Dr. Wendy Sue Swanson: The foreskin is easy for a boy to keep clean

Dr. Wendy Sue Swanson of the Seattle Mama Doc 101 blog discusses what the foreskin is, and how easy nature has made it for a boy to take care of his own penis without meddling from parents.

Transcript
(slightly modified)

Hi! Welcome to Seattle Mama Doc 101.

I'm going to talk to you about the foreskin!—no one really wants to talk about it, but I talk about it in clinic, and I have 2 boys at home, too.

So, here's the thing about the foreskin: Think of it like an eyelid; the foreskin is a loosely connected piece of skin over the head of your son's penis.

Now, at birth, it's more like a fingernail; it's really attached by a little layer of connective skin cells [NOTE: The first step when performing circumcision on an infant is to rip apart this connection by forcibly running a metal instrument between the foreskin and the head of the penis; the foreskin is then crushed, slit, clamped, and cut away.] Naturally, as time goes forward, the foreskin releases from the head of the penis. Boys tug and pull on their foreskins—but they don't tend to pull it back; they tend to tug it forward, and they won't hurt themselves doing that!

You don't have to rush the process of a foreskin retracting (or pulling [behind] the head of the penis); most boys, by the age of 5, are able to fully retract their forskins [behind] the [head] of their penises, meaning that they can pull their foreskins all the way down, [thereby exposing the head of the penis]. But, even if at age 5, your son can't do that, don't pull it back! Your son is the one who should be pulling [his] foreskin back, not you! I think both of you will be happy about that.

Now, once your son can pull the foreskin all the way back over the shaft of the penis, it's time to teach your son how to clean and wash and keep [himself] healthy and well. The thing is, [he doesn't] have to think about that skin as any different than the skin on [his] fingers, or the skin on [his] toes, or the skin on [his] knees; [he] can retract the foreskin gently, wash it with soap and water, rinse it fully so there's no soap left, and then let the foreskin of the penis come back over the [head] of the penis. [NOTE: Soap might be an irritant if used excessively:

Apparently, a few adult males wash under their foreskin quite frequently with the use of soap.¹² We cannot define excessive washing, but over washing can deplete the natural oils from the mucosa of the inner lining of the foreskin that covers the glans penis.¹² Depletion of natural oils causes non-specific dermatitis (NSD) that may be mistaken for balanoposthitis.¹² Excessive washing and the use of soap generally should be avoided¹⁵ because it may cause balanoposthitis or yeast overgrowth. If soap is used, any residual soap should be rinsed away before the foreskin is returned to its forward protective position.

It has been suggested that simply retracting the foreskin and rinsing with just warm water (without soap) is all that is required to maintain cleanliness and good health.

For more, look at the diagrams and drawings, look at the links below, and ask any questions you have about helping your son learn [about] and care for his foreskin.