care-of-the-intact-penis

 

Care of the Intact Penis

Some American doctors would have you believe that the intact penis is hard to take care of – but this is just not true! In our circumcising culture, most people, including doctors, are simply not very familiar with the normal, intact penis, and a lot of false and negative information about the foreskin gets passed around. Unfortunately, bad advice about care of the intact penis – such as recommendations to routinely retract the foreskin and scrub underneath – actually causes more problems than it prevents.

The truth is: Care of the intact penis is super easy! It is easier than cleaning the folds of a little girl’s genitals. It is certainly easier than taking care of a circumcision wound and the adhesions that happen with many boys after circumcision. Boys are perfectly competent to learn how to wash their genitals, just as they will learn to take care of the rest of their bodies, the same way girls do. And parents are perfectly capable of teaching them!

“The best advice that a parent can follow is to simply ‘leave it alone’.”
Vincent Iannelli, M.D.

Just a few instructions (and a dash of common sense) are all that’s needed to know how to care for your son’s intact penis: Just wash off the outside and never forcibly retract the foreskin.

Or as we like to say: “Only clean what is seen!” and “I’m intact – don’t retract!”

To understand the reasons for this simple advice, it helps to know a little bit about how the foreskin develops. In the young child, the foreskin is firmly fused to the head of the penis. There is no need to clean under it, because at this stage, there is no “under.” As a boy grows up, the foreskin will gradually (possibly over many years) separate from the head of the penis (also called the glans), so that eventually there will be a space underneath. Then the boy will be able to slide back (retract) the foreskin to expose the glans, if desired.

Even once the foreskin has separated, however, it normally fits snugly over the glans throughout life, keeping foreign matter out. Plus every time the boy urinates, the foreskin opening is flushed outward, again keeping the inside of the foreskin clean. (Urine is sterile when it leaves the body.) So there is rarely, if ever, a need for a parent or other caregiver to clean under the foreskin of a young child.

The first person to ever retract the foreskin should be the boy himself, not a parent or a doctor. Only he will know when he is comfortable doing this, and he will be less likely to harm himself than another person would.

“There’s no evidence there’s any need to clean under
the foreskin before puberty.”
Peter Anderson, M.D., pediatric urologist

Very likely, sitting in clean bathwater is all the cleaning needed before puberty. With a very messy stool that has gotten all over, simply wipe the penis off, put the baby in warm water, and swish the penis around. As he gets older, explain to him that one day his foreskin will be able to slide back, and that when that happens – and when he is comfortable with it – he can occasionally retract it in the bath or shower, rinse underneath, and then always replace the foreskin back over the glans. With the hormonal changes of puberty, more regular rinsing under the foreskin is suggested.

Probably the most important thing to know about care of the intact penis is what not to do.

  • Never forcibly retract the foreskin! The belief that the foreskin must be routinely retracted for cleaning is probably the #1 piece of incorrect advice about foreskin care. This is actually the most harmful thing that can be done to the foreskin, and can lead to serious problems! Forcible retraction can cause pain, tearing, bleeding, scarring, infection, and other complications. Make sure that all of your son’s caregivers – doctors, nurses, grandparents, babysitters, day care workers – know correct care of the foreskin: that is, to only clean off the outside and to never forcibly retract.Click here (scroll down) to order “I’m Intact – Don’t Retract” reminder stickers to put on your child’s diaper when he is being cared for by another or visiting the doctor.
  • Avoid soap. Although most people equate cleanliness with “soap and water,” soap can be irritating to the genitals of both boys and girls, and should be avoided. Bubble bath can cause the same problems. While soap is not necessary, mild soap may be okay on the outer genitals. However, soap should not be used on the mucous membrane surfaces of the glans or inner foreskin. Clean warm water and a soft cloth are all that is needed for cleaning the intact penis.
  • Avoid scrubbing. Aggressive cleaning is not necessary. Scrubbing removes helpful bacteria and other healthy substances found under the foreskin, and can be damaging and painful to sensitive genital tissue.

Now you know how easy it is to take care of your son’s intact genitals!

Resources on Care of the Intact Penis

For you and your caregivers

Intact America
Circumcision Decision Maker
NOCIRC Intact Care Pamphlet (English)
NOCIRC Intact Care Pamphlet (Spanish)
DrMomma.org
The Whole Network
Your Whole Baby (with videos)
The Good Mommy’s Guide to Her Little Boy’s Penis, by Adrienne Carmack, M.D.

Published March 2016