Let’s talk about penis and foreskin care, as we get a lot of questions about it in my free Facebook sex education group for parents, that parent group. The information in this Guide is relevant for children of all ages, from babies to teens.
It is something that a lot of parents struggle with. Especially mums, who don’t have a penis of their own. Which means they have no personal experience in keeping it clean.
Looking after foreskins can be challenging too.
For many parents, depending on your cultural and/or religious background, they may be more used to circumcised penises. Where the foreskin may have been removed for medical, cultural or religious reasons.
So this blogpost is designed to be a primer in penis and foreskin care. You’ll also find guidance for teaching your child to care for their own penis.
And regardless of whether your child is intact (with a foreskin) or circumcised, the information within this blogpost is based on keeping your child’s penis healthy and helping your child to grow up with a positive body image.
And please do let me know if you still have any questions that are unanswered. As I will add them to this post!
You’ll also find more information about sex education in my Sex Education 101 page.
The Circumcision Debate: This blogpost has been written for parents who have already made a decision about circumcision. Therefore you won’t find any information about the benefits or risks of circumcision in this article.
Quick Index
The reproductive system
Anatomy of the penis
The intact penis
- The foreskin
- Why do penises have a foreskin?
- Foreskin separation
- When will the foreskin separate?
- When will the foreskin retract?
- What if the foreskin doesn’t retract? Or is tight?
- What can happen if the foreskin is forcibly retracted?
- What about adhesions?
- Do I teach my child to self-retract?
- How rough can I let my child get? With their foreskin?
- What about ballooning?
- What is smegma?
- What are smegma pearls?
- How do you remove smegma?
- Common foreskin problems
There are no photographs of penises in this post but there are illustrations. The illustrations are of penises that are coloured green. Why green? Simply because customised illustrations are expensive, and to include genitals that are representative of the many different skin colours will cost too much. So for now, the penises are green.
The reproductive system
Before I start talking about penises and foreskins, I just want to give you a refresher on the reproductive system. As the penis and foreskin are a part of the reproductive system.
Everyone has a reproductive system and the sole purpose of the reproductive system is to reproduce ie make babies.
There is the male reproductive system that is made up of internal parts (organs inside the body) and external parts (genitals outside the body).
The internal organs are the testes (or testicles), the epididymis, the vas deferens, the seminal vesicles, the prostate gland, the cowper’s gland and the urethra. The genitals are the penis and the scrotum (which holds the testicles).
Let’s talk about the different organs and what they are for.
Bladder: A stretchy bag that holds the urine (pee) before it comes out of the body. The urine leaves the bladder through a small tube called the urethra. People with a vulva also have a bladder.
Cowper’s gland: These two small, round glands (the size of a pea) are found underneath the prostate gland. When a male starts to feel sexually aroused, they will start to make a special fluid that will lubricate the penis and keep the sperm safe as it travels through the urethra. The other name for this part is the bulbourethral gland.
Epididymis: The testicle is connected to the epididymis. Once sperm has been made in the testicles, it is sent to the epididymis. It is here that the sperm is grown up or matured, ready for reproduction. If felt through the scrotum, it will feel soft and squishy, like a piece of cooked spiral pasta.
Prostate gland: A gland that is at the base of the penis, near the bladder. The urethra runs through the center of it. The prostate gland helps with bladder control and secretes fluids that mix with the sperm to make semen.
Rectum: A tube that is used to store feces (poo) before it is pushed out through the anus. People with a vulva also have a rectum.
Seminal vesicles: A pair of glands that lie on either side of the bladder. They open into the vas deferens and secrete fluids that mix with the sperm to make semen.
Testicles: The male sex organs that make sperm. They are two soft oval-shaped parts that will grow much bigger during puberty, to about the size of a plum. Sperm is made in the testicles. If felt through the scrotum, a testicle will feel like a hard-boiled egg that has been peeled.
Urethra: A narrow tube that leaves from the bladder and goes through the penis to the small opening at the tip of the penis (urethral opening). It also carries the semen after it leaves the vas deferens. People with a vulva also have a urethra.
