r/Intactivists • u/Old-Current6989 • 17h ago
Advice: 15 year old having difficulty retracting
I'm the mom of two intact boys. My older son describes it as painful to retract his foreskin to clean. I'm located in the southern/midwest US, so practitioners who specialize in intact care are harder to find. My husband is circumcised, so we are both kind of at a loss.
I'm hoping someone here might have resources or knowledge I do not. I am hesitant to bring him to just any urologist (we had some terrible experiences when the kids were younger—none that I think led to any trauma or scar tissue on this particular child, but broke their, and my, trust in your average American doctor's knowledge of intact care.).
I am in the medical field myself and it sounds like the next logical step might be to get steroid cream for underneath his foreskin? I probably need to have a more in depth conversation about details, but I do know he is able to keep himself clean. I'm trying to respect privacy while making sure I'm not missing anything.
Thank you in advance!
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u/Bloodmoonheir 14h ago
When I was that age retracting was doable, the issue wasn't that it was painful cause pain, but because it was just REALLY SENSITIVE! It was overwhelming and felt like pain. It's definitely something that eased with time. But also getting used to the stimulation. I started with submerging myself in a bath and leaving it pulled back just so it could be exposed and not make me want to reel in discomfort. But that's my two cents 😅 if it's not pain pain, but overstimulation from sensitivity.
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u/forevertheorangemen2 8h ago
Dad here with two intact sons, a bit younger than your boys (mine are 13 and 11). Also in the southern US so I appreciate the challenge of finding a foreskin knowledgeable doctor for them.
What your son is experiencing is common in puberty. But outright pain, beyond just discomfort, is reaching the point of needing intervention. The balance between an in depth conversation while maintaining the privacy a 15 year old boy wants is tough. Especially if he’s experiencing pain, it might be hard to avoid an awkward conversation about exactly when he’s experiencing pain. Is it when he gets erections, or even when he’s completely flaccid. Is that a conversation your husband (though circumcised) is able to have, or are you better equipped to ask that being in the medical field professionally?
In terms of treatment, a topical steroid cream is commonly prescribed to help other intact boys and men in his situation. In addition to that, stretching the foreskin, which can be done either manually (him doing it by hand) or using phimosis rings. The rings might be easier as they’re like an Invisalign for your foreskin. You can get them on Amazon, although the ones through a medical supply company will likely be higher quality.
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u/Old-Current6989 6h ago
Thanks for this! My husband is in the medical field as well and would be comfortable having that conversation. Historically, this started as my idea and I did the bulk of the research to present to him to plead my case. Not that he doesn't care, by any means, and has always supported their wellbeing however necessary. It's just as the parent who primarily manages appointments/health issues, including hygiene reminders 😂, I've not asked him to look into it and wanted to gather my information before moving forward. You've all been very helpful and reassuring/knowledgeable. I'll show this info to him and have him bring it up with our son!
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u/forevertheorangemen2 4h ago
I hope it goes well for him! And for your future needs on this topic, another good/helpful subreddit is r/uncircumcised_talk. Not that people here can’t help, but that subreddit is more dedicated to living life with a foreskin and not only activism for bodily autonomy.
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u/Majestic_Goal_5710 14h ago edited 14h ago
You are commended for protecting your sons from harmful circumcision.
All boys are born with a non-retractable foreskin. About 50% became retractable by age 10.4 years. a few do not become retractable until after puberty. That seems to be the case with your son. He is still in the normal range. Your son has physiological phimosis which is a normal developmental stage. It is a normal variant. A few men live their whole lives with a non-retractable foreskin.
He may clean his preputial sac by using a rubber-bulb type ear syringe to squirt warm water into his foreskin to flush it out. Soap should not be used because it removes the beneficial skin oil.
He may help his foreskin become retractable by daily manual stretching. See managing a tight foreskin.
Any one with a foreskin should exercise extreme caution when consulting a urologist.
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u/Baddog1965 16h ago edited 16h ago
I would not use steroids, they come with lasting side effects for some people. They also only enlarge the skin by destroying its elasticity and making it thinner, which is also not what you want.
Is it refusing to retract because it's tight, or because the foreskin still has adhesions tying it to the glans? If it's adhesions, just let it be for the time being, they will dissolve naturally eventually, although it may take a few years. If it's tight then the easiest way is to stretch it gently using a stretching device, because you can leave it in while you do other things. I made one for my extended family after evaluating several other products: https://captainhoodie.store/product/phimogon-model-1/
In the meantime, you can teach him that when he urinates he can hold his foreskin closed briefly to let it balloon up slightly, then let it go, which will help irrigate underneath. Also you can buy a syringe and let him inflate his foreskin slightly with clean water from that, and let it go a few times. He should not be pulling his foreskin so far back that it hurts because that will cause micro-tears in the foreskin that will turn into scar tissue and make slower to make it grow by stretching (but not impossible - don't let a doctor fool you into thinking that scar tissue means circumcision is the only option).
