A Note About Foreskins

Nature’s sleeve

As a male fetus develops, the penis starts to form about eight weeks after conception. The foreskin also begins to form from tissue growing on the outer side of the penis. This tissue grows quickly and folds over into a flap, or sleeve, that covers the penile shaft and the glans—the acorn-shaped end of the penis. The foreskin is “glued’ to the glans by connective tissue called synechia.  When the synechia dissolves, or is cut, the foreskin can slide off the end of the penis.

What is the purpose of the foreskin?

One purpose is thought to be to protect the developing penis during pregnancy, when waste is floating around in the amniotic fluid in the uterus. Another evolutionary purpose may have been to  protect the penis from being scratched—especially when males were running naked through the brush. And, importantly, the foreskin provides a lubricant during sexual activity.

Separation issues

For some infants, about 1 in 10, the foreskin separates from the glans by the time they are born. (Note that for a very few males, the penis tissue never grows into a foreskin. Supposedly, Mohammad, Noah, and Adam were born without foreskins.)

In 10 percent of male infants, the foreskins will have separated by birth. Nearly half will have separated by the time boys are 3 to 5 years old. By adolescence, the foreskins of most males will have separated.

Separation can be helped along by gentle manipulation of the foreskin (by the boy’s “playing” with himself). What should not occur, however, is a forced separation of a foreskin from the penis. Why? Because forcing a separation of the foreskin from the penis can cause pain, bleeding, and infection.

Circumcision and separation

During an elective (voluntary) or medical (necessary) circumcision of an infant, the foreskin may need to be surgically forced off the glans. This is what causes much of the possible pain, bleeding, and infection of a circumcision. And this is the reason that a foreskin should never be forced off the penis during cleaning or any other time.

If a foreskin fails to separate

If the foreskin has not separated from the penis, erection can be difficult, painful or impossible. The same problems may occur if the foreskin has separated but the opening is too tight to allow the glans to push through—a condition called phimosis.

If your school-age son has a problem with separation, or a foreskin opening that is too tight, it is time to seek medical help. The doctor may first suggest that he gently play with himself. Sometimes, however, it is necessary to separate the foreskin surgically. And sometimes it is necessary to remove it, in a medical circumcision.

Remember to follow the rule

It’s okay to encourage your son to gently play with his foreskin, in private, of course. It is never okay for you or any caregiver to force the separation—including when diapering or bathing the child. Never!