Cracked foreskin presents with mild burning, itching, swelling and red patches, and with a tight foreskin (phimosis).
Cracks or fissures on the foreskin may be due to infection of the foreskin (called posthitis) or head of the penis (balanitis) or both (balanoposthitis). These cracks can be painful and may be associated with fungal or bacterial infections, scarring conditions such as lichen sclerosus (BXO), and tight foreskin (phimosis and Paraphimosis).
Fungal Infections
Fungal infections are usually responsible, most commonly caused by the yeast Candida albicans, which is often associated with bacterial infections. Foreskin yeast infection, also called “candidiasis” or “thrush,” is uncommon in healthy individuals but common in people with cancer, immunocompromised conditions, and diabetes.
Bacterial Infections
Bacterial infections, especially those caused by streptococcus organisms, are the second most common cause of foreskin infection. The sexual health clinic needs to exclude sexually transmitted infections (STIs). The most common STIs are Chlamydia trachomatis, genital mycoplasmas, and Neisseria gonorrhoeae. These can produce cracks and red foreskin.
Hygiene
Poor hygiene due to a tight foreskin can cause cracks on the foreskin and irritant balanitis.
Diabetes
Diabetic patients with uncircumcised men have a high (35%) prevalence of balanitis, which gives them cracks to the foreskin. Among men with an acquired tight foreskin, 26% had a history of diabetes. Tight foreskin (phimosis) in men with diabetes increases the risk of infection of the foreskin and glans.
BXO (Balanitis Xerotica Obliterans)
Balanitis xerotica obliterans (BXO) is a chronic, progressive, and sclerosing inflammatory disease of the foreskin of unknown cause. BXO will produce scars and cracks. BXO is very common in people with diabetes.
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Treatment
Treatment of the cracks is medical (antifungal, antibiotics and steroids) and surgical (dorsal slit, preputioplasty or circumcision). Control of blood sugar in patients with diabetes is critical to managing the above treatment.
Phimosis and Cracks
If cracks of the foreskin are associated with a tight foreskin (a condition called phimosis).
The treatment of phimosis depends on several factors, including age and the degree of tightness. Here are the available options:
- Steroid Cream or Ointment: These reduce inflammation and improve foreskin elasticity.
- Stretching Exercises: Beneficial, especially in the early stages of Phimosis.
- Stretching Rings (Phimostretch): Devices that aid gentle foreskin stretching.
If cracks of the foreskin are associated with diseased foreskin, called a condition called BXO, the person will need circumcision and biopsy of the foreskin.
Our Services
We provide circumcision, dorsal slit or preputioplasty at our London and Cambridge circumcision clinics.
Please get in touch with us for professional advice by calling the doctor directly at the mobile number below.
Please call us at +447527314081 to discuss this further and get advice from our specialist team.
Our Specialists
- Dr Nkwam: Consultant Urologist