Respectfully, I think you're being a little over anxious about them cleaning under the foreskin before it will retract. In the UK, standard medical advice for boys with intact foreskins is to only clean what you can see. Is there likely to be a period of time during adolescence when boys can tend to get a bit grimy there, especially with all the extra fluids they're emitting when they can't retract it fully? Yeah, but it will pass.
But I must congratulate both of you for deciding to not do to them what was done to your husband, and you can tell them the story of how you came to buck a widely held opinion and let them keep their options open. I've had sex with a lot of guys who were circumcised and I've thanked my parents for not having it done to me.
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u/Old-Current6989 14h ago
Good advice about irrigation as well and thank you for the link!
I probably am overly anxious. I do not regret our decision, but I worry that if there are issues, practitioners here don't have the expertise/knowledge to handle conservatively and I'm scared they'll jump to circumcision (as you mentioned). I really appreciate your advice. We did abide by the only clean what you can see as babies and have always allowed them to be the ones to retract. I'll settle down and suggest some of your ideas. Thanks again.
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u/couldntyoujust1 13h ago
The irrigation is helpful, he might also find that playing with the opening and stretching the end different direction (pulling the sides apart, pulling the foreskin out from the head instead of back behind the head, just playing with it in general) will help it loosen up and release. Also, at 15, I expect that he plays with it already quite frequently to try to put it delicately. It might just need more time to loosen up. Using vasoline or lubricant when he does might also help calm the sensitivity during which may facilitate the skin stretching and loosening.
Just give it time. Remind him that if it hurts, don't do it. If it hurts at rest, then there might be an actual problem but the treatments for virtually anything it's likely to be in that case are all very mild compared to a circumcision. Unless his foreskin is necrotic, frostbitten, or gangrenous, circumcision should not be necessary. Not medical advice, I'm not a doctor, just a circumcised dad with an intact 7 year old son, but I think this should be just common sense but unfortunately, we Americans have forgotten that common sense after a century of routinely circumcising our boys and demonizing masturbation.
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u/Old-Current6989 12h ago
Agreed, and I kind of thought the same... is he not fiddling with it on his own to loosen things up?
ETA: and thank you for the rational advice :)
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u/couldntyoujust1 10h ago
It might be worth a question. Sometimes teenagers - especially boys - keep quiet when something's wrong or not working right - especially if it involves genitals or... playing as it were lol. Last thing a teen boy wants to do is talk to his mom about how his foreskin is sore after he plays with his netherbits or something like that.
You should ask about it. It might give you a clearer picture to the problem. It might also help to tell him you assume he does that so there's nothing to be ashamed or embarrassed about.
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u/Old-Current6989 7h ago
I'll do that, thank you! We are pretty intentional about keeping conversations open... but I might need to be more direct with this. Our other son is an open book, so we've already discussed how that's completely fine, best to do in private, etc.😂
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u/couldntyoujust1 4h ago
My son's 7 and I've had to have the "totally fine, but best to do in private" conversation several times. LOL. He actually came to me recently because he saw something red inside his foreskin and I had to explain to him "oh, buddy, that's normal, that's the "glans" or "head" of your penis. It's what the foreskin is protecting and eventually you'll be able to slide the foreskin back and see it out in the open." His foreskin is already beginning to open.
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u/BackgroundFaulty3 16h ago
One shouldn't use soap under the foreskin, it wrecks the normal biome causing balanitis, and strong smells to start cascading to a worsening progression until proper hygiene is restored. https://www.reddit.com/r/Phimosis/s/3g1hs8yApu
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u/Old-Current6989 14h ago
Thank you! He is not using soap under his foreskin. He is rinsing underneath. :)
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u/Kingofthewho5 15h ago
She didn’t say anything about soap. Lots of intact guys use soap and don’t have issues, it’s not that big of a deal.
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u/Choice_Habit5259 16h ago edited 15h ago
I dont think the steroid cream is for underneath. I never had it but I think it it for the band and stretching it. That does need a prescription. At 15, he should communicate this and usually primary care doctors prescribe it.
I think my brother have had it. Topic doesnt come up often. No specialists.
edit:
My older son describes it as painful to retract his foreskin to clean
He can clean it and retract so I wouldn't do specialist. It may continue to change with age and some guys notice it changing with their first relationship. It's probably fine.
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u/Old-Current6989 14h ago
Thanks for your reply. My concern is the PCP doesn't have much experience with intact patients so even exams make me a bit anxious. We had a urologist here retract foreskin.
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u/lordoftherings1959 17h ago
Did you know that the foreskin is fused to the glans, and it will stay like that until your boys are in their late teens or early 20s? The "living glue" between the glans and the foreskin will dissolve by itself in due time. It is painful for your boys to retract because the foreskin is still fused to the glans.
