I'm 15 years old and my foreskin won't stretch open. What should I do?

Under normal circumstances, the inability to retract the foreskin at age 15 may be related to non-disease factors such as delayed physiological development, or it may be associated with medical conditions including phimosis, balanitis, paraphimosis, and true phimosis, requiring targeted treatment.

I. Non-disease Factors

Delayed physiological development: At age 15, individuals are typically in puberty, during which male genital organs undergo physiological changes, including increased softness and flexibility of the foreskin to allow exposure of the glans. However, in some males, genital development may be slightly delayed, resulting in the foreskin not fully retracting as expected. This is usually a normal phenomenon.

II. Disease Factors

1. Excessively long foreskin (preputial redundancy): This refers to an abnormally long foreskin or excessive adhesion beneath the foreskin, making it difficult to retract. This condition can prevent natural stretching of the foreskin, thus preventing full exposure of the glans. It can be treated medically via circumcision.

2. Balanitis: In patients with a long foreskin who do not maintain proper hygiene, bacterial infections may occur, leading to balanoposthitis (inflammation of the glans and foreskin). Under inflammatory stimulation, patients may experience redness, swelling, and pain of the foreskin and glans. In severe cases, the foreskin may become difficult or impossible to retract. Treatment may include topical antifungal medications such as clotrimazole cream or miconazole nitrate cream, as directed by a physician.

3. Paraphimosis: This occurs when the retracted foreskin cannot return to its original position, causing the foreskin opening to tightly constrict the coronal sulcus, impairing local blood and lymphatic circulation. It may result from a narrow foreskin opening that becomes trapped during retraction, preventing the foreskin from returning to its normal position.

4. Phimosis: Phimosis refers to the condition in which the foreskin cannot be fully retracted to expose the glans. It may lead to difficulties in hygiene, inflammation of the urethral opening, or discomfort during sexual activity. Medical intervention, such as preputioplasty, may be required.

When any of the above conditions occur, it is recommended to seek medical evaluation and follow the doctor’s advice for appropriate management. Additionally, maintaining good hygiene in the foreskin area is important to prevent complications and discomfort.