What To Know About Being Uncircumcised: Problems, Tips, and Benefits

Male circumcision is a surgical procedure to remove the foreskin, which is the flap of skin that covers the tip of the penis. In recent decades, circumcision rates on newborn males in United States hospitals have hovered between slightly over half to about two-thirds. It’s neither good nor bad to be uncircumcised, but there are potential health considerations to know about it. 

On the beneficial side for an uncircumcised male organ, the natural foreskin covering the head of the penis offers protection. Retaining this skin may potentially improve penis sensation relative to removing it. The main downside of being uncircumcised, from a health perspective, is that the anatomy of the foreskin may also make the penis more prone to infection, as it can trap microbes and moisture.

Here, learn about the most common issues that uncircumcised individuals are more likely to face, the underlying causes of these problems, and potential treatment options.

The foreskin, medically known as the prepuce, is a layer of skin that covers and protects the glans (head) of the penis. The foreskin is rich in nerve endings that contribute to penile sensitivity. The foreskin is retractable in most adult men, allowing for the exposure of the glans during personal hygiene routines or sexual activity.

Factors such as improper hygiene, infections, and more can contribute to foreskin-related problems. 

There are some common uncircumcised issues to consider, like a higher risk—relative to circumcised males—of developing certain conditions and infections.

Phimosis

Phimosis is a condition where the foreskin becomes too tight to retract over the head of the penis. Children are born with a tight foreskin, so phimosis isn’t uncommon in young boys. It typically resolves on its own by adolescence. This type of phimosis is what experts call "physiological" phimosis, meaning it occurs without an underlying condition.

It’s hard to tell how common phimosis is, as it varies with age and other factors. One review estimates that by the age of 18 or older, the prevalence ranges from 0.5% to 13%.

Phimosis is  characterized by signs and symptoms such as:

• Inability to retract the foreskin

• Pain during urination or sexual activity

• “Ballooning” of the foreskin during urination

• Swelling or redness of the foreskin

• Inflammation

In adults, phimosis may develop or persist due to factors such as scarring, inflammation, or recurrent infections, including sexually transmitted infections (STIs). In this case, healthcare providers call it “pathological” phimosis. It is frequently associated with balanitis xerotica obliterans (BXO), an inflammatory skin condition affecting the foreskin and sometimes the head of the penis. Experts don’t know the origins of the condition, and some think that it may be autoimmune, especially in adults. 

Other potential contributing factors to phimosis include:

• Congenital tightness, meaning tightness of the foreskin present from birth

• Repeated infections 

• Scarring due to forceful retraction

Treatment 

Treatment often isn’t needed for children with phimosis since most will naturally outgrow it. For adults who have phimosis, circumcision may be the doctor-recommended treatment. 

An alternative is a surgical procedure called preputioplasty. This procedure involves loosening or widening the foreskin without completely removing it.

If phimosis isn’t associated with BXO, your doctor may prescribe steroid creams applied to the foreskin for four to eight weeks. Your doctor could also recommend combining this regimen with regular attempts to manually pull back your foreskin. 

Paraphimosis

Paraphimosis is an uncommon emergency condition characterized by the foreskin getting trapped behind the tip of the penis with an inability to return to its original position. It occurs in an estimated 0.2% of children between 4 months and 12 years old and an estimated 1% of uncircumcised males over 16 years old.

Paraphimosis can lead to:

• A swollen and painful penis head

• Restricted blood flow

• Severe pain.

• Possible discoloration of the penis due to reduced blood flow

In severe cases where blood flow is restricted for extended periods of hours to days, permanent damage may occur to cells in the tip of your penis. 

Paraphimosis can happen after medical procedures, like a cystoscopy or the placing of a catheterization. It may also occur when the foreskin is retracted for cleaning.

Treatment

Emergency medical attention is required to treat paraphimosis in order to reduce swelling and restore blood flow. 