Vas deferens: The tube that connects the testicles/epididymis to the prostate and seminal vesicles. If felt through the scrotum, it will feel like a piece of cooked spaghetti.
There is the female reproductive system that is made up of internal parts (organs inside the body) and external parts (genitals outside the body).
The internal organs are the ovaries, the fallopian tubes, the uterus, and the vagina.
The genitals are the vulva.
Anatomy of the penis
Let’s have a refresher of the anatomy of the penis.
You have a penis, which may or may not have a foreskin that covers the head of the penis (glans). All penises are made with a foreskin, they aren’t born without a foreskin. During puberty, pubic hair will start to grow around the base of the penis, on the scrotum and around the anus. And the end (or the head) of the penis also has a fancy name – the glans.
The urethra is the tube that urine and semen (which carries the sperm) leave the body through. We call the hole that you can see at the tip (or end) of the penis, the urethral opening.
The scrotum is the special bag that holds the testicles. The testicles will usually start to drop by the age of 9 months. The scrotal skin is usually a bit darker than the rest of the skin on the body and hair will start to grow on it during puberty.
And just like our faces are made up of smaller parts (like a nose, mouth, ears), the penis is also made up of smaller parts (like a corona and frenulum).
And just like our faces look different to each other, so do penises and scrotums. Penises come in all different shapes and sizes and colours. So there’s no such thing as a ‘normal’ penis. Some penises are short and thick, some are long and thin, some lean or bend a little to one side. The penis may be darker or redder than other skin on the body and may have veins sticking out. Pubic hair grows around the base of the penis, the testes and the anus.
If you’re unsure about what names to use, then this blogpost about naming the private parts can help. And you can also find some child-friendly diagrams and a parent guide for talking about genitals.
During puberty, these parts of the body start to change as the sex hormones mature them and make them fertile and ready for sexual intercourse. Colours, size and texture can change, as well as the growth of hair.
The intact penis
An intact penis is one that still has a foreskin. Sometimes you will also hear an intact penis referred to as an uncircumcised or uncut penis.
The foreskin
The foreskin is a layer of skin that protects the sensitive head of the penis (glans). It almost always covers the head of the penis at birth and is fused to the glans of the penis (similar to how your fingernails are fused to the nailbed underneath it).
The foreskin is made up of smooth muscle tissue, blood vessels, nerves, skin and mucous membrane.
The innermost mucosal layer is the layer that is next to the head of the penis. This layer is like the skin on the inside of your eyelid or the inside of your mouth. It helps to keep the glans moist.
The next (or middle) layer is the muscular layer. The Dartos muscle helps to keep the foreskin closed over the head of the penis.
It opens to let urine out and closes to protect things from getting in (like poo when wearing a nappy). It is also sensitive to temperature, expanding as the temperature increases and contracting when the temperature decreases. The Dartos muscle helps to keep the foreskin mobile and elastic.
The outer layer of the foreskin is the skin, which also contains blood vessels and nerves.
The join between the inner layer of the foreskin and the outer (skin layer) is called the ridged band.
You can find more information in this article, about the anatomy of the penis (just be warned though, as there are photos of real penises on there) or in this academic journal – The Prepuce. Or in The Good Mummy’s Guide to her Little Boy’s Penis by Adrienne Carmack.
Why do penises have a foreskin?
The foreskin is not an unimportant piece of skin.
In babies and toddlers, it protects the head of the penis (glans) and the urethral opening, preventing irritation from dirty nappies (urine and faeces).
It also protects the highly sensitive head of the penis from chafing and friction. Plus it plays an important role in sexual arousal. You can read more in this blogpost about the many other functions of the foreskin.
Foreskin separation
At birth, the foreskin is fused to the head of the penis (glans). This means that it is not retractable ie it is stuck to the head of the penis and is unable to be pulled back over the head of the penis.
The foreskin should never be forcibly retracted as there is a risk of scarring and infections that may lead to circumcision.
The membrane that fuses the glans to the foreskin is called the balano-preputial lamina (BPL). This gradually dissolves and is fully dissolved by puberty (around 10 years of age).
Over time, the foreskin will naturally separate from the head of the penis.
