Here’s something you may not know. A tight foreskin is not always true phimosis.
There are two things that are common to boys that remain uncircumcised at birth:
- Their foreskin is always physically fused to the glans underneath
- Their foreskin opening is usually too narrow to pull over the glans
This means that every intact boy is born with a tight foreskin which is a normal part of male anatomy and does not require any treatment. A tight foreskin at this stage is not considered true phimosis.
As the child gets older, the foreskin begins to separate from the glans and the opening of the foreskin widens.
The following statistics can give you a good idea of what your chances of spontaneous recovery really are.
Here are some estimates of when the foreskin becomes retractable by age:
- At birth almost 100% of children have a tight foreskin
- By 6 months of age over 20% of children have a retractable foreskin
- By age 1 over 30% of children are retractile
- By age 2 the number doubles to about 60%
- By age 7 about 80% of children can retract their foreskin
- By age 15 less than 10% of boys can’t retract their foreskin
- By 18 about 2% of boys remain unable to pull their foreskin back all the way
There are two things to deduce from this.
Firstly, a tight foreskin is fairly common until the late teen years and secondly, most cases of tight foreskin keep resolving on their own with age.
As you can see from the estimates above, unless a child has other complications, simply having a tight foreskin is nothing to be concerned about.
However, let’s put the same statistics in another way and you begin to see when phimosis really becomes a concern:
- At birth there’s a 2% chance that the child’s foreskin will remain tight
- By age 2 there’s a 5% chance of it developing into adult phimosis
- By age 7 there’s a 10% chance of it remaining as is
- By age 15 you have a 1 in 4 chance of staying non-retractile
- By 18 if your foreskin still doesn’t retract, it will probably remain that way for life
In other words, after the age of 15, the older you get the less likely it is for your phimosis to go away on its own.
Here are a few more important things to note:
If you were born with a tight foreskin and never injured it, your chances of outgrowing phimosis are close to the numbers above – Being born with a tight foreskin means it’s natural to your physiology and will either treat itself or will be much easier to treat that pathologic phimosis.
If you were born with a tight foreskin and injured it, your chances of spontaneous recovery are much smaller than shown above – Many times concerned parents injure a child’s foreskin by trying to force it down. Other times a boy may develop a urinary infection that affects the foreskin and injures it. Regardless of how the foreskin experiences damage, the physical attributes of the foreskin change and now the same rules of expansion don’t apply to it. Where at age 7 you would have had an 80% chance of the foreskin growing and fixing itself, an injury may now hold back that potential for growth and significantly reduce your chances of recovery.
If you had a normally functioning foreskin and it became tighter later in life, you have the least chances of recovery – A foreskin that tightens not because it’s been that way but because something happened to it is called pathological phimosis. This is the worst kind of phimosis to have and has the poorest long term outcome.
There could be many reason a foreskin can tighten during a person’s life. It could be from physical trauma, infections, exposure to irritants, etc. Regardless of the cause, the fact that the foreskin responded by tightening means that its physiology has changed and it is has no reason to revert to its old healthy state.
Usually, pathological phimosis sufferers have some degree of scarring in the foreskin orifice that also nullifies any attempt at treatment with manual stretching or steroid creams. In these cases, the patient needs to either give more time for conservative treatments to work or opt for more aggressive treatment options.