Mild cases may be treated by manually returning the foreskin to its usual position without the need for sedation or painkillers. More severe scenarios may require medical intervention with:

• Sedation

• Dorsal penile block injections

• Oral painkillers

If your condition can’t be treated with manual readjustment of the foreskin, you may need to undergo surgery—most commonly a small procedure that involves cutting the upper part of the foreskin. Surgery for paraphimosis aims to realign the foreskin and reestablish blood flow.  

Balanitis

Balanitis is a condition where the head of the penis is inflamed; inflammation of the foreskin and glans is called balanoposthitis.

Balanoposthitis only presents in uncircumcised men; it’s estimated to affect about 6% in their lifetime. Balantitis is estimated to occur in about 1 in 25 uncircumcised boys and 1 in 30 uncircumcised men in their life.

Potential symptoms of balanitis include:

• Redness and swelling of the glans and foreskin

• Pain or discomfort

• Itching or burning sensation

• Discharge with a foul odor

• Accumulation of smegma 

The area under your foreskin is prone to trapping moisture and microbes like yeast. Many factors can contribute to the development of balanitis such as:

• Poor penile cleaning habits

• Fungal or bacterial infections

• Allergic reactions or irritation from products such as:

  • Soaps

  • Lotions

  • Detergents

  • Condoms

  • Lubrication

• Cancer and cancer treatment 

• Skin conditions such as eczema

• Penile trauma

• Medication side effects

Balanitis is most often associated with yeast infections, especially Candida yeasts. These yeasts normally exist on your skin without causing problems until they overgrow. People with certain conditions, such as diabetes, are at an increased risk of contracting balanitis.

Treatment

The initial treatment for men with balanitis is usually gently washing your penis with a saline solution. 

Antifungal medications that may be available over-the-counter or with a prescription can help kill yeast contributing to your symptoms. 

More severe or persistent cases might require taking the oral antifungal fluconazole or a steroid cream, such as 0.5 % or 1% hydrocortisone. 

Circumcision might be recommended for recurrent cases or cases that don’t respond to treatment. 

Foreskin Infections

The most common causes of balantis and balanoposthitis are yeast infections, but both issues may also present as a result of other types of infections. Those infections include:

• Infections caused by certain bacteria, including:

  • Streptococcus

  • Staphylococcus (staph infection)

• Bacterial sexually transmitted infections (STIs), including

  • Chlamydia

  • Gonorrhoea

  • Syphilis

• Viral infections such as:

  • Human herpesvirus 1 and 2

  • Human papillomaviruses

• Scabies, a parasitic mite infection

Treatment

Depending on the underlying cause of your uncircumcised penis infection, your doctor may recommend:

• Antibiotic creams

• Oral antibiotics

• Steroid creams

• Antiviral medications such as acyclovir

• Circumcision for recurrent or persistent infections

Smegma Buildup

Smegma is a mixture of natural lubricant for the foreskin produced by glands under your foreskin and other substances such as:

• Sweat

• Oils

• Dead skin cells

The buildup of smegma usually appears as a white, cheese-like substance under the foreskin. It often emits a foul odor. 

Although smegma buildup might be mostly harmless (besides the unpleasant smell), it may be a sign of infrequent cleaning of the foreskin, which can also be a risk factor for balanitis. 

Treatment

Smega can often be treated by cleaning under your foreskin regularly. It’s best to use gentle products to avoid irritation to your genitals. 

If increasing your cleaning frequency doesn’t improve your symptoms, you may benefit from visiting your healthcare provider to see if hormonal factors may be contributing to smegma development. 

Research suggests that uncircumcised men may have a slightly higher risk of acquiring certain STIs, including HIV and genital herpes. One contributing reason for this is that the foreskin’s inner lining is thin and susceptible to microtears, which can provide an entry point for pathogens. In 2007, the World Health Organization (WHO) even endorsed safe, voluntary medical male circumcision after studies showed doing so reduces the risk of female-to-male HIV transmission by about 60% in areas where the prevalence of heterosexually transmitted HIV is high.

