Foreskin - habits, care and management:

Father of three boys offers good advice from family experience

The following letter was sent to Circumcision Information Australia by a man in his late 60s, born in country Victoria and now living in a major coastal city. As an uncircumcised man himself and the father of three uncircumcised sons, he knows what he is talking about when it comes to foreskin care and management. His basic message is: leave it alone, don’t worry about, and handle minor problems as they arise in a conservative spirit.

Warning: some of the comments below are of an explicitly sexual nature.

Dear Circumcision Information Australia

I read your brochure for parents on care of the penis, which I thought was very sensible. I’m glad you mentioned possible problems, as the penis, like any other bodily organ, can have problems from time to time. Episodes of balanitis (inflammation of the glans) are more common than many people think, but they do not require circumcision. I first got balanitis when I was 14, but it responded quickly to a medicated cream and was gone in a few days. I had another episode when I was in my early twenties, when open weave nylon underpants were the vogue. My doctor just looked at them and said, “Are they nylon.” I said “Yes”, and he replied: “Don’t wear artificial fibres in underclothing; they don’t let the body breathe properly and can be irritants.” Cream again solved the problem. I had another episode more recently, after many problem-free years, whilst in Central Europe, where it was very hot and humid. I asked my local travelling companion if he could get some cream, which he did, and he remarked that he also had the problem occasionally. Again, it quickly did the trick. I think that tight underclothing is a frequent cause of the sweating which gives rise to balanitis. I don’t think boys should wear any underclothing in hot weather, and only very loose cotton underwear at other times. When I was a boy we only wore them on Sunday, like most other people in our community.

As a man gets older his foreskin, even if very loose, can start to tighten up. I noticed that my acroposthion [the tapering part of the foreskin, extending beyond the glans] was becoming less easy to draw back over the corona last year and mentioned this to my urologist, fearing the worst. He examined it and prescribed a cream, which he said to apply lightly to the area a couple of times a day, and the foreskin would loosen up again If the problem recurred, repeat the process. This worked instantly and I’ve only had to apply the cream once since.

Washing foreskins is a great shibboleth: they don’t need washing nearly so much as people say, and certainly not until puberty. It is, in my view, mainly the natural secretions arising from sexual activity (how’s that for a euphemism!) which create any real need to wash frequently. The interior of the foreskin should never be washed with soap or body lotions etc; that’s like cleaning one’s mouth out with soap.

Yours sincerely

David Priestly

In reply to our inquiry about what sort of creams were applied to resolve the balanitis and tightness problem, and what style of underpants he preferred, the author of the letter replied:

I can’t remember what I used the earlier times in adolescence or my twenties, but I was subsequently told by a doctor that a Canesten, a cream commonly prescribed for women, was useful, and I still have the tube of ointment from Europe. It is Fenistil, made by the Swiss company Novartis, and contains, so it’s English website says, Dimethindene.

When I saw him about my acroposthion getting a bit tight, my doctor told me that he almost never circumcises older men whose prepuces start to get tight, but instead prescribes the cortisone cream he recommended to me. He commented that circumcision is a more difficult operation than usually thought, and that in older uncircumcised men the sudden permanent exposure of the glans, which (especially in cases of long foreskins) has been covered for nearly a lifetime, can be very painful for a long time.

I wore boxer shorts for many years, but currently wear very soft cotton underpants, I suppose half-way between briefs and boxers. If doing heavy physical work I wear no underclothing at all, as I find it more comfortable. I was surprised by your comment that circumcised men often preferred tight underwear, because the rubbing of the fabric on the exposed glans can be uncomfortable, and tight underpants reduce the movement. I had no idea that the bare heads of circumcised penises would still feel uncomfortable after so many years.

Note on medications

Clotrimazole (brand name Canesten or Lotrimin) is an antifungal medication commonly used in the treatment of fungal infections (of both humans and other animals) such as vaginal yeast infections, oral thrush, and ringworm. It is also used to treat athlete’s foot and jock itch.

