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(14.05.2025) A tight foreskin is completely normal in young boys. But when does it need treatment - and when doesn't it? An expert gives tips.

"The narrowing of the foreskin, medically known as phimosis, is initially a completely natural condition," explains Prof. Dr. Martin Schönthaler, senior physician at the Department of Urology at the Freiburg University Medical Center. In almost all newborn boys, the foreskin is still tight and cannot be pushed back over the glans. However, this tightness usually disappears by itself during the course of development. Many parents therefore ask themselves: When do you have to do something? Schönthaler emphasizes: "There is no specific age at which the foreskin must be able to be pushed back." Treatment is only necessary if complications arise.

When treatment for phimosis makes sense

Complications include inflammation, accumulation of pus or pain, for example during erections at the onset of puberty. "We have to take action here," says Schönthaler. Simple measures such as rinsing under the foreskin or chamomile baths often help. It is important that children and parents never try to force the foreskin back, for example in a warm water bath. "This can cause minor injuries that later lead to scarring and a real foreskin constriction," warns Schönthaler.

Therapy: ointments or circumcision

If treatment is necessary, it usually starts with a cortisone ointment. "The ointment is applied several times a day for four weeks and dilates the foreskin in around 90 percent of cases," explains Schönthaler. However, in around 20 percent of boys, the tightness can reoccur. In these cases, or if the ointment therapy does not work, Schönthaler recommends circumcision. "We advise against partial circumcisions or foreskin-preserving procedures, as these often lead to scarring." Traditional circumcision is performed on an outpatient basis and is usually uncomplicated.

Advice for parents and children

"Treatment is not necessary for the vast majority of boys, as the tightness disappears on its own by the age of three or by the time they start school at the latest," says Schönthaler. If the foreskin does not retract until puberty or if symptoms occur, the specialists at the Urology Clinic are available for a consultation during consultation hours.

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