What to do if you have a tight foreskin – AKA phimosis

I was probably about 11 when I first realised my dick was different. It was during my first few weeks at secondary school, staring at the endless gallery of illustrated cocks that were scribbled on the walls of the boys’ bogs – none of which looked like mine.

Unlike those painted onto school books and bus stops, my foreskin wouldn’t fully retract over my glans. I learnt via the internet that I had a condition called phimosis – or a tight foreskin. The condition affects around 10 per cent of boys aged three and then decreases through puberty, with an estimated 1-5 per cent of 16-year-olds having a non-retractable foreskin.

Dr Challacombe has been working as a urologist in London for 10 years. He says that he can expect to see between 5 and 10 patients every week who have phimosis. “It’s pretty common. It can be congenital or it can develop due to something happening to the foreskin – most often chronic irritation or infection,” he explains. 

Despite it being under-discussed, phimosis has been around for centuries. Some historians cite it as the reason that Louis XVI of France was unable to impregnate his wife in the late 1700s. Just over a decade later, Charles J Guiteau’s assassination of US president James A Garfield was, at the time, believed to have been caused by phimosis-induced insanity. 

It wasn’t until I was 17 (and spurred on by a few bottles of Lambrini) that I found the courage to tell a friend about what I was experiencing. After a few failed and extremely painful attempts at home stretching, I finally went to see my GP. They offered me a few different methods of treatment but told me that circumcision was the only one that would be 100 per cent effective. After weighing up the pros and cons of a cut cock, namely the decreased risk of STIs and penile cancer, I decided to go full out. 

Admittedly it was painful, debilitating and a little humiliating – but not without its humour; I recall my dad frantically searching for a cricket guard so I could attend Leeds Festival post-surgery, a friend drunkenly sobbing over my dearly departed foreskin in a beer garden, and my grandparents awkwardly navigating cock convo over episodes of Countdown. 

“There’s something embarrassing about your private bits having problems. We are not used to discussing it, and it makes you feel abnormal and weird when you’re dealing with something like this. People might laugh or think you’re gross, or find you unattractive because of it” – Alex 

Despite a few years passing since my own circumcision, phimosis still remains a taboo topic with many men embarrassed to address it. From a queer perspective, you only have to have a quick scroll on Grindr to see men announcing their distaste for tight foreskins, which doesn’t really spur you on to speak openly about the issue. “I was an awkward scared gay kid who didn’t fit in with other boys and therefore missed out on locker-room-lad-culture, so I didn’t get the same opportunity most boys do to learn what’s ‘normal,” says Alex from London, who discovered he had phimosis after his first sexual encounter, aged 16. “There’s something embarrassing about your private bits having problems. We are not used to discussing it, and it makes you feel abnormal and weird when you’re dealing with something like this. People might laugh or think you’re gross, or find you unattractive because of it. Nobody really cares though. Ultimately what I’ve learnt is that people actually respect you more for being brave enough to talk about these things.”

Aside from circumcision, which remains one of the more popular treatments for phimosis, there are other treatments available. Some opt for preputioplasty, which is where the foreskin is surgically widened, or a frenectomy, a procedure which sees you surgically have your “banjo string” cut in order to release the foreskin. while many instead utilise non-surgical treatments like steroid creams and home stretching. A GP will be able to explain what options there are for you, as it differs depending on the person. Alex used the internet as a guide for DIY treatments to cure the condition. His home healing attempts were successful, and after a year of stretching his foreskin at home, it’s now fully retractable. “I now realise it’s quite common and nothing to be ashamed of. I figured out early on that it wasn’t my fault that I had Phimosis. I now have a fully functioning beautiful penis, and I’m quite proud of myself!”

Dan from Leeds, discovered he had phimosis when he was 13 years old. He recalls spying on a boy at the urinals and realising that his penis looked completely different to his own. “I spoke to my parents – I remember my dad showing me how he pulled his foreskin back. I still struggled. At this point, my mum booked a doctor’s appointment who explained the possible procedures I could have to alleviate the symptoms.” He remembers feeling confused and a little scared, wondering whether everyone went through the same experience and why he’d only just found out about it as a teenager. 

Dan decided to have a frenectomy, which is one of the alternatives to circumcision. Despite fainting before the first attempt, his surgery was successful. Unlike many others, Dan doesn’t feel embarrassed about sharing his experiences. “I suppose anything sex-related is private and can be embarrassing, but I’m speaking today about it with no issue! I look forward to an episode of Sex Education on Netflix that covers the topic!”

Despite the options available, some people still decide to avoid the issue and feel it doesn’t affect their life enough to take any serious action, as one anonymous man told me: “Aside from my teenage angst about it, I’m quite at peace with it now. In terms of sex I’m always a bottom, and could count on one hand the times I’ve tried topping people, so phimosis doesn’t really get in the way of sex,” he explains, “I’ve just come to learn how far it can go. When I have topped I’ve just used a condom and copious amounts of lube, but I don’t remember it being overly uncomfortable.”

“If you have phimosis, it won’t just go away so something will need to be done. If the foreskin gets too tight it can become non-retractile and even close to the point of obstructing the flow of urine. Smegma can build up underneath and you can’t clean it and it can lead to infections and irritation” – Dr Challacombe, urologist 

Dr Challacombe is keen to ensure that people are aware that phimosis is a stressful condition and that men who have it require a lot of empathy and support when approaching the topic. He refers to a unique case in Alex Hardy, who took his own life after a circumcision that was linked to phimosis while living in Canada. “It can stop men from wanting to have sex and therefore really affect their relationship. But urologists are used to talking about this, and assessing it and treating it.

“Overall if you have phimosis, it won’t just go away so something will need to be done,” he explains. “Treatment is advised. If the foreskin gets too tight it can become non-retractile and even close to the point of obstructing the flow of urine. Smegma can build up underneath and you can’t clean it and it can lead to infections and irritation.” Leaving it untreated also increases the risk of paraphimosis, which is where a tight foreskin is forcibly retracted and can become swollen and stuck, which may slow or stop the flow of blood to the tip of the penis. This is considered a medical emergency. 

Despite how embarrassing the experience was for me at the time, I know I made the right decision in seeking medical help and getting circumcised. The NHS offered me a lot of support in helping me understand the condition and how to overcome it. It almost felt like a right of passage to take this issue into my own hands and get it sorted. I’ve had no problems since, and now feel comfortable speaking about my circumcision story, even without the help of a bottle of Lambrini… 

If you think you might have phimosis you can find further information here.