When will the foreskin separate?
It depends, as it is different for every penis.
If you allow your child to touch their genitals (when changing their nappy, in the bathtub, or when watching cartoons), over time their tugging and touching of their penis will help the foreskin to separate.
So in some children, the foreskin may be fully separated from a younger age than in others.
I don’t like to give an age as every child (and penis) is different.
But The Royal Children Hospital Melbourne suggests that the foreskin will have separated in 10% of one-year-olds, in 50% of ten-year-olds, and 99% of seventeen-year-olds. (Separation – not retractability.)
However, for some children, the separation may not happen until puberty. This is normal. In a rare condition called phimosis, the foreskin will never retract. (You can read more about phimosis in this section of the blogpost – Common Foreskin Problems.)
As the penis and foreskin naturally separate, there is often redness or pain when passing urine (peeing). This is normal and usually gets better after one to two days. While the separation occurs, small collections of white/yellow lumps (smegma) can accumulate. The smegma is normal and nothing to worry about. It also helps the foreskin to separate from the head of the penis.
When will the foreskin retract?
In penises, retraction or retractability refers to the ability of the foreskin to be pulled back over the head of the penis (leaving the head of the penis exposed)
Now everyone has a different opinion on this, so don’t be surprised if you find many different answers.
The Royal Children’s Hospital Melbourne suggests that retractability increases with age, with full retraction possible in 10% of one-year-olds, 50% of ten-year olds, and 99% of seventeen-year-olds.
This is what YourWholeBody.org has to say about retraction of the foreskin.
If your foreskin does not retract all the way, don’t worry! The average age by which a male can fully retract his foreskin is 10.5 years old [3-6], but there is a wide range. Some guys are much older than when their foreskin can fully retract, and this is completely normal. You were born with a membrane fusing your foreskin to your glans. Over time, this membrane gradually releases. For some kids, this process completes at a very young age, and for some it occurs much later. Puberty changes our bodies significantly, and tends to complete the separation process for most.
So basically, retractability may happen in younger children or it may not happen until puberty (or even after).
What if the foreskin doesn’t retract? Or is tight?
So what should you do if the foreskin doesn’t retract? Because it is too tight to be pulled back over the head of the penis?
The Royal Children’s Hospital Melbourne states that a non-retractable foreskin is a normal variant and needs no intervention. It is different from true phimosis. Most penises have some degree of phimosis at birth, but as they get older the foreskin will naturally loosen.
I have spoken with adults with a non-retractable foreskin, and they are successfully having penetrative sex, with no pain and have even fathered children. But I have also spoken to some adults who find sex uncomfortable due to their non-retractable foreskin. I have also heard complaints from teens who find their erections uncomfortable. Their non-retractable foreskin means that they have less skin to stretch as their penis grows wider and longer with an erection.
So the situation for every child (and adult) is different. And keep in mind that for many people, full retraction usually happens after puberty.
If unsure, the best approach is to see your family doctor if there is any discomfort or if you (or your child) are worried about it. They will usually prescribe a steroid cream that will help to loosen the skin, thinning it to make it easier to stretch over the head of the penis.
⚠️ A WARNING. Don’t try to self treat with a steroid cream you already have at home. It has to be the correct strength and if you use too much you will damage the skin.
In younger children, they usually wait to see as the foreskin will usually loosen as they get older, unless there are problems. If an older child still has a tight foreskin after puberty, the recommendations are that it should be checked by your family doctor.
What can happen if the foreskin is forcibly retracted?
The foreskin should never be retracted with force. The first and only person to retract your child’s foreskin, should be your child.
But forcible retraction does happen. And it is usually done by unaware parents, a babysitter or childcare worker or a health professional.
Forcible retraction can cause pain and trauma as it forcibly separates (or tears) the foreskin from the head of the penis (the glans). This can create a raw surface which can then lead to infection, adhesions (where 2 raw surfaces of skin grow together as they heal), acquired phimosis (where the foreskin’s narrow opening may tear and scar, preventing it from widening later on), and paraphimosis (where the foreskin gets stuck behind the glans and it can’t be pushed back to cover the head of the penis). (You can read more about infection, adhesions, phimosis and paraphimosis in this section of the blogpost – Common Foreskin Problems.)
