Understanding Phimosis: Causes, Treatments, and Alternatives to Circumcision

Dr Khan
Understanding Phimosis

Understanding Phimosis and Alternatives to Circumcision

Tight foreskin is a topic that often does not receive the attention it deserves, leading to a lack of information about conditions. Among these conditions, phimosis is a common yet frequently misunderstood issue. This blog aims to shed light on its causes, available treatments, and alternatives to full circumcision.

What is Phimosis in Adults and Men?

It is a condition where the foreskin is too tight to be pulled back, making it difficult or impossible to expose the tip of the penis. While some cases may resolve naturally as children grow, others can lead to complications when left untreated. Let us discuss this condition in detail and explore its contributing factors.

Causes of Phimosis:

1. Skin Conditions: Skin disorders like Balanitis xerotica obliterans (BXO), Lichen planus, or Eczema can result in scarring that leads to tight foreskin. It can cause cuts or tears of freoskin.

2. Infections: Studies show that circumcised men have a lower risk of sexually transmitted infections (STDs) such as syphilis, chancroid, and genital herpes (HSV-2).

3. Scarring:  Severe scarring, often caused by BXO or repeated infections, can tighten the foreskin.

4. Potential Cancer: Uncircumcised men have an increased risk of penile cancer. Phimosis, especially chronic, is linked to a higher incidence of penile cancer.

Differentiating Between Types of Phimosis in Children and Adults:

It's essential to distinguish between physiological phimosis (natural tight foreskin) and pathological phimosis (diseased or scarred foreskin). Treatment options vary depending on the type and severity of phimosis.

Nonsurgical Treatment Options:

For mild cases, nonsurgical treatments may be effective:

1. Steroid Cream/Ointment: Applying these can help reduce inflammation and loosen the foreskin.

2. Stretching Exercises: Gentle stretching exercises can gradually increase the flexibility of the foreskin.

3. Anti-Fungal or Antibiotics: These can address infections contributing to scaring.

However, it is essential to note that scarred foreskin in adults might not respond well to stretching and could lead to further complications.

Surgical Treatments for Tight Foreskin:

When nonsurgical methods fall short, surgical interventions are considered:

1. Frenuloplasty: A procedure to release the frenulum, allowing the foreskin to detach from the head of the penis.

2. Preputioplasty: This procedure involves an incision to expand the foreskin's diameter, facilitating retraction.

3. Partial Circumcision: Removing part of the foreskin, leaving some coverage over the glans.

4. Full Circumcision: The complete removal of the foreskin, often considered for severe cases like BXO phimosis or penile cancer.

Considering Alternatives to Circumcision:

If full circumcision isn't preferred, alternatives include various treatments and procedures, e.g. steroids cream or ointment and stretching exercises. These can be discussed with specialists or urologists based on individual preferences and needs.


Phimosis in men and children is a condition that requires attention and proper treatment. Whether it is tight since birth or diseased freoskin, understanding the causes and available treatments is essential for maintaining penile health. While surgical options like circumcision exist, nonsurgical methods and alternative management offer viable choices. If you are experiencing phimosis, consulting with a top London Urologist will provide insights into the best course of action for the best sexual health.

For further consultation and expert advice, please consider booking an appointment at the London Circumcision Centre.

Testimonials - Patients for Phimosis at London Circumcision Clinic  2023

"Great service and efficient staff"

"Everything was beyond my expectations; the doctor and the assistant gave me confidence, and everything ran smoothly! It felt like a straightforward operation because those people are real professionals! Thank you!"

"Dr. Khan is professional, kind and knowledgeable."

Contact us directly from Dr Khan for free telephone advice for circumcision and tight freoskin (phimosis) without any obligation.