How do I know if I have a phimosis?

Question

Hello doctor,

I am an 18-year-old male and want to understand if I have phimosis and assess my penile health. I am concerned and would appreciate guidance.

I would really appreciate any advice or insights you can share.

Thank you for your help and advice.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for sharing your concern. From the image, it looks like your foreskin might be tight. This could be phimosis, especially if it does not pull back easily over the head of the penis.

Phimosis means the opening of the foreskin is too tight to pull back fully. In teens and adults, it matters if it causes pain, trouble cleaning, painful erections, or problems with urination or sex.

From what I can see:

The opening of the foreskin looks a bit narrow.
Only part of the head of the penis is visible.
There also seems to be some mild dryness or whitish flakes near the edge of the foreskin. This could be from irritation, dryness, or mild inflammation.

Right now, it does not look dangerous, but it may show mild to moderate phimosis.

To better understand how serious it is, I have a few questions:

Can you pull back the foreskin when the penis is soft (not erect)?
Can you pull it back when the penis is erect?

These differences are:

If you can pull it back when soft but not when erect, it is usually mild phimosis.
If you cannot pull it back at all, it may be more serious.

Please do not force the foreskin back, as this can cause small tears and scarring, which can make things worse.

Instead, you can try the following:

Clean gently with warm water.
After bathing, gently pull back the foreskin only as far as it feels comfortable.
Stop right away if you feel any pain.
Do not force the foreskin back.

Often, doctors treat this with a steroid cream (like Betamethasone 0.05%) and gentle stretching exercises for a few weeks. This usually works well for people your age.

See a doctor quickly if you notice any of the following:

Redness or swelling that gets worse.
Pain when you urinate.
Discharge that smells bad.
The foreskin gets stuck behind the head of the penis and will not go back to its normal position (this is called paraphimosis and is an emergency).

Please know that this is common and treatable in young adults, and surgery is not always needed.

If you want, you can tell me if you can pull back the foreskin when the penis is soft or erect. I can then help you understand how serious it might be.

Please feel free to ask any further questions.

If you have any more questions, please do not hesitate to ask.

Thank you.