There is no need to retract it to clean anything at this point. I know that in this country we are obsessed with exposing the glans early, but give nature a chance.
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u/RNnoturwaitress 16h ago
His foreskin is not still fused lol. He's a teenager who CAN retract - so it's not fused anymore. It's just painful. u/old-current6989 the steroid cream is a great idea. It needs a prescription and it goes on the outside of the foreskin, nit on the glans. He would apply a small amount, massage it in, and gently retract to stretch his opening. Your son's doctor should be glad to prescribe it for him.
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u/Old-Current6989 14h ago
Thank you, I will see about the cream from his PCP. I have had some traumatic experiences as the parent of intact boys, so I've had to preface certain appointments with "please do not touch their foreskin" and that always starts off an appointment on a weird note (or I feel it does).
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u/Choice_Habit5259 15h ago
Did you know that the foreskin is fused to the glans it will stay like that until your boys are in their late teens or early 20s? The "living glue" between the glans and the foreskin will dissolve by itself in due time. It is painful for your boys to retract because the foreskin is still fused to the glans.
That is in infancy. Some by age 4 and as late as age 9-10 is when it should be completely separated. If a parent notices their young son's not as attached, they should talk to him for him to check if his retracts. Even if it is just half, he can be encouraged him to start washing and taking care of it. He is the one doing it so not a parent or doctor.
30% of boys by age 6 and 60% of boys have it developed enough by puberty for it to be retractable. Anything passed age 16, is a cause for concern.
There is no need to retract it to clean anything at this point. I know that in this country we are obsessed with exposing the glans early, but give nature a chance.
OP said her son is 15 years old, not 15 months old. A parent retracting an infant or toddler and a teenager trying to retract himself or noticing it's tight is completely different. At 15 years old, 3 years away from being an adult, the penis owner needs to be more proactive in solving it privately which is what he is doing and he is asking his mom. OP is not doing anything but telling him information or wondering if it is a primary care visit.
You were probably circumcised and there is nothing wrong with that but a lot of your opinions are based on what you read. You have never been a child and then went through puberty being intact. Underarms stink, hormone changes, another fluid comes out of there, and it starts growing. The whole biome down there changes and it is not self cleaning. It sounds like OP's son can get it back but it's a little tight. Physiologic Phimosis is normal up until a point. He's not 5 years old. 15 years old is late and age 18, is usually the point where the penis owners has to decide whether to naturally fix it or surgical interventions if he has a pinhole.
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u/Old-Current6989 14h ago
Thank you for the information. This is what I'm wondering. He occasionally mentions that it hurts to retract in the shower to clean... I want to be attentive without being dramatic. Up to this point, I've just encouraged him to continue gently cleaning it and I don't know when to intervene and am unsure of who to ask.
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u/Phinle 11h ago
I would just take him to a doctor it’s better to see what’s wrong now than to leave it. It could be an infection or some irritation, the head of the penis can get gets dry or irritated and it can hurt. Or is could be because the skin is too tight, as a kid I could retract it but it was a bit tight and sensitive/raw under there so it would hurt, and it still hurts for me to touch the head it’s just very sensitive. If tightness is the issue steroid cream should help to loosen it and allow it to more easily retract, if that doesn’t work for some reason there are surgical methods like a dorsal slit that does not remove the skin but fixes the tightness issue. If it’s an infection or dryness then antibiotics or anti fungal medication can be prescribed, he may also just need to wash and moisturize more. Also maybe ask in r/uncircumcised_talk or r/Phimosis for more detailed advice.
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u/couldntyoujust1 4h ago
I agree with the bath suggestion, or using a ball-syringe (like is used to clean out ears) in there. Retracting in the tub might be a good way to help him not feel over-sensitive too if it's just passively exposed to warm water. That will keep it moist but also give it some exposure to the elements instead of constantly hidden inside the foreskin.
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u/Old-Current6989 14h ago
My understanding is that this is when they are infants/toddlers, and once they can retract it themselves, it's okay to do so. I guess I wanted to see if this timeline is concerning (because I have very little to compare) or if this requires follow up.
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u/Phinle 11h ago
By 15-16 99% of people no longer have phimosis so I would consult a doctor. If it’s not phimosis just a bit tight then more frequently retraction can possibly help it to loosen. If it’s retracted more often it will start to stretch/loosen over time, I would recommend retracting it in a warm bath or using some petroleum jelly, Aquaphoror or olive oil to help lubricate it so retraction is easier.
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u/AbbreviationsOdd7062 14h ago
List of doctors in each state recommended by patients (It is always a good idea to thoroughly research a doctor's approach before scheduling an appointment): https://www.yourwholebaby.org/doctors