What about adhesions?
As the foreskin begins to naturally separate from the head of the penis, sometimes parts of it remain attached. These are called adhesions, where the inner layer of the foreskin is still connected (or attached) to the head of the penis. Adhesions are quite normal and will usually separate during puberty.
Adhesions can also occur when the foreskin is forcibly retracted. Where tearing of the skin happens, the 2 raw surfaces will fuse together as it heals.
If adhesions do not naturally resolve, treatment includes steroid cream applied to the area or surgery (as a last resort).
⚠️ A WARNING. Don’t try to self treat with a steroid cream you already have at home. It has to be the correct strength and if you use too much you will damage the skin.
Do I teach my child to self-retract?
A lot of parents are unsure about when (and if) they need to teach their child to self-retract their foreskin (or not).
Now, this is a contentious topic! As everyone has a different opinion on what you should do.
Some experts say that parents should encourage their child to self-retract only once puberty has started.
If the foreskin has separated before then, an occasional retraction with cleaning underneath it will do. But once puberty begins (or around the age of 12), parents need to encourage their child to clean under their foreskin as part of their daily hygiene routine (along with brushing teeth, using deodorant etc). The belief is that the foreskin will loosen by itself and that it doesn’t need any help before then.
Some thoughts are that when we teach kids to self-retract early, that you run the risk of making them worry that they aren’t ‘normal’ if they can’t retract by a certain age. Which means they may use more force than is necessary when retracting, traumatising the skin which can then lead to scarring and other problems. I have also heard from quite a few teens who have ended up with paraphimosis (foreskin caught under the head of the penis) that required an urgent trip to the Emergency Room for treatment. (You can read more about paraphimosis in this section of the blogpost – Common Foreskin Problems.)
Other experts disagree and say that parents should encourage their child to self-retract as soon as the foreskin has separated from the head of the penis.
So what do you do?
Let’s review the data on when most foreskins will separate and retract.
The foreskin will have separated and full retraction will be possible in 10% of one-year-olds, 50% of ten-year olds, and 99% of seventeen-year-olds.
Honestly, I’d just let them play with their penis in the bath as much as they like (as long as they aren’t damaging it). And if they are already retracting by the age of six, then you could encourage them to try in the bathtub. Some parents will start teaching this earlier (to their four or five year old) but it depends on whether the child is interested and if they have the dexterity for the task.
If you want to leave it until the age of ten, then you can. You could casually ask them if they are already retracting their foreskin, and if it isn’t encourage them to gently start trying.
Don’t forget to tell them that if it hurts to retract, then they should stop trying. Retraction should never hurt and they should never force the foreskin back. And if you’re unsure, the best approach is to see your family doctor if there is any discomfort or if you (or your child) are worried about it.
Once they are retracting, they’ll need to retract their own foreskin and to clean underneath it at least once a week during bathing. This will help to prevent poor hygiene and infection. And you will need to remind them until a habit. So as they are heading off to the bathroom, casually remind them to wash their face and to not forget about their foreskin.
As long as the foreskin is easily retractable, and isn’t forced, everything should be fine. Remember, forcing can cause scarring and problems in the future. So tell your child, that if it hurts, they should stop what they’re doing.
So do you teach your child to self-retract or not?
That’s totally up to you! Just make sure you collect the facts first, so you’re making an informed decision.
How rough can I let my child get? With their foreskin?
A lot of parents are unsure about how rough they can let their child be when playing with their penis. Some kids can get pretty rough, stretching their foreskin to lengths that make you cringe and cross your legs!
Usually, most kids will stop when it hurts. But if they don’t, or you start to notice redness and/or swelling, then it’s time to intervene.
What you do depends on why they’re doing it (and how old they are). If it’s a baby or toddler, try distracting them with a toy (or something else to do with their hands). Or make it harder for them to get to their penis, with clothing that makes access more difficult.
With older children, try to find out why they’re tugging their penis so much. Maybe their penis is sore, or itchy? Is it a sensory thing or are they just bored? You can try distraction, replacing the talk about your family rules for touching genitals, and explain the concepts of public and private.