Whether you’re circumcised or not, you may be able to reduce the risks of contracting and spreading STIs by:

• Using condoms consistently during sexual activity

• Practicing good genital hygiene

• Getting regular STI screenings

Treatment options for STIs depend on which type you have.

Penile cancer is a rare condition but can be devastating for men who are diagnosed. The American Cancer Society estimates that about 2,190 new cases will be diagnosed in the United States in 2025. 

Though uncommon (even in uncircumcised men), penile cancer is more commonly associated with uncircumcised men than those who have undergone the procedure. Higher rates of chronic inflammation, phimosis and persistent infections are thought to increase the risk.

Uncircumcised men are at an increased risk of developing balanitis. Balanitis has been associated with about a 3.8-fold increased risk of penile cancer, and up to an estimated 45% of people diagnosed with penile cancer have a history of balanitis. 

Potential ways you can decrease your risk of penile cancer include:

• Cleaning under your foreskin regularly

• Treating chronic conditions such as phimosis or balanitis promptly

• Getting vaccinated against human papillomavirus (HPV), a major risk factor for penile cancer.

Treatment

The treatment for penile cancer depends on factors such as the stage of your cancer. Common treatment options include:

• Surgery

• Radiation therapy

• Chemotherapy

• Local therapies such as laser therapy or cryotherapy

The choice to get circumcised or not is usually not the person’s own, but rather one made during their infancy by their parents. The decision is often made with consideration for religious or cultural norms. And, again, being uncircumcised is neither good nor bad. 

If you’re not sure if you should circumcise your child, you may find it helpful to see a pediatric healthcare professional to discuss the potential benefits and drawbacks. Some of these benefits and drawbacks include the following.

Potential benefits of being uncircumcised include:

• Avoiding (rare) complications of circumcision, such as damage to nerves or a poor cosmetic result.

• May be in line with the social norm, depending on your culture and where you live.

• Improved protection to the head of the penis, which may in turn help prevent injury to the penis, especially during early childhood.

• Possibility of improving sexual enjoyment, since the penis may be more sensitive, but the jury is still out here. Research suggests that medical male circumcision does not impact sensitivity, sensation, or sexual satisfaction. 

Potential drawbacks of being uncircumcised include:

• Increased risk of balanitis and yeast infection

• Higher risk of contracting certain STIs, such as HIV and HPV

• Higher risk of getting of urinary tract infections (UTI)

• More difficult to keep tip of the penis clean

When you’re uncircumcised, practicing proper penile hygiene can help reduce your risk of contracting conditions like balanitis. Some ways you can keep your penis clean include:

• Daily cleaning: Try retracting your foreskin gently (if possible) and clean the area with warm water. Aim to avoid harsh soaps or rough scrubbing.

• Drying: Pat the area dry after cleaning to prevent moisture buildup.

• Avoid irritants: Try using mild, fragrance-free soaps and cleansers or products specially formulated for the genitals. 

• Regular medical checkups: Consult a doctor for persistent issues or concerns about your penis and foreskin health.

• Educate children: If you have uncircumcised kids, teach them about proper hygiene practices early in order to prevent infections and complications.

Being uncircumcised involves leaving the penis in its natural state, without removing the foreskin around the tip of the penis. Whether or not to get circumcised is often a decision made by parents early in their children’s lives, based on personal preference or religious beliefs. 

Being uncircumcised comes with specific benefits and challenges. Leaving the foreskin unmodified may increase sensitivity during sexual activity for some men because of the many nerve endings in the foreskin. But with poor hygiene or phimosis, a foreskin may also lead to an increased risk of conditions such as some STIs, balanitis, or yeast infections. 

Maintaining penis health and practicing good hygiene is integral for all males, but especially with uncircumcised males. 

Learn more about keeping your penis healthy.