Phimosis describes a condition in which the foreskin is too tight to be pulled back over the head or glans of the penis.
Most uncircumcised babies and toddlers will have phimosis, meaning the foreskin cannot be retracted. This is because the glans and the foreskin remain connected for the first few years of life.
In adults, there are a number of risk factors and causes of phimosis, though it only tends to be a problem if it causes symptoms.
In this article, we take a look at the causes of this condition, along with what can be used to treat it when symptoms occur.
Causes and risk factors
There are various potential causes for phimosis, including infections or skin conditions. A diagnosis may be made based on the patient’s medical history.
Phimosis only affects uncircumcised males and is more common in boys than men.
Phimosis is normal in uncircumcised babies and toddlers, as the foreskin is still attached to the glans. It will start to detach naturally between 2 and 6 years of age, though it might happen later. It can happen at up to around 10 years old, in some boys.
The foreskin can be pulled back behind the glans in about 50 percent of 1-year-old boys, and almost 90 percent of 3-year-olds. Phimosis will occur in less than 1 percent of teenagers between 16 and 18.
It is most likely to occur in older boys with:
repeated urinary tract infections
repeated rough handling of the foreskin
In adults, risk factors for phimosis include sexually transmitted infections.
Phimosis may be caused by a skin condition, such as:
Eczema: A long-term condition that causes the skin to become itchy, red, dry, and cracked.
Psoriasis: This skin condition leads to patches of skin becoming red, flaky, and crusty.
Lichen planus: An itchy rash that can affect different areas of the body. It is not contagious.
Lichen sclerosus: This condition causes scarring on the foreskin that can lead to phimosis. It may be caused by a urinary irritation.
A possible symptom of phimosis is an inability to urinate, or empty the bladder properly.
Phimosis does not always lead to symptoms. When it does, however, these may include redness, soreness, or swelling.
A tight foreskin may interfere with the normal passage of urine. In severe cases, this can prevent the person from emptying their bladder fully.
Phimosis can lead to inflammation of the penis, called balanitis, or inflammation of both the glans and the foreskin, called balanoposthitis. These conditions both tend to be caused by poor hygiene.
Symptoms of balanitis include:
soreness, itchiness, and odor
redness and swelling
a buildup of thick fluid
pain when urinating