You can also remind them that if it hurts, they should stop what they are doing. Otherwise they might damage their body.
You’ll find more suggestions in this blogpost, about how to keep your child’s hands out of their pants.
If you think they are doing it for a sensory reason, then you try to find a fidget toy that will replicate and replace the behaviour. At some training I attended by Sue Larkey (an Australian teacher with expertise in teaching autistic kids), she shared a fidget toy that works well as a replacement, as they can discretely put it in their pocket and play with it instead of their foreskin.
What about ballooning?
A common question from parents is about ballooning i.e. when the foreskin swells like a balloon during urination.
Usually, this isn’t a problem, as the urine that is trapped under the foreskin will usually only cause spotting of urine on your child’s underpants. But there is an increased risk of balanitis (inflammation of the head of the penis).
So if you’re worried, see what your family doctor has to say about it.
You can learn more in this blogpost about ballooning as well as find an illustration of what it looks like.
What is smegma?
Smegma is a thick, white substance found on all genitals.
This is what the American Academy of Paediatrics have to say about it.
When the foreskin separates from the glans, skin cells are shed. This begins in childhood and continues through the teen years. New skin cells regularly replace the ones that are shed. Since this shedding takes place in a closed space – with the foreskin covering the glans – the shed skin cells may look like whitish lumps, resembling pearls, under the foreskin. These whitish lumps are called smegma. Specialized glands, called Tyson’s Glands, located under the foreskin are largely inactive in childhood. At puberty, Tyson’s Glands produce an oily substance, which when mixed with skin cells, make up adult smegma. Adult smegma serves as a protective lubricator for the glans.
As the foreskin separates from the head of the penis, smegma can build up and become problematic – leading to irritation and infection under the foreskin. So it is something to be aware of, especially if your child complains of a sore penis or you notice redness.
What are smegma pearls?
Before the foreskin becomes separate and retractable, it is common for smegma to collect in small yellow/white lumps which may be visible or palpable through the foreskin. These are normal and need no intervention.
You can see a photo of a smegma pearl at the very bottom of this blogpost.
DrMomma.org has some great information about smegma pearls. You can read what she has to say here:
Something you may also see is called a smegma pearl. This is a whitish lump that can range in size from very tiny to pea size or larger. Smegma (the Greek word for soap) is a substance that consists of dead skin cells, body oil and other debris that clumps together forming a ball. It is not damaging and will work its way out once separation is sufficient for it to do so. It is not recommended that you try to massage it out or mess with it since this could cause tearing between the foreskin and the glans and result in pain and possible infection.
The time that smegma pearls are seen is when separation has started. It may make the glans under the foreskin appear like it is crooked. When touched it may feel hard but slightly squishy. It may also look like a blister under the foreskin. If there is any pain in that area odds are that it is being caused by separation and not the pearl, since Smegma is not a irritating substance in itself, unless there is a foreign body in there like lint, that can cause a bit of irritation. For the most part nothing will get under the foreskin but sometimes it happens, especially if separation is well underway.
You may also see a milky whitish discharge. This is smegma mixed with urine and is no cause for alarm. On occasion you may see a very large amount come out or it may just be a small amount.
Smegma can be the consistency of cottage cheese or it can be like liquid. It comes in many colors, pure white, yellowish, greenish, tan or a combination, it is often confused with pus. But the main thing between pus and smegma is that pus will have a really bad odor like an infection. While smegma may smell strong like unwashed genitals depending on how long it has been under the foreskin but not have an odor you would associate with sickness.
How do you remove smegma?
It depends on the age of your child.
In babies, you shouldn’t retract the penis, and you don’t need to use cotton buds or try to irrigate water into the foreskin. Just gently wash the outside of the penis at bathtime.
In older children with a retractable penis, they can gently retract their penis and wash the smegma away in their bath water or under the running water in the shower.
If the smegma has built up and is sticking to the skin, they can use a flannel or facecloth and gently rub the smegma away.
If the foreskin has separated before puberty, an occasional retraction with cleaning underneath it will do. Once or twice a week will be enough.
