What Happens To The Skin After Circumcision

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Penile adhesions and skin bridges can occur in both circumcised and uncircumcised boys. They occur when the skin surrounding the penis adheres to the head of the penis or the glans.

Types of Penile Adhesions

Adhesions course when the skin on the shaft of the penis attaches itself to the glans (the bulb-shaped head of the penis). Adhesions are especially common in babe boys who appear to have a "hidden penis," in which the unabridged penis seems to disappear every bit the baby puts on fat in the pubic area. In that location are 3 types of penile adhesions:

Glandular adhesions: These adhesions occur when the skin that's attached to the glans covers the coronal margin—the regal line that separates the glans from the shaft of the penis.
Penile pare bridges: These adhesions are thicker, potentially permanent, and may need to be corrected surgically.
Cicatrix: This type of adhesion, which is basically scar tissue, can develop when the penis drops dorsum into the pubic fat pad and the surgical expanse contracts, essentially trapping the penis and making it impossible to betrayal the glans at all.

Symptoms

While penile adhesions are usually visible to the naked centre, they may have no other symptoms and often do not cause any type of pain. Consequently, the penis may look like it's buried in the pubic fat pad. If the adhesions persist, the boy may feel a tugging sensation during erections as he continues to grow.

In uncircumcised boys, sometimes oil and expressionless skin cells can get trapped under the foreskin and cause a white discharge chosen smegma. Although this belch can look like pus, it's non an infection nor is information technology a sign that anything is wrong. Still, it'south a good idea to get it evaluated by your pediatrician if information technology persists.

Causes

At that place are a multifariousness of reasons why penile adhesions and skin bridges tin occur in children who are circumcised and uncircumcised.

Uncircumcised Penises

When a penis is not circumcised, the foreskin may attach to the glans, causing an adhesion if the foreskin is not retracted or pulled back periodically once the foreskin has naturally released from the glans. Adhesions may likewise occur when the skin of the shaft is pushed forrad by a large pubic fat pad.

It's normal and expected for the foreskin of an uncircumcised newborn to be fastened to the head of the penis—this is not considered an adhesion. Usually, the foreskin isn't able to be retracted until the kid is several years former.

Caregivers should never attempt to retract or force dorsum an uncircumcised infant'south or young child'due south foreskin. As the child gets older, the foreskin will naturally brainstorm to dissever from the caput of the penis, allowing for rubber retraction. If information technology does not, your child's pediatrician may await for signs of a penile adhesion.

If the foreskin tightens over again afterwards in life, it may exist an issue. The tightening could exist the effect of skin irritations from chronic adhesions, which requires an evaluation past your child's doctor.

Circumcised Penises

Circumcision is not medically necessary for infant boys, simply some parents may choose to have their babe circumcised, a procedure in which the skin around the tip of the penis, known as the foreskin, is surgically removed. If done, the process is performed in the hospital before long after birth or, in the case of Jewish families, in a religious ceremony known as brit milah or bris about eight days later nativity.

In either case, as long equally the circumcision is performed by a trained professional, the process is relatively low risk. There is, however, the risk of developing penile adhesions after circumcision.

Adhesions can develop in circumcised boys if an excess of the foreskin is left behind after circumcision. They also can occur when the remaining pare is non retracted or pulled back frequently enough during circumcision intendance.

Adhesions can likewise develop as the circumcised infant develops more fat in the pubic area. As this happens, the skin may go irritated and stick to the surrounding tissues. When this occurs, the penis tin announced trapped or similar it disappears in the pare or fat pad.

Diagnosis

Usually, penile adhesions are benign and crusade no pain or discomfort. In fact, you may not even notice them until your child'due south md points them out at a routine physician's visit.

If yous do discover what looks like an adhesion while irresolute your baby'southward diaper, yous may want to phone call your doctor'due south office to schedule an date. While penile adhesions are typically not an emergency, you practice need to accept them evaluated by your child's doc. This way, you can begin treatment right away and forbid the skin from adhering further.

Treatment

When a babe develops a granular adhesion, it's likely your md volition recommend simply applying petroleum jelly to keep it soft and otherwise leaving it alone. Somewhen, a white substance called smegma, a mix of dead skin cells and secretions from oil glands, volition begin to form under the stuck skin, gently helping it to split from the caput of the penis.

This substance, along with spontaneous erections, will eventually have care of the adhesion. Smegma may look a bit like pus, so don't exist alarmed when yous see it but exercise phone call your pediatrician if you aren't certain.

The other 2 types of penile adhesions require more involved treatments. Pare bridges usually tin exist surgically separated in an outpatient procedure. In extreme cases in circumcised boys, the circumcision may take to be redone, which is chosen a circumcision revision.

To treat a cicatrix, which is sometimes called a trapped penis, your child'south pediatrician may prescribe a corticosteroid, such as betamethasone. Research shows this can exist an constructive way to avoid surgery, every bit was the case for 11 of 14 baby boys in 1 small written report who were treated with betamethasone three times a day for three weeks.

The medication softened the cicatrix enough to easily release it with gentle retraction, or pulling back, of the foreskin. Another option, which tin be performed in the role with local anesthesia, is to lightly stretch the skin and follow upward with the cream. This retracting action should never be performed at home.

The results of this combination therapy have shown that babies often don't require follow-upwards treatment, different using the cream alone. Conspicuously, these methods are the preferred choice compared with having to go through a revised circumcision. But in some cases, surgery will still be required.

A Word From Verywell

When dealing with penile adhesions, parents may be worried that their babies will accept to undergo additional treatments or surgeries. But in most cases, the complication is not serious and the condition will heal with minor, non-surgical interventions. Consult your dr. to find out all available treatment options.

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Palmer J, et. al. The use of betamethasone to manage the trapped penis post-obit neonatal circumcision.J Urol. 2005;174(four Pt 2):1577-8. doi:x.1016/S0022-5347(01)68726-3
Alpert SA, Ching CB, Dajusta DG, McLeod DJ, Fuchs ME, Jayanthi VR. Combination handling for cicatrix after neonatal circumcision: An function-based solution to a challenging problem. J Pediatr Urol. 2018;fourteen(five):471-475. doi:10.1016/j.jpurol.2018.05.022

Additional Reading

Children'south Hospital of Philadelphia. Penile adhesions.
Cleveland Clinic. Penile adhesions and skin bridges. Updated July fifteen, 2016.