Lifestyle & Health : Treating tight penile foreskin

October 18, 2016

Dear Readers,

Diabetic L.R. says his penile foreskin becomes "tight" at intervals and is a hindrance to enjoyable sex. He doesn't sleep around. He notices at times a white discharge on the head of his penis. He washes the area only with water and applies a cream, which helps. He also applies cider vinegar diluted with water and this also helps, but there is no permanent cure. He asks why the tight skin occurs and for a more long-lasting treatment.

All diabetic men are at a higher risk of experiencing penile foreskin tightness than the regular male population. This as the cause of penile foreskin tightness is most often an infection, and in most cases the infecting organism is yeast (Candida albicans).

Yeast is an organism found normally over and inside our bodies, and it is only under certain conditions that it manifests as a disease. The yeast Candida is located under the foreskin of many healthy, uncircumcised men.




It does not normally overgrow in these men to cause disease. It is only under certain conditions - heat, sweat, increased moistness in the area, poor hygiene, compromised immunity, and uncontrolled blood sugar - that the pathological form of yeast manifest.

Some risk factors for this occurrence which often is the cause of phimosis, or tight penile foreskin are:

• Poorly controlled diabetes, which increases the level of blood sugar reaching moist skin areas that allows the candida to be well fed and enhances its growth.

• Medical conditions which tend to weaken the immune system, like diabetes, HIV, prolonged use of corticosteroids, cancer treatment drugs, chemotherapy.

• Antibiotic use, which wipes out both bad bacteria as well as good commensal bacteria and which then, by sparing the fungal organisms, allows them to overgrow.

• Uncircumcised men who do not wash the penis often may also get recurring penile foreskin infections. Each time uncircumcised men bathe, they need to pull back the penile foreskin and properly wash both penis and foreskin. When this is not done, a cheesy-like material called smegma builds up under the foreskin, which irritates the skin and favours candida infection.

• Increased moisture in the genital area, mostly in the form of sweat, facilitates growth of yeast and other infecting organisms. Men should wear loose boxer underpants rather than close-fitting briefs if they are experiencing the problem of recurring penile foreskin tightness as this helps to keep the groin area and penis cooler. Keep the genitals cool and dry! Change underclothing more frequently.

• The use of harsh soaps when bathing or incorrect lubricating gels for sex can injure the penile skin and allow inflammation and growth of abnormal organisms.

• Sexually transmitted infections (STIs) can lead to penile foreskin infections.

Signs and symptoms of penile foreskin infection:

• White, curd-like discharge under the foreskin.

• White plaques seen under the foreskin.

• Mild itching of the penile head and foreskin.

• Redness of the penis and foreskin.

• Burning on urination.

• Penile and foreskin ulcers.

• Odour.

• Tight penile foreskin which can be difficult to retract.

It is always best to visit a doctor when any abnormal condition persists for long. When penile phimosis occurs for the first time in a grown man, he should have his blood sugar level checked to rule out the possibility of diabetes developing. When it recurs often in a diabetic, this is often an indication that the blood sugar levels are poorly controlled and medications may need to be adjusted. The doctor may also wish to test for other disorders associated with this condition, such as STIs and HIV, as well as treat the phimosis (penile foreskin tightness).

When the foreskin tightness is experienced repeatedly, a doctor should be consulted as repeated infections can lead to scarring of the foreskin eventually, with a permanent inability for the foreskin to retract.




There are several antifungal and antibiotic preparations used topically as skin creams, as well as taken orally, which can be used successfully to treat the skin infections causing the foreskin tightness. Steroidal skin preparations also help with resolving the inflammation.

These are prescribed medications obtainable from a pharmacy with a prescription. Note also that alcohol favours these foreskin infections; and it is a very good practice to avoid alcohol use when this kind of infection becomes bothersome. Also, minimise sugar intake, even if you aren't diabetic.

Good hygiene is always important and the penis must be washed every day and dried properly afterwards. When the topical and oral routes of treatment don't work then surgery in the form of penile circumcision may be advised.

The apple cider vinegar wash mentioned by L.R., when used on the genitals, is thought to be helpful in treatment of penile phimosis. Yoghurt, is also helpful when plain acidophilus yoghurt which does not contain sugar or any other added ingredient, is used. Apple cider vinegar results from the fermentation of pulverised apples. It is an antioxidant, antiseptic and antifungal agent which is used to help in the treatment of several disorders such as acne, Indigestion, high blood cholesterol, diabetes, obesity, skin problems, dandruff and fungal skin infections.

For use in all yeast (fungal) infections as well as those which affect the genitals and penile foreskin, one tablespoon in one quart of water of apple cider vinegar should be applied over the affected areas three times daily for it to work properly. Long term use of apple cider vinegar requires physician monitoring as it can have side effects in older people who have osteoporosis or suffer from low potassium blood levels.

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