Once puberty starts, smegma should be washed away every time they shower. If this is left for several days, it may start to feel sensitive and sore underneath the foreskin.
Common foreskin problems
Like any other part of the body, sometimes things can go wrong with the foreskin. Especially if your child gets lazy and doesn’t wash their penis properly. So make sure your child knows there are consequences when we don’t care for our bodies properly.
Common signs that show there may be a problem include:
- A red and swollen penis.
- Your child cries or complains about it hurting when they pass urine (or pee).
- Their penis is red, sore and/or it may have a discharge or pus coming out.
- Their foreskin balloons when they pass urine (or pees).
- Your child also has a temperature.
If your child has any of these signs, then it is a good idea to see your family doctor.
The most common problems that I hear from parents are balanitis, paraphimosis and phimosis.
Balanitis. A common problem that happens when the penis and foreskin is not properly washed, is balanitis. Balanitis is when an infection causes the foreskin to become red, swollen and itchy. If this keeps on happening, it can cause scarring and lead to circumcision.
Paraphomisis. Another problem that can happen with older children, is paraphomisis. Paraphimosis is when the foreskin is retracted (rolled or pushed down so the head of the penis is exposed) and it can’t be pushed back up to cover the tip of the penis. This can be problematic if left untreated, and requires urgent medical treatment (especially if their penis becomes dusky or dark in colour). Paraphimosis isn’t as common as balanitis, but I do hear from a lot of tweens and teens in this situation (who find it really embarrassing to tell a parent, despite the pain). So make sure your child know that they should always return their foreskin to it’s original position (covering the head of the penis).
Phimosis. Phimosis is another problem that can happen, with parents presenting to their family doctor when they notice the foreskin ballooning when their child passes urine (or pees). Phimosis is when the foreskin is too tight to be retracted or pulled down over the head of the penis.
The circumcised penis
Circumcision is the surgical removal of the foreskin that covers the tip of the penis.
Circumcision usually happens to infants but we are now seeing it happen in older children and adults for medical problems such as:
- Scarring of the foreskin that stops it from retracting (phimosis).
- Recurring inflammation or infections of the penis (balanitis or lichen sclerosis).
- A foreskin that is too tight and causes pain or spraying when urinating.
- Recurrent urinary tract infections.
I have had quite a few chats with a paediatric surgeon about the increasing number of older children needing circumcision (a specialist who views circumcision as a last resort). He felt that he was seeing more older children because they weren’t being taught how to care for their penises. And they aren’t encouraged or taught to self-retract their foreskin. He thinks that if kids were self-retracting from a younger age, that he wouldn’t be seeing so many teens requiring circumcision because of tight foreskins.
What about adhesions?
Adhesions in circumcised penises can happen when the penile shaft skin adheres to the glans of the penis. The adhesion can be located anywhere around the head of the penis, ranging from a small amount of skin to quite a lot (to the extent that it can look as if the foreskin was never removed). They are usually painless and may even resolve on it’s own, with no treatment (depending on the type of adhesion).
Sometimes adhesions can happen when some of the foreskin has been left behind (after circumcision). Or it can happen because the penis is buried under the fat in the pubic or lower abdominal area (especially in babies that are chubby).
Most parents notice penile adhesions when the area around it becomes red and irritated. Or they may notice a white spot that looks and feels like a cyst around the head of the penis (smegma caught under an adhesion). Or notice smegma coming from the adhered area (a thick, white substance that can be found on all genitals). The accumulation of smegma can sometimes help with separating the adhesion. Smegma can also be mistaken as a cyst or pus under the skin.
The best way to prevent adhesions post circumcision (even after the penis has healed), is to gently pull back any excess skin of the penis shaft away from the head of the penis. This should be done a few times a day. You’ll need to check with the doctor who circumcised your child, as to when you should start doing this and for how long. If you don’t pull the excess skin back, the skin of the shaft can start to adhere to the glans. Penile adhesions may be more common if a circumcision left an excess amount of residual foreskin.
Also, once your child has an adhesion, there’s a good chance they will have more. This means that once the adhesion has healed, you will need to regularly retract the skin of the penis shaft to prevent another adhesion from recurring.
