In children – a phimosis is usually completely normal there are occasions where a type of scarring has formed, or the child gets recurrent infections. This is not normal, and a circumcision may be offered.

In adults – a phimosis is usually abnormal, but may not necessarily need treatment. The foreskin may split during sex, and the scar formed may constrict the skin in a band. A special type of scarring may affect the foreskin called BXO. This makes it thickened and stops it retracting. This condition can be very disfiguring and affect the top of the water pipe (meatus) as well. Very rarely a cancer can present this way.

What are the treatments?

In children – treatment is often not required as most children will grow out of a physiological phimosis. Performing a circumcision is reasonable if the foreskin is scarred or the child is missing significant amounts of school, then there is a relative indication for circumcision.

In adults – creams containing antibiotics and antifungal medication, with or without steroid may be helpful to settle infections and aid pliability. They tend to treat symptoms rather than causes, however, and if the problem keeps returning, surgery may be the only option. It is reasonable to check for medical conditions associated phimosis, including diabetes, urinary tract infections and to take a swab of the foreskin to look for fungal infections.