In uncircumcised men and boys, a foreskin covers the head of the penis. Typically, the foreskin is flexible and stretches to allow exposure of the glans penis (head) when pulled back, offering no resistance. When the foreskin can’t be pulled back, this is called phimosis.

Phimosis is a common condition. There are two types:

Physiologic phimosis is the normal state for a newborn male. As boys grow older, their foreskin becomes retractable. Usually this occurs by age 7, but sometimes it takes a few more years.

Pathologic phimosis is the result of infection, inflammation, or scarring.

Pathologic phimosis is sometimes caused by poor hygiene. If a man or boy does not wash the area under the foreskin thoroughly and consistently, he may develop an infection, such as posthitis (inflammation of the foreskin) or balanitis (inflammation of the glans penis). Sometimes these two infections occur together.

After these infections, the foreskin may have an area of fibrosis, and it may look like there is a tight ring around the tip of the penis. The area may be swollen and red, and the man might have trouble urinating or discomfort with sexual activity.

Medical conditions like diabetes can make men more susceptible to these infections and, consequently, phimosis.

Phimosis is sometimes treated with a topical ointment applied to the penis. More serious cases may require surgery.

Complications of phimosis include bleeding, infections, difficult or painful urination, and painful erections.

Sometimes paraphimosis, a condition in which the foreskin stays retracted and can’t be pulled forward, occurs as well. These cases need urgent medical evaluation as this condition can impair penile oxygenation.

Phimosis should not be ignored as it impairs proper hygiene, and over time, the ring can become tighter.