her quest to end circumcision and protect children’s bodily integrity. She currently serves on the board of directors of Intact America.

Georganne

Georganne Chapin is a healthcare expert, attorney, social justice advocate, and founding executive director of Intact America, the nation’s most influential organization opposing the U.S. medical industry’s penchant for surgically altering the genitals of male children (“circumcision”). Under her leadership, Intact America has definitively documented tactics used by U.S. doctors and healthcare facilities to pathologize the male foreskin, pressure parents into circumcising their sons, and forcibly retract the foreskins of intact boys, creating potentially lifelong, iatrogenic harm. 

Chapin holds a BA in Anthropology from Barnard College, and a Master’s degree in Sociomedical Sciences from Columbia University. For 25 years, she served as president and chief executive officer of Hudson Health Plan, a nonprofit Medicaid insurer in New York’s Hudson Valley. Mid-career, she enrolled in an evening law program, where she explored the legal and ethical issues underlying routine male circumcision, a subject that had interested her since witnessing the aftermath of the surgery conducted on her younger brother. She received her Juris Doctor degree from Pace University School of Law in 2003, and was subsequently admitted to the New York Bar. As an adjunct professor, she taught Bioethics and Medicaid and Disability Law at Pace, and Bioethics in Dominican College’s doctoral program for advanced practice nurses.

In 2004, Chapin founded the nonprofit Hudson Center for Health Equity and Quality, a company that designs software and provides consulting services designed to reduce administrative complexities, streamline and integrate data collection and reporting, and enhance access to care for those in need. In 2008, she co-founded Intact America.

Chapin has published many articles and op-ed essays, and has been interviewed on local, national and international television, radio and podcasts about ways the U.S. healthcare system prioritizes profits over people’s basic needs. She cites routine (nontherapeutic) infant circumcision as a prime example of a practice that wastes money and harms boys and the men they will become. This Penis Business: A Memoir is her first book.