You can learn more in this article, about the different types of penile adhesions after circumcision and how they are managed.
Will my child’s penis now be less sensitive after circumcision?
This is a difficult question to answer, as it depends.
Yes, there are lots of nerves in the foreskin, but there are also lots of nerves in the head of the penis and within the penis itself. But the penis will still feel nice when touched, regardless.
And yes, the head of the penis will feel less sensitive as the skin toughens up whilst it adapts to chafing and rubbing from clothes (just like breaking in a new pair of shoes). But the penis (and the glans) will still feel nice when touched!
As a sexologist and a parent, I think we need to let kids know that their circumcised penis may look a little different to intact penises, but it will still work in the same way. This forum has some interesting comments from teens and young men about their experiences post circumcision.
At the end of the day, sexual touch is still going to be pleasurable, regardless of whether a penis is circumcised or not.
So yes, the head of their penis (or glans) may be a little less sensitive (and the jury is still out on this) but your child will never know the difference!
Do circumcised penises make smegma?
All genitals makes smegma, even circumcised penises.
It may not be as noticeable in circumcised penises, as the smegma will rub onto their underwear.
(Smegma is a thick, white substance found on all genitals, even in babies.)
How do I remove smegma?
With a circumcised penis, the smegma can be gently washed away at bathtime.
If the smegma has built up and is sticking to the skin, theyyour child can use a flannel or facecloth and gently rub the smegma away.
Erections
A lot of parents have questions about erections. So many questions that I’ve written a blogpost for them. You can find it here – How to talk to your child about erections.
Penis care for kids of all ages
As your child grows older, you’ll need to teach them to look after their own penis. This lesson becomes even more important during puberty, when personal hygiene is vital as their body begins to change and grow. Puberty also tends to be the age that things start to get smelly!
Can you use soap?
In regards to soap, that’s up to you.
Some people believe that you shouldn’t use soap at all when washing the sensitive skin of the genitals.
Too much soap and excessive cleaning removes essential body oils that normally keep our skin moist and reduce friction. And when it is left on the skin, it can cause skin irritation.
Whereas others say that it is okay to use soap, as long as it is properly rinsed away. If you do use soap, try to use one that is more natural – with less perfumes and additives in it. Generally, too much soap is worse than none at all. So if you use soap, use it sparingly.
And as always, do your own research so you can make an informed decision about whether to use soap or not.
Can you use baby wipes?
In regards to baby wipes, again… it’s up to you!
Some people will use them and some people won’t. If you do use them, try to find sensitive, fragrance-free baby wipes. You can even buy natural, chemical-free baby wipes.
If you decide to use baby wipes on your child’s genitals, you may want to first check that it won’t irritate his skin. You can do this on his leg or arm, and if there is no reaction in 24 hours, then you should be safe to use it on the genitals.
Babies and toddlers
Lots of parents are unsure about how to keep their baby or toddler’s penis clean (I still remember the uncertainty with my own son).
So let’s look at what you need to do!
Intact penis
With an intact penis, the motto is ‘If it’s intact, do not retract’ and ‘Only clean what is seen’.
So what does this mean?
At bath time, all you need to do is gently wash the outside of the penis. Dr Adrienne Carmack suggests that you wash the penis in the same way you would wash your finger.
If you ever notice poo collecting in the tip of the foreskin, just remove what you can see. And don’t be tempted to go digging with a cotton bud. The next time your child pees (passes urine), the poo will be pushed away by the stream of urine.
And remember, you never retract the foreskin. If you’re ever worried, check with your family doctor.
Circumcised penis
With a circumcised penis (that is fully healed), just gently wash around the outside of the penis as you would wash any part of the body. You will still need to pull the skin back so that you can wash around the head of the penis. Check the penis for redness and wash away old poo, nappy lint, and smegma. Just like when you clean and check the folds and creases in the rest of their body to wash away any foreign particles that can irritate the skin.
If your child has just been circumcised, you will need to follow the instructions your doctor gave you. This usually includes applying Vaseline and gauze around the area until healed. You’ll also need to change nappies more frequently so their penis is left as clean and dry as possible.
