Caring for male genitals: A guide for parents

As parents, it is our top priority that our children grow up happy and healthy. One component of health that often doesn’t get talked about enough is proper care of male genitalia. We know there are still some common misconceptions within this area, so our aim of this blog is to help you promote good hygiene and health with clear and concise information. We know that taking care to look after your child’s penis and foreskin will keep it healthy and help minimise the risk of redness, pain and infection ⚡

Anatomy:

The loose skin covering the end of the penis is called the foreskin. Most newborn’s foreskin cannot be retracted (pulled back from the head of the penis), however over time the foreskin separates and will be able to be retracted. Full retraction of the foreskin from the penis is possible for 10% of boys at one year of age, 50% of boys at ten years of age, and 99% of boys at 17 years of age^. 

In the years before the foreskin fully separates from the head of the penis, skin cells can accumulate under the foreskin and produce a white substance called smegma. The build up of smegma may cause lumps under the foreskin, which is seen in approximately 10% of children*. Smegma can be washed with water, however it will not cause any problems if left. Like many body parts, foreskins can look different person to person, and the length of the foreskin can vary.

The testicles are usually located in the scrotum, however occasionally one or both of the testes do not move down into the scrotum once they develop. This is known as undescended testes. We know that approximately 5% of male babies are born with undescended testes^^. If your baby is born with undescended testes, this will be picked up by a health professional after birth and will be monitored over time. If your baby was born with testes in the scrotum at birth and one or both disappears from the scrotum, it is important to see your GP. You will be referred to either a paediatrician or paediatric surgeon as it is important that the testes be brought down into the scrotum to minimise any potential complications. We know that sometimes the testes may move up out of the scrotum temporarily when your baby is cold or frightened, and return into the scrotum - however, it is important to contact a trusted health professional if you have any concerns about your baby’s testes.

Does the foreskin need to be retracted for cleaning?

During infancy and childhood, you do not need to do anything in particular to care for the foreskin. It does not need to be pulled back for cleaning (a common misconception that we still hear!). If your child does happen to pull back the foreskin on their own whist in the bath or shower, that is not a concern, but it is not needed to be done by a caregiver for care. Once a child goes through puberty and the foreskin can be easily retracted, it is good to do so in the shower for cleaning. It is important to teach your child to rinse off any soap and to replace the foreskin to cover the head of the penis at the end of the shower. It is important to see a trusted health professional if there are any concerns regarding male genitalia at any point in a child’s life.

Is penis and foreskin play during childhood normal?

YES - it is typical and can be a normal part of development to see some penis and foreskin play, and is certainly not something to worry about.

Red flags:
🚩 Swollen, red or painful foreskin or penis
🚩 Discharge or pus
🚩 Painful urination
🚩 Ballooning of the foreskin when urinating
🚩 If the foreskin remains tight after puberty, it is best to see a doctor
🚩 If the foreskin has been pulled back and is stuck/unable to return to usual position, seek urgent medical care
🚩 If the foreskin gets stuck in a zip, seek urgent medical care
🚩 Pain and/or swelling to the scrotum/testicles, nausea, vomiting and abdominal pain may be signs of a testicular torsion (a twisted cord that carries blood to the testes) and this is a medical emergency that requires urgent assessment.

This blog is written by Shayna, a NICU/Emergency Nurse and Mum to her young daughter.

References:
^ https://www.rch.org.au/kidsinfo/fact_sheets/penis_and_foreskin_care/
*https://raisingchildren.net.au/guides/a-z-health-reference/foreskin
^^https://www.rch.org.au/kidsinfo/fact_sheets/Undescended_testes/
https://kidshealth.org/en/parents/torsion.html