When phimosis is a problem

Phimosis isn't usually a problem unless it causes symptoms such as redness, soreness or swelling.

If your child's glans is sore and inflamed they may have Balanitis (inflammation of the head of the penis). There may also be a thick discharge underneath the foreskin. If both the glans and foreskin are inflamed it's known as balanoposthitis.

Take your child to see your GP if they have these type of symptoms. Your GP will be able to recommend appropriate treatment.

Most cases of balanitis can be easily managed using a combination of good hygiene, creams or ointments, and avoiding substances that irritate the penis. Urine can irritate the glans if it's retained for long periods under the foreskin, so if possible you should withdraw the foreskin to wash the glans.

Ifbalanoposthitis is caused by a fungal or bacterial infection, an antifungal cream or a course of antibiotics may be needed.

In adults, phimosis can occasionally be associated with sexually transmitted infections (STIs) . It can also be caused by a number of different skin conditions including:

• eczema a long-term condition that causes the skin to become itchy, red, dry and cracked
• psoriasis a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales
• lichen planus a non-infectious itchy rash that can affect many areas of the body
• lichen sclerosus a scarring condition of the foreskin (and sometimes glans) that's probably caused by urinary irritation in susceptible men and boys

Topical steroids (a cream, gel or ointment that contains corticosteroids ) are sometimes prescribed to treat a tight foreskin. They can help soften the skin of the foreskin, making it easier to retract.

Phimosis can cause pain, skin splitting, or a lack of sensation during sex. Using a condom and lubricants while having sex may make your penis more comfortable.

When surgery may be needed

Surgery may be needed if a child or adult has severe or persistent balanitis or balanoposthitis that causes their foreskin to be painfully tight.

Circumcision (surgically removing part or all of the foreskin) may be considered if other treatments have failed, but it carries risks such as bleeding and infection. Therefore, it's usually only recommended as a last resort, although it can sometimes be the best and only treatment option.

Alternatively, surgery to release the adhesions (areas where the foreskin is stuck to the glans) may be possible. This will preserve the foreskin but may not always prevent the problem recurring.