With all babies, be mindful of what you use to clean your child’s skin when changing their nappy or diaper. Baby wipes are often filled with fragrances and additives, which may irritate sensitive skin. So look for a baby wipe that is additive free. And watch for any redness or irritation on this sensitive part of the body.
Lots of parents talk about diaper lint or diaper fuzz that collects on their child’s genitals. It may be from the nappies or even wipes (and yes, it may even be smegma). Parents describe it as ‘fuzzy stuff’ or ‘stringy lint’ or even ‘fibres’. You can either remove it as you find it, or gently soak it off at bathtime.
So if this happens, and the lint or fuzz begins to irritate your child’s delicate skin, you may need to try a few different diaper brands or baby wipes until you find the one that works best. Every diaper is made differently, and some have a fine net inside them that can prevent excess fuzz. Don’t be surprised if it takes time to work out the cause i.e. is it the diaper or the baby wipes or both?
And don’t forget to let your baby have diaper free time (or nappy free time) each day. It gives their genitals a chance to air, will help their genitals to dry out (especially after wearing a moist diaper for most of the day) and is a great way to let rashes heal.
Drying the genital area properly after bathing is also important. This area spends a lot of time covered up, so you need to keep things as dry as possible.
Older children
As your child grows up and becomes more independent (and capable) you can slowly start to encourage them to care for their own body. Along with washing their own face and dirty feet, they can also start to wash their own genitals.
They will require many reminders before this becomes a part of their daily routine. And even once they hit puberty, it still doesn’t hurt to occasionally remind them too! When my son was younger, I would randomly ask him if he had been washing his penis properly (and often he hadn’t been).
Circumcised penis
If your child has been circumcised, just sitting in the bathtub or letting the shower water run over their penis should be enough. Now that they are no longer wearing nappies, the risk of skin irritation is low. If your child has loose skin that partially covers the head of the penis (the glans), you could encourage them to pull this skin down and to wash around the head of their penis (with their fingers or a soft cloth), as smegma may collect and irritate the skin if it left there for too long.
Intact penis
If your child has an intact penis, just sitting in the bathtub or letting the shower water run over their penis should be enough. It’s up to you, as to whether you want to teach your child to self-retract or not.
Read the section on self-retraction to learn more about whether you should teach your child to self-retract (or not).
If you want to encourage self-retraction, you can encourage your child to push back their foreskin, to wash away any smegma that they see, and to pull their foreskin back into position. They can either do this every couple of days to once a week, depending on how much smegma is there, and whether the skin is irritated or not. And make sure you tell them that they’ll need to pull the foreskin back into it’s original position when they’ve finished i.e. so that the foreskin covers the head of the penis.
And if they use soap, to make sure that it is all washed off properly before pulling the foreskin back. Otherwise they may end up with a sore penis.
Once puberty happens, you’ll need to tell your child that they need to do this more often, otherwise it will get sore and smelly underneath the foreskin. Some will wash under their foreskin daily whereas others will only wash every 2-3 days. Everyone is different. So if there’s lots of smegma (or it gets sore) you’ll need to wash under the foreskin more often.
Also let your child know that if ever their penis is sore, or it hurts to pee, they need to let you know! This way you can help to get things fixed before it worsens and causes more problems than it should.
As long as the foreskin is easily retractable, and isn’t forced, everything should be fine. Remember, forcing can cause scarring and problems in the future. So tell your child, that if it hurts, they should stop what they’re doing.
Resources about penises and foreskins
Planet Puberty has a simple guide on cleaning your penis, with an illustrated printable that shows how to wash an intact and circumcised penis.
My list of children’s books about private body parts contains books that are mainly about genitals. There’s also a few books in there that are just about penises. The more general sex education books (that cover a lot of different topics) also include a page on naming the genitals.
I have a blogpost that will help you to start naming private body parts.
I have a detailed parent guide about private body parts, that will walk you through the many different conversations you may want to have with your child about penises.
If you are looking for age-appropriate illustrations of penises, then my anatomically correct cartoon illustrations have quite a few penises inside them.