What Causes Tight Foreskin and How Is It Treated?

Is this cause for concern?

Usually, the foreskin of an uncircumcised penis can be pulled back from the head (glans) of the penis. But in rare cases, the foreskin may become too tight and be unable to be retracted. This condition is called phimosis.

Most cases of phimosis resolve before adolescence, but it’s possible for the condition to last into adulthood. Although there aren’t any serious health complications related to phimosis, it’s associated with conditions that can cause soreness, swelling, and difficulty urinating.

Keep reading to learn more about the conditions tied to phimosis, how phimosis is treated, and more.

Causes of tight foreskin

Your age may determine the cause of your phimosis. Children and adults may experience phimosis for different reasons.

In young boys, a tight foreskin is considered congenital, which means it’s something they have at birth. When this happens, it’s categorized as physiologic phimosis. The foreskin usually becomes more pliable over the next few years, with phimosis completely resolving by age 7.

If a boy is circumcised, then phimosis isn’t possible.

The other category is pathologic phimosis. This means that phimosis is due to an infection, inflammation, or scarring from an underling condition. Pathologic phimosis can be caused by the following conditions.

Balanitis

Balanitis is a type of skin irritation that develops on the head of the penis. It’s especially common in males who haven’t been circumcised.

Symptoms include redness, itching, and swelling, which can cause foreskin tightness. Balanitis can also cause pain when urinating.

Practicing good hygiene is usually enough to treat and prevent balanitis. Cleaning the penis with lukewarm water and soap every day, and gently drying it after bathing and urinating, should help. In some cases, your doctor may recommend a topical cream or antibiotic.

Balanoposthitis

This occurs when the glans and the foreskin are inflamed. This inflammation of both foreskin and glans make the foreskin tighter. Although a yeast infection known as candidiasis is often to blame, bacterial or other types of infections can also cause balanoposthitis. Topical creams containing antibiotics or antifungals are often helpful for treating the infection.

STIs

Certain sexually transmitted infections (STIs) can cause balanitis. Symptoms of balanitis, such as swelling and inflammation, can then lead to a tight foreskin.

Genital herpes: Balanitis is a common symptom of genital herpes. Other herpes symptoms include pain and small fluid-fill sacs like blisters on the penis and sometimes on the scrotum.

Gonorrhea: This STI may also cause balanitis symptoms, such as swelling and redness. Other gonorrhea symptoms include:

• pain in testicles
• discharge from the penis
• more frequent urination

Syphilis: This STI can cause penis redness and swelling as well. Other syphilis symptoms include:

• mucus patches on the penis
• a rash elsewhere on the body
• muscle aches
• fever
• overall unwell feeling

Other skin conditions

Though less common, other skin conditions can also lead to phimosis or cause the condition to worsen. These include:

Lichen planus: This itchy, noncontagious skin disorder can cause shiny, flat bumps to appear on the penis. Topical steroid creams are usually effective at making the rash disappear.

Lichen sclerosus: This can cause white patches to develop on the foreskin and sometimes the glans. Lichen sclerosus can also cause scarring of the foreskin. Corticosteroid ointments may help. In some cases, circumcision may be necessary.

Eczema: This common, long-term skin condition causes dry patches to form on the skin. Certain types of soaps, the way you dry yourself, and other triggers can cause flare-ups. Work with your doctor to learn how to avoid or limit triggers. The doctor may also prescribe corticosteroid ointments and other medications to help manage your symptoms.

Psoriasis: This chronic skin condition can cause crusty, dry patches of skin to form as a result of abnormal skin cell production. Your doctor can help you identify any possible triggers and prescribe corticosteroids to help relieve your symptoms.