Dimethindene (brand name Fenistil) is an anti-histamine used to treat inflammation of allergic origin.

Various forms of steroid cream (cortisone, betamethasone valerate, and others) are very effective in resolving tight foreskin problems. See pages on treatment of phimosis for details.

Further comments on foreskin care and management

In a further letter, David elaborates on foreskin care, from his own experience and that of his father and his three sons … and dispels many old prejudices and myths.

The acroposthion, even more than the rest of the foreskin, is what sets people off. My brothers were allowed to play with their circumcised penises, but I was not allowed to fiddle with mine, because it had a moving part and the glans, being protected, was supersensitive.

The first time I became aware, as it were, of what I now know to be the acroposthion as a separate entity, was during a medical examination just before I began secondary school. I was 10 years old and was then boarding with a family, as I’ve mentioned, and was taken by the mother to their doctor, so that he “Could just have a look at you”. I was asked to strip off to my undies and he proceeded to look at my eyes, test reflexes etc. After a while he asked me to take my underpants off and come and stand right in front of him. He first fiddled with my balls, made me cough etc, and then ran his thumb and forefinger down my penis, grasped the foreskin extending beyond the tip and rolled it firmly between his thumb and forefinger. It was not comfortable, and I could feel for the first time that the foreskin had two layers, a soft loose outer one and a firmer tubular inner one. He then let it go, but grasped the very tip and pulled it out as far as it would go, without actually hurting and repeated the performance. It no longer felt so tubular inside. He then let it go and from the shaft of the penis, pulled the foreskin back as far as it would go, again without actually hurting, closely inspected the head of the penis, which luckily was clean as I’d not cleaned it specially, not expecting anything like this. Evidently satisfied he pulled it right forward, but pulled it back and forth again a few times. I had never had a medical examination before, and I was so frightened that I didn’t get an erection, which was what I expect was intended. He then said I could go over to the chair on which my clothes were lying and get dressed whilst he spoke quietly to the mother, who had watched the whole examination in silence. He did not like the overhang as I’ve found since with others. It’s too long, they say.

When I was married I had a medical examination, mainly testing for blood groups etc, using my wife’s doctor, an old English man who, whilst very pleasant personally, was a keen circumciser, as I discovered. When he saw my penis for the first time, he told me I had a redundant foreskin. I didn’t know what he meant, as it worked properly and seemed OK to me. He said it was too long and would cause troubles and that I had to get circumcised. I said I’d think about it – which I did, but I thought that I wouldn’t do it. He and my mother-in-law tried to get my wife to have the boys circumcised, but I insisted that they were not to be. After the first one my wife was happy with things as they were and told her mother not to raise the matter again if, as happened, she gave birth to further sons.

My father very much wanted to get me circumcised, but once he found out that I did not want to be, he said that it was my choice, but that I would have to look after my foreskin properly. This was in early adolescence, i.e. 13 years in my case, by which time my foreskin had become easily retractable. He told me to pull the skin back to urinate, grasping the foreskin from behind the glans, not at the tip or opening, which he said would risk infection from dirty hands. Afterwards I should shake off excess urine and just release the foreskin and let it slide forward naturally. He also told me to pull the foreskin back in the same way when in the shower or bath and just let fresh water (not soap) bathe the glans, and that if there was any smegma, to rub it off gently with my forefinger and thumb. I should not use cloth on the glans and never use soaps etc, as they irritated the delicate tissues. He said not to pull the foreskin forward (as is often taught these days), as this can cause it to fold back on itself and become uncomfortable or swell up and get stuck. He also said that if it had rolled forward by the time bathing was ended, merely to pull it back to let any water out, but not to dry it with a towel. It would roll forward when it was ready. After a time as I grew through adolescence, I found that my foreskin never rolled forward after being pulled back in the shower until I was about to dress, keeping the glans really fresh and naturally damp, whilst in no way diminishing its sensitivity, which formal washing and drying with cloths would have done, let alone the harm from harsh soaps. This practice certainly did not make it any shorter either. I found that this worked very well for me, and I taught my sons the same ways when it was due time.

