Foreskin cracks in men and children

The foreskin is a fold of skin that covers the head of the penis outside of sexual arousal. During an erection, it moves toward the base, exposing it. It happens that the skin petal is damaged, causing redness, swelling, and then cracks, causing men a lot of discomfort and suffering.

Epidemiology

According to statistics, 9 out of 10 boys have problems related to the inability to retract the foreskin. In adult men, phimosis to a greater or lesser degree occurs in approximately 14% of those who consult a urologist. [ 1 ]

Balanoposthitis is recorded in 3% of males. [ 2 ]

Causes foreskin cracks

The formation of cracks in the foreskin occurs for several reasons. Here are the most common ones:

• phimosis or narrowing of the foreskin - is divided into physiological (age-related) and pathological. Most boys under 16 years of age have a congenital problem with the exposure of the head; [ 3 ]
• balanoposthitis – inflammation of the glans and foreskin. In adults, it is caused by infection, inflammatory dermatoses, allergies, precancerous skin conditions. In children, infection most often occurs with opportunistic flora, which is constantly present in the body; [ 4 ]
• mechanical trauma. [ 5 ], [ 6 ]

Risk factors

There are factors that increase the risk of cracks forming:

• improper care of the genital area (smegma accumulates between the head and the foreskin, which becomes infected if hygiene is not performed in a timely manner);
• use of detergents that cause irritation;
• diabetes mellitus, which reduces the body's immune defenses.

Pathogenesis

The mechanism of narrowing of the foreskin is not completely clear, but it is associated with a lack of connective tissue, which occurs due to genetic predisposition. During puberty, there is sometimes a discrepancy between the development of the head and the skin that forms a ring around it.

The pathogenesis of inflammation is the same, regardless of its localization: under the influence of a pathogenic irritant, the cells and tissues of the organ are destroyed, exudate is released, then comes the productive stage of tissue restoration. Frequent relapses thin the skin, making it vulnerable to the slightest physical impact.

Symptoms foreskin cracks

Cracks appear on the inner side of the skin leaf. They can be small, unnoticeable, not causing pain, or large, which cannot go unnoticed.

The first signs that indicate the presence of pathology are pain that occurs when retracting the foreskin, urinating, sexual intercourse and forces a visual examination of the organ. This is where redness, cracks, and swelling are found.

• Cracks in the foreskin in diabetes

Often, hyperemia of the head of the penis is a hint to the endocrinologist about diabetes, since sugar is excreted with urine, its remains settle on the skin, serving as a breeding ground for bacteria and fungi. [ 7 ]

This is how a pathological process occurs, leading to cracks, and sometimes ulcers and erosions, which are difficult for a weakened immune system to cope with. Scarring of wounds leads to narrowing of the openings of the foreskin - phimosis.

Crack in the foreskin of a child

Almost all little boys have a foreskin that completely covers the head of the penis, and this should not worry parents until they complain of pain or see a red tip of the penis.

As the child grows, starting somewhere around 3 years old, the skin fold gradually stretches, and the head begins to be exposed. A crack in the foreskin of a child may appear if hygiene rules are not followed. During bathing, the groin area should be washed with soap and rinsed with clean water, without exposing the head, and washing should be done with liquid baby soap.

Complications and consequences

Cracks in the foreskin often result in severe scarring, which narrows the rim around the head of the penis and leads to difficulty urinating or its complete retention, preventing sexual intercourse. Pinching of the head is fraught with edema, congestive hyperamia, sometimes even tissue necrosis.

If purulent exudate gets into the cracks, it is dangerous because it can cause cancer. [ 8 ], With balanoposthitis, lymphangitis often develops – inflammation of the lymphatic vessels of the penis, and then inguinal lymphadenitis.

Diagnostics foreskin cracks

A urologist diagnoses a crack in the foreskin by conducting a visual examination, clarifying individual details regarding concomitant diseases, whether there were problems with exposing the head before, whether there were sexually transmitted infections.

To clarify the diagnosis, a smear is taken for culture, analysis for syphilis, herpes, glucose level. A consultation with an allergist may be prescribed.

Differential diagnosis

Differentiation of the disease that causes cracks is very important, as the treatment plan depends on it. It occurs between STIs, phimosis, balanoposthitis, diabetes mellitus and other pathologies that can lead to defects of the foreskin.

Treatment foreskin cracks

In addition to tactics aimed at treating the underlying problem, local therapy is used, which consists of the following:

• proper daily hygiene care, including warm baths with decoctions of anti-inflammatory and antiseptic medicinal herbs;
• limitation of sexual intercourse, refusal of masturbation;
• wearing swimming trunks made from natural fabrics;
• application of healing ointments.

In case of balanoposthitis, antibiotics can be taken orally. In case of detection of sexually transmitted infections or human papillomavirus, long-term and serious therapy is required.

Medicines

The main means for healing cracks in the foreskin are ointments

Based on antifungal, anti-inflammatory, antibacterial components. After washing with warm water and drying, you can resort to applying the following preparations:

• Bivacin is a combination antibiotic that has a destructive effect on most gram-positive and gram-negative bacteria. It is packaged in a tube with ointment and an aerosol can. The ointment is applied in a thin layer to the affected area, the can is shaken and sprayed from a distance of 20 cm. The frequency of the procedure is 2-3 times a day. When it gets on the skin, pain and burning may be felt. The drug can cause an allergic reaction, so a preliminary test should be done;
• triderm is an ointment that combines 3 components: anti-inflammatory, antifungal and antibacterial. It is applied to the genitals by lightly rubbing twice a day: morning and evening. The duration of use should not exceed one week. The drug is not recommended for children, due to the lack of testing in this age group;
• Cortomycetin is an ointment that combines an antibiotic and corticosteroids. It can be used not only for adults, but also for children over 2 years old. Apply twice a day to the skin. It can cause burning, dryness, itching, and hypersensitivity reactions;
• levomekol – promotes healing, has an antimicrobial effect, accelerates cellular regeneration. Can be used starting from 3 years, lubricating cracks for 4-5 days;
• Bepanten 5% - reparative ointment, its use does not lead to overdrying of the skin, can be used after applying corticosteroids. Creates a fatty protective shell. Suitable even for the smallest. It is used once a day or several times if necessary. It practically does not entail side effects.

Vitamins

The development of inflammation of the skin of the head and the inner leaf of the foreskin, leading to the formation of cracks, is facilitated by a lack of vitamins C, B2, B6, PP and others. Therefore, it is important to saturate your diet with products containing them, periodically drink vitamin complexes.

Physiotherapy treatment

Of the entire arsenal of physiotherapeutic methods, in case of cracks in the foreskin, baths with a decoction of chamomile, plantain, elder flowers, echinacea, motherwort are suitable. They, unlike a solution of potassium permanganate, do not dry the skin and do not lead to rough scarring.

Surgical treatment

Surgical intervention is performed in case of phimosis. This operation is called circumcision and is the cutting off of the foreskin. In other cases, only conservative treatment is used. [ 9 ], [ 10 ]

Prevention

The main preventive measures to prevent the formation of cracks in the foreskin are daily hygiene using mild hypoallergenic soap solutions, and annual examinations by a venereologist and urologist to identify problems.

In diabetes, it is important to keep blood glucose levels under constant control. It is also necessary to use protection against sexually transmitted infections during contact with a woman, and avoid traumatic effects on the head of the penis.

Regarding children, parents should not use force to open the head of the penis. The child should be able to retract the foreskin to the point where it does not cause discomfort.

Forecast

Timely visits to a doctor and treatment of problems make the prognosis of the disease favorable.