Foreskin And Personal Hygiene

Glans penis, commonly known as head of the penis is covered by a layer of skin (also known as foreskin). This fold of skin and glans penis are joined lightly at the time of birth and is partially pulled back at the age of five. Statistics suggests that in nine out of ten boys, foreskin is completely retracted by the time of puberty.

A lot of people opt for circumcision due to personal, religious or cultural choices, but a fair share of population is against the idea of circumcision. It is imperative to mention that all uncircumcised men are at high risk of developing infections and serious diseases if optimal caution and genital hygiene is not maintained.

Foreskin And Genital Hygiene

Foreskin must be thoroughly cleaned on daily basis because bacteria and dead skin cells along with oily secretions can accumulate beneath it and may cause infections. Cleaning of foreskin can prevent its infections and inflammation but it should not be cleaned with strong chemicals and soaps, due to fairly high risk of allergic reactions.

Foreskin should be cleaned with care. Here are some cautions that must be maintained to minimize the risk of serious complications:

• Foreskin should not be retracted forcefully as it may lead to bleeding, scarring or any other serious injury.
• Scarring can make cleaning of underside of foreskin difficult; therefore all infections should be treated/ managed adequately.

If there is infection then doctor will prescribe antifungals or antibiotics for optimal treatment. Sometimes circumcision is recommended when infection or inflammation becomes severe.

What Happens If Genital Hygiene Is Not Adequately Maintained?

Here is why you should maintain adequate genital hygiene:

1. Balanitis:

Balanitis, an inflammatory condition of head of penis or glans penis. As compared to circumcised men, it is more common in males who are not circumcised.

It happens when inner side of foreskin is not kept cleaned or foreskin is scarred due to which it is not ab

le to retract completely. It is more likely to be caused due to fungal or bacterial agent. But some other causes include:

• Being allergic to some medications
• Presence of latex in condoms (some individuals are genetically susceptible to latex)
• Presence of harsh chemicals used in soap
• Cloth washing detergents and powders can also cause an allergic reaction that may culminate in balanitis.

Balanitis can also be an indication of diabetes. If balanitis keeps reoccurring then men should be checked for diabetes because when urine traps beneath the foreskin, moisture and glucose present in urine can also lead to over-growth of bacteria, leading to balanitis. Viruses such as human papilloma virus (HPV) can also be the cause for balanitis.

Classic Symptoms Of Balanitis include:

• Itching
• Rashes
• Unable to retract foreskin
• Tenderness or soreness in head of penis
• Swelling
• Redness and discharge from penis

Treatment:

Washing penis and the inside of foreskin thoroughly with warm water and soap can help in treating the inflammation. If balanitis is due to an overgrowth of microorganisms then topical (ointments and/or creams) antibiotics or antifungals are usually given. Circumcision is suggested when balanitis becomes very severe or reoccurs on frequent basis.

2. Balanitis xerotica obliterans (BXO):

Balanitis and balanitis xerotica obliterans are two different conditions. BXO is also known as lichen sclerosis. At the tip of foreskin a ring of white tissues is formed, this ring makes the foreskin very tight due to which its retraction becomes very difficult. Although it is not a very common condition but it can spread to the glans penis and becomes worse with the passage of time. Depending upon the severity, circumcision may be required for its treatment. If there is white scarring then you must consult a doctor.

Balanitis xerotica obliterans and balanitis, both increases the chances of penis cancer. Although this type of cancer is not very common and usually happens in men who are not circumcised. Study reported in Pediatrics (3) suggested that the risk of foreskin related voiding problems is about 27% in uncircumcised males and about 17% young male boys develop balanitis prior to circumcision.

References

1. Celis, S., Reed, F., Murphy, F., Adams, S., Gillick, J., Abdelhafeez, A. H., & Lopez, P. J. (2014). Balanitis xerotica obliterans in children and adolescents: A literature review and clinical series. Journal of pediatric urology, 10(1), 34-39.

2. Wilkinson, D. J., Lansdale, N., Everitt, L. H., Marven, S. S., Walker, J., Shawis, R. N., ... & Godbole, P. P. (2012). Foreskin preputioplasty and intralesional triamcinolone: a valid alternative to circumcision for balanitis xerotica obliterans. Journal of pediatric surgery, 47(4), 756-759.

3. Sneppen, I., & Thorup, J. (2016). Foreskin morbidity in uncircumcised males. Pediatrics, e20154340.