My father was evidently speaking from his experience from the time before he was circumcised. I have no idea why he got circumcised, or why he was so keen on doing it to others (maybe Aesop’s fable about the fox who lost his tail …), but at least he let me be and gave very good advice on how to look after an uncircumcised penis. He told me, after I asked him how he knew such things, that his father, who was not circumcised, had taught him. When I had sons he told me that I should get them circumcised, but when I said that I would not (which he must have known) reminded me to tell them how to look after their foreskins as he had for me at adolescence.

Having a foreskin which extends beyond the glans, even when erect can sometimes present a minor problem during intercourse (though it makes no difference, or improves sensation, with masturbation and similar handling). Although the foreskin opening is very stretchable, if it is very loose it won’t slide back during penetration of itself, nor during intercourse, but tends to just move over the glans, rather than letting it become exposed. This is not very satisfactory for either partner. We discovered by trial and error that the best approach was to pull the foreskin right back after penetration and keep it held back. This allows the foreskin to slide on the shaft, leaving the glans fully exposed and giving maximum pleasure to both participants.

I have written this, not to be salacious, but because I have seen claims by pro-circumcisionists suggesting that a foreskin of this type (i.e. like mine), needs to be removed because it limits sexual pleasure. This is rubbish. I was totally mystified as a young man when I heard assertions that the penis of a circumcised man and an uncircumcised man looked the same when erect. They might occasionally, but certainly not always. I have never seen another uncircumcised male with an erection since I was about 12, and had no idea that in some cases the foreskin would pull back naturally during an erection to expose the glans.

I hope that this information is of use to parents and uncircumcised boys, even though it’s only from the experience of one man and all others may be different.

P.S. Incidentally, re dirty hands and urination. When I was at university, the chairman of our College council was a well known old medico. Once, giving a talk to the students after dinner, he began jocularly, by saying to us that he supposed we all washed our hands after touching our penises when urinating. Yes yes, we all went. He then said that if we thought about where our hands had been, what they’d been touching and how much we, as young men, valued our penises, we should wash our hands before, not after touching them. It brought the house down.

With best regards

David Priestly

Secret men’s business: What dads once told boys about their body

Comments by Circumcision Information Australia

David was born in western Victoria in 1944, at the height of the vogue for circumcision, and it was only by an odd chance that he himself was not circumcised. In an account of his childhood and adolescence available at History of Circumcision, he recounts the prejudices and hostility that his unusual penis aroused at that time, but also his firm attachment to his foreskin, and his adamant resistance to the idea that he should get circumcised. What is particularly interesting about David’s letters here is the how he shows that in the days before circumcision became accepted, and knowledge of foreskin physiology and habits was lost, correct advice on foreskin care was handed down from father to son. This is still the case in cultures where circumcision never got a foothold. Neither David’s grandfather nor his father were circumcised (though his father had it done as an adult for unstated reasons), and having the experience of growing up intact they passed the knowledge down. No doubt David’s grandfather had similarly been advised by his own father, and so back in time through all the male line.

The story they told about the ease and simplicity of foreskin care, and the many pleasures of having one, was very different from the narrative that appeared in the manuals of baby and child care being published at the same time. From the late nineteenth century these were full of Victorian myths and prejudices about the foreskin, painting it as difficult to look after, prone to problems, and likely to encourage both disease and bad habits. Such myths linger even today in many popular publications. The old medico’s advice is very sound. Unless a person has some sort of urinary tract infection (such as gonorrhoea), urine is sterile, and can safely be used to wash hands and even the interior of the foreskin itself. People forget that our hands are generally much dirtier than our genitals.

The first-hand knowledge from somebody with the good sense and wide experience as our correspondent here is a most valuable corrective to all this antiquated nonsense.

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