Phimosis is defined as a condition where the foreskin of the penis cannot pulled back or retracted. As it involves the foreskin and penis, phimosis is exclusively a man's medical issue. The female equivalent is clitoral phimosis, the inability to retract the clitoral hood. There are three types of phimosis: physiologic, pathologic and paraphimosis.
Physiologic phimosis is a naturally occurring condition in newborn males. It is a result of the foreskin adhering to the glans (head) of the penis. Physiologic phimosis resolves by itself over time, as the male matures. Full retractability may not happen until the teenage years. No treatment is necessary.
Pathologic phimosis can occur in a penis that once experienced a retractable foreskin or one that has never experienced retraction. A common cause of pathologic phimosis is BXO (balantis xerotic obliterans), which is a skin condition that affects the genital region. It is believed that between 4% and 6% of boys will experience this condition by the age of fifteen. Pathologic phimosis in a penis that once experienced retracting foreskin may be caused by chemical irritation (bubble baths), abnormal masturbatory techniques (forcibly pushing back the foreskin) and poor hygiene. Treatment is necessary in cases of pathologic phimosis. Treatment may range from topical steroid creams, stretching the skin and surgery.
Paraphimosis is a condition where the retracted foreskin becomes trapped behind the glans (head) of the penis. It is typically a temporary condition that is resolved by gently bringing the foreskin back into position. In some cases, fluid becomes trapped in the skin and it becomes medically urgent and needs treated by a professional. Treatment may be as simple as manually manipulating the foreskin or as drastic as a vertical incisions to free and loosen the restricting ring of skin.