Springdale Mason Pediatrics

Foreskin Infection

Definition

  • A bacterial infection of the space between the foreskin and head of the penis
  • The medical name is posthitis

Call or Return If

  • After 3 days on antibiotic ointment, still has pain
  • Foreskin not healed up in 1 week
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • Foreskin is pink or red.
  • The foreskin is also often swollen.
  • Passing urine thru the tender foreskin causes pain or burning.
  • Pus or cloudy discharge may drain from the opening of the foreskin. This means a bacterial infection has occurred. Usually, the inside of the foreskin just looks reddened.
  • Rare to have any fever.
  • Peak age is 2 to 5 year old boys who are not circumcised.

Cause

  • The infection is in the closed space under the foreskin.
  • May start as reddened foreskin from getting soap or bubble bath trapped under it.
  • May also start in a small cut. Cuts can be caused by pulling the foreskin back with too much force.
  • Then germs get on the foreskin while touching it with dirty hands to pee.
  • Usually, the foreskin is tight and can only be retracted a little. This makes it hard to keep the area clean.
  • If there is pus, the most common bacterial cause is Strep. (as in Strep throat)
  • Frequent bouts of foreskin infection often means the child needs a circumcision. This is when the foreskin is removed.

Prevention of Future Infections

  • Wash the hands before touching the foreskin and penis.
  • Retract and clean under the foreskin at least weekly.
  • Don't leave any soap under the foreskin.

After Care Advice

Overview:
  • Infections under the foreskin are usually mild.
  • If treated early, an antibiotic ointment usually works.
  • Sometimes, an antibiotic given by mouth is needed.
  • Here is some care advice that should help.
Clean Under the Foreskin:
  • Cleaning the infected space is the most important step.
  • Retract the foreskin as far as it will go easily. Be gentle.
  • Then wash the exposed head of the penis gently with warm water. Reason: To help prevent foreskin infections.
  • Do not use soap or leave any soap under the foreskin. Reason: This can cause redness and swelling.
  • Wipe away any pus or dried discharge that you find there.
  • After cleansing, dry the head of the penis.
  • Then always pull the foreskin forward to its normal position.
  • Other option: soak in warm bath water without any soap in it. Shake the penis in the bath water
  • Do this 2 times per day to help clear up the infection.
Antibiotic Ointment:
  • Put an antibiotic ointment on the head of the penis and under the foreskin. No prescription is needed.
  • Do this 2 times per day.
  • Examples are Bacitracin or Polysporin. You can also use one you have at home.
  • Repeat the cleansing followed by ointment 2 times per day.
  • Keep using the ointment until the foreskin looks normal.
Antibiotic by Mouth:
  • Sometimes the infection needs a prescription antibiotic to clear it up.
  • The drug will kill the germs that are causing the foreskin infection.
  • Give the drug as directed.
  • Try not to forget any of the doses.
Foreskin Partial Retraction - How to Do It:
  • Start gentle partial retraction at 1 to 2 years of age.
  • It can be done once per week during bathing.
  • Gently pull the skin on the shaft of the penis backward towards the stomach.
  • This will make the foreskin open up. You will be able to see the part of the glans (head of the penis).
  • Be gentle. Pulling the foreskin back should never cause pain or crying.
  • Then clean the area with warm water.
  • Normal cleaning under the foreskin only needs to be done 1 or 2 times a week.
What to Expect:
  • On treatment, pain when passing urine should be gone in 2 days.
  • Foreskin should look better by 3 days.
  • Foreskin should look normal by 1 week.
Return to School:
  • The infection cannot spread to others. No need to miss any child care or school.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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