The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 30-year-old and currently doing foreskin stretching exercises every day to loosen up my foreskin while taking a bath. I always use virgin coconut oil when I stretch and at the end of the day, I use Betamethasone Dipropionate 0.05 % twice each day. I wash my glans with water only and was able to retract two weeks ago when flaccid but scared to pull the foreskin all the way back because of getting paraphimosis. I do not have any pain when pulling back when flaccid but the foreskin is still slightly tight when erect. I had really tight foreskin when I first started which was just a pinhole opening. I am still doing stretching exercises but recently I noticed this wrinkly glans with a white residue. Is this infection? I am not sexually active and did not have sex with anyone. I tried to wash it with plain water but not coming off. Is this serious?
Hi,
Welcome to icliniq.com.
Noted the pictures you attached (attachment removed to protect patient identity). You have done a great job doing retraction using steroid cream. This course using cream is to be done for six weeks. You need to retract the foreskin to back completely and clean all white stuff called smegma which is not really infection but can lead to infection if not cleaned regularly. And after complete retraction and cleaning do not forget to get your foreskin back to position this is to avoid paraphimosis. Retraction is fine now during flaccid state you need to do it during erection state then to pull the foreskin back to normal to avoid paraphimosis. The smegma can be attached and difficult to clean as with your case just do it gradually as much as you can, do not use force as it might cause injury to glans. It should be clean after a few days to weeks. No need to use a steroid cream for more than six weeks. Always keep the area dry and clean.
I hope this helps.
Patient's Query
Hi doctor,
I just want to give an update and wanted to let you know that the smegma came off and I was able to retract the foreskin during the flaccid stage without holding the skin. The skin however is still tight when I get erect but I do not feel any pain or discomfort. Should I continue to stretch and use Betamethasone cream? If I do not apply coconut oil over my glans it gets dry and the foreskin does not have the glide motion even during the flaccid stage. I posted pictures for your observation. The first picture is in the flaccid stage. The two other pictures are in the erect stage. Kindly suggest.
Hello,
Welcome back to icliniq.com.
From the pictures (attachment removed to protect the patient's identity) it seems that your foreskin is still a bit tight. Therefore you need to continue with the same steroid cream treatment for six weeks with complete retraction then pull back every time twice daily. After completing six weeks please follow again to check the results and know if it is enough or need to proceed with any other thing. About coconut oil it is good but apply it after two hours of the cream application so it does not interfere with the cream. It is great that Smegma came off completely. These are good results so far. I hope you get a complete resolution. Keep your follow up and please ask if you have any further questions.
Thank you.
Patient's Query
Hi doctor,
I recently have new symptoms such as feeling itchy at the front of the foreskin tip, which started two days ago. I started using Clotrimazole cream and stopped using Betamethasone dipropionate 0.05 % cream. I am still doing stretching exercises but noticed this brownish spot on the foreskin, which is not a bump just flush to the skin. What is this? And how do I cure the itch?
Hello,
Welcome back to icliniq.com.
I reviewed the pictures attached (the attachment was removed to protect the patient's identity). I am happy the foreskin now is retractable easily. Itching actually can have many causes but the most common is a fungal infection and you have done the right thing by stopping Betamethasone and starting antifungal treatment. Carry on at this time and we see how it goes for a week. If cured no worries but if itching is the same or increased then we need to investigate further. Is Smegma completely clear? Just make sure to clear it completely. The red spot is not to worry about it as it will disappear with the treatment. Please do not hesitate to ask if you have any queries. Otherwise, I will inquire about you about a week later.
Thank you.
Patient's Query
Hi doctor,
I just want to give you an update. So far, I made good progress starting just from almost pinhole 8 mm opening of my foreskin. I purchased these Primocure silicone rings which might have created circular scars as seen in the pictures. I can retract and clean while flaccid but it is still tight when erect as I attached a few pictures showing the problem. Do you think I will be able to succeed by stretching for more months or will I require a circumcision? I really want to avoid surgery but want to know your recommendation. Are these circular scars from using silicone rings? It feels somewhat hard to touch when I run my finger on it.
Hello,
Welcome back to icliniq.com.
I am happy to see fantastic results. At this stage, I do not advise circumcision. There is mild tightness at the erect position and since you improved there is no need to rush to do surgery as surgery can be done at any time. I suggest you apply Betamethasone 0.05 % cream for another six weeks and we follow up to see how it goes. I hope without surgery all will be fine. Please make sure you pull the foreskin forward at all times to avoid paraphimosis during the treatment period. Please update me about the outcome of the treatment given and if you have any more queries.
Thank you.
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