Tight foreskin and non-retractable foreskin of the penis are two terms that are often used interchangeably. Boys usually are born with a non-retractile foreskin. In those who are not circumcised, the foreskin gradually becomes retractable over a variable period of time ranging from birth to 18 years or more. There is no “right” age for the foreskin to become retractable. Non-retractile foreskin does not threaten health in childhood and no intervention is necessary. Many boys only develop a retractable foreskin after puberty.
There is much uncertainty among health care providers and sexologists about when the foreskin of a boy should become retractable. This has caused many false diagnoses of Phimosis. It is, therefore, very critical to differentiate between a “tight foreskin” and “Phimosis” and not to treat both as the same, one condition.
Difference between tight skin & phimosis
While many people often use both terms synonymously, there is a key technical difference between the two terms.
Tight foreskin: Having just a tight penis foreskin is not considered a “medical problem” unless it occurs or does not go away after puberty. Almost all boys are born with the foreskin fused with the underlying glans penis. Most also have a narrow foreskin that cannot retract. Non-retractile foreskin is normal at birth and remains common until after puberty (age 18). Therefore, having a tight foreskin before puberty is not a medical problem and does not usually require treatment unless it is painful.
Phimosis: Phimosis is an adult condition. If the tight foreskin stays or occurs after puberty or the age of 18, it is medically called as Phimosis. It is said that about 2 percent of males have a non-retractile foreskin throughout life. Non-retractile foreskin is not a disease and does not require treatment.
What causes tight foreskin and phimosis?
The causes of a tight foreskin & phimosis can vary, but most commonly it is simply because males are born with it that way. There are three possible conditions that cause tight or non-retractile foreskin:
- Fusion of the foreskin with the glans penis
- Tightness of the foreskin orifice
- Frenulum breve (which is rare and cannot be diagnosed until the previous two reasons have been eliminated)
- The first two reasons are normal in childhood and are not pathological in children. The third can be treated conservatively, retaining the foreskin
Occasionally a male reaches adulthood with a non-retractile foreskin. Some men with a non-retractile foreskin happily go through life and father children. Other men, however, may want to make their foreskin retractile. The foreskin can be made retractable by:
This traditionally involves circumcision and plastic / cosmetic surgery. Circumcision is considered the most widely practiced and cheapest method available to deal with the issues of tight / non-retractable foreskin.
Sexperts recommend two key methods that can be effectively used to address tight or non-retractable foreskin of the penis.
Manual stretching (tissue expansion) through exercises: There are quite a few recommended foreskin stretching exercises that do not take much effort and in a couple of weeks, men begin to notice the changes from these exercises. In the beginning, your foreskin may not retract fully when you are erect, but in due time, it will start to. Such exercises offer a cost-free and safe method to deal with the issue. However, in many people, they require a lot of time, effort and practice to finally produce the results.
Stretching through special devices: A balloon-based device (foreskin stretcher) and a caliper that work to stretch a tight foreskin are usually recommended. These devices have a very good track record and are widely accepted as providing the ideal means to widen your foreskin. Sometime you will need to use a steroid cream with these devices that stretch a tight foreskin to get the very best results. Medical experts will recommend trying one of these devices and for the foreskins that are resistant to stretching by a device, surgical intervention is recommended as the last resort.
Balloon device: Once positioned under the foreskin, the balloon is inflated to apply gentle pressure to the foreskin to stretch the skin of the foreskin. With daily use over 14 days the foreskin is gradually stretched so that it can be properly retracted.
Caliper device: A caliper if a device that is commonly used to measure thickness of parts of the body. It essentially works on the same principle i.e. the penile foreskin skin is stretched back and then sort of clamped with the help of the caliper. This gradually and progressively results in the loosening of the foreskin of the penis.