A GP has highlighted the warning signs and possible treatments for phimosis, a painful condition that affects the penis.
Talking about sexual health can feel uncomfortable for many people, even though being open about symptoms is often the first step toward getting proper help.
Now, one doctor has shared advice about a condition that can affect people with a penis and may become very painful if it is ignored.
The condition is known as phimosis, which happens when the foreskin is too tight to be pulled fully back over the head of the penis.
In babies and young boys, a non-retractable foreskin is often completely normal. The foreskin is commonly attached to the head of the penis in early childhood and usually loosens gradually over time without treatment.
However, doctors distinguish that normal childhood development from pathological phimosis, which can happen when the foreskin becomes scarred, inflamed or persistently tight. In adults, phimosis may cause pain during sex or erections, tearing, bleeding, problems cleaning under the foreskin, ballooning of the foreskin during urination, or recurrent infections.
It is more commonly seen in children and often improves naturally with time. However, Dr Philippa Kaye has explained that it can sometimes persist into adulthood.
In a piece for the Daily Mail, Dr Kaye said phimosis ‘wasn’t much of a problem in the US’ because circumcision rates have historically been high.
She wrote: “Still today, around eight in ten adult American men are circumcised, however that number will keep falling as fewer than 50 percent of babies are given the procedure today. And as they do, rates of phimosis will rise and rise.”
Recent US data supports the broader trend she is pointing to. A 2025 research letter in JAMA Pediatrics found that inpatient neonatal male circumcision in the United States fell from 54.1 percent in 2012 to 49.3 percent in 2022. The figures cover circumcisions recorded during newborn hospitalizations, so they may not capture every circumcision performed later or outside hospital settings, but they show a clear decline in hospital-based newborn circumcision.
That does not mean every uncircumcised person will develop phimosis. Many people with foreskins never experience any medical issue. But as more boys grow up without circumcision, doctors may see more foreskin-related problems simply because more people have foreskins.
When phimosis is left untreated, it can lead to irritation, inflammation and infection, all of which may cause significant discomfort.
Common warning signs include soreness, redness, swelling, itching, cracking of the foreskin, pain when trying to retract it, pain during sex, discharge, an unpleasant smell, or repeated episodes of balanitis, which is inflammation of the head of the penis. Some people may also notice that urine pools under the foreskin before coming out, or that the stream becomes weak or difficult to control.
Dr Kaye said some patients delay getting help because they feel too embarrassed to discuss what is happening.
“They will have probably put off seeking medical help for months, gritting their teeth and hoping the problem goes away,” she wrote.
“In some cases, they have even hidden the painful condition from their partners, who can’t understand why they have started to avoid sex.”
The good news, according to Dr Kaye, is that phimosis can often be managed or prevented with simple measures at home. However, she stressed that people should not avoid seeking advice, because ‘the sooner phimosis is assessed, the more straightforward the treatment options tend to be’.
Dr Kaye said maintaining good hygiene is an ‘essential foundation’ when it comes to reducing the risk of problems.
“Patients should wash daily using water and a fragrance-free, non-irritating soap,” she wrote.
She also advised avoiding products that could irritate the area, including perfumed items, talcum powder and antiseptic creams, as these may worsen symptoms and ‘make the phimosis worse’.
Failing to clean the area properly can also increase the chance of infection, she added, while keeping the area clean and dry is important.
Medical advice generally warns against forcing the foreskin back, especially in children, because this can cause pain, small tears and scarring, which may make tightness worse. Once the foreskin becomes naturally retractable, it can usually be gently pulled back for washing and then moved forward again afterward.
For adults with phimosis, treatment often begins with a prescription steroid cream or ointment applied to the tight ring of skin, sometimes alongside gentle stretching exercises recommended by a clinician. These treatments should be done carefully and only as advised, because aggressive stretching can cause tearing and further scarring.
If there is infection or inflammation, a doctor may treat the underlying cause first. In some cases, phimosis is linked to conditions such as recurrent balanitis, diabetes, yeast infection, or lichen sclerosus, also known in men as balanitis xerotica obliterans. Lichen sclerosus can cause white, scar-like patches and progressive tightening, and it may need specialist treatment.
Surgery is not always needed, but it can be recommended when symptoms are severe, recurrent or caused by significant scarring. Options may include circumcision, partial circumcision, or other foreskin-preserving procedures such as preputioplasty, depending on the case and what is available from the treating clinician.
One complication people should know about is paraphimosis. This is different from phimosis and happens when the foreskin is pulled back behind the head of the penis and cannot be moved forward again. It can cause swelling and restrict blood flow, so it is treated as a medical emergency.
Anyone whose foreskin becomes trapped behind the head of the penis, or who develops severe pain, major swelling, discoloration, fever, discharge, bleeding, or difficulty urinating, should seek urgent medical care.
Anyone who thinks they may have phimosis, or who is experiencing pain, swelling, redness or difficulty retracting the foreskin, should speak to a doctor for advice.