|The diagrams above come from Circumcision, Volume 1,
Number 1, June, 1996,
an article by George C. Denniston, M.D. M.P.H.
Newborns: Care of the
Guidelines for Parents
American Academy of Pediatrics
At birth, the
penis consists of a cylindrical shaft with a rounded end called the
glans. The shaft and glans are separated by a groove called the sulcus.
The entire penis - shaft and glans - is covered by a continuous layer
of skin. The section of the penile skin that covers the glans is called
the foreskin or prepuce. The foreskin consists of two layers, the outer
foreskin and an inner lining similar to a mucous membrane.
Before birth, the foreskin and glans develop as one tissue. The
foreskin is firmly attached - really fused - to the glans. Over time,
this fusion of the inner surface of the prepuce with the glans skin
begins to separate by shedding the cells from the surface of each
layer. Epithelial layers of the glans and the inner foreskin lining are
regularly replaced, not only in infancy but throughout life. The
discarded cells accumulate as whitish, cheesy "pearls" which gradually
work their way out via the tip of the foreskin.
Eventually, sometimes as long as 5, 10, or more years after birth, full
separation occurs and the foreskin may then be pushed back away from
the glans toward the abdomen. This is called foreskin retraction. The
foreskin may retract spontaneously with erections which occur normally
from birth on and even occur in fetal life. Also, all children
"discover" their genitals as they become more aware of their bodies and
may retract the foreskin themselves. If the foreskin does not seem to
retract easily early in life, it is important to realize that this is
not abnormal and that it should eventually do so.
Infant Smegma: Skin cells from the glans of the penis and the inner
foreskin are shed throughout life. This is especially true in
childhood; natural skin shedding serves to separate the foreskin from
the glans. Since this shedding takes place in a relatively closed space
- with the foreskin covering the glans - the shed skin cells cannot
escape in the usual manner. They escape by working their way to the tip
of the foreskin. These escaping discarded skin cells constitute infant
smegma, which may appear as white "pearls" under the skin.
Adult Smegma: Specialized sebaceous glands - Tyson's Glands - which are
located on the glans under the foreskin, are largely inactive in
childhood. At puberty, Tyson's Glands produce an oily substance, which,
when mixed with shed skin cells, constitute adult smegma. Adult smegma
serves a protective, lubricating function for the glans.
Foreskin Hygiene: The foreskin is easy to care for. The infant should
be bathed or sponged frequently, and all parts should be washed
including the genitals. The uncircumcised penis is easy to keep clean.
No special care is required! No attempt should be made to forceably
retract the foreskin. No manipulation is necessary. There is no need
for special cleansing with Qtips, irrigation, or antiseptics; soap and
water externally will suffice [Ed. Intact boys should avoid harsh
detergents, bubble baths, etc., just as should girls do, in order to
prevent urinary tract infections. Mild soap and water are all
Foreskin Retraction: As noted, the foreskin and glans develop as one
tissue. Separation will evolve over time. It should not be forced.
When will separation occur? Each child is different. Separation may
occur before birth; this is rare. It may take a few days, weeks,
months, or even years. This is normal. Although many foreskins will
retract by age 5, there is no need for concern even after a longer
period. Some boys do not attain full retractability of the foreskin
Hygiene of the Fully Retracted Foreskin: For the first few years, an
occasional retraction with cleansing beneath is sufficient.
Penile hygiene will later become a part of a child's total body
hygiene, including hair shampooing, cleansing the folds of the ear, and
brushing teeth. At puberty, the male should be taught the
importance of retracting the foreskin and cleaning beneath during
his daily bath.
Summary: Care of the uncircumcised boy is quite easy. "Leave it alone"
is good advice. External washing and rinsing on a daily basis is all
that is required. Do not retract the foreskin in an infant, as it is
almost always attached to the glans. Forcing the foreskin back may harm
the penis, causing pain, bleeding, and possibly adhesions. The natural
separation of the foreskin from the glans may take many years. After
puberty, the adult male learns to retract the foreskin and cleanse
under it on a daily basis.
1990. American Academy of Pediatrics
Please read more about this very important topic! There is no
site I want to link to in particular as many of them are a bit graphic
and some speak casually of things I don't want to endorse, but use
Google and your own judgement -- and note that Michelangelo's statue of
David is uncircumcised, so there go the "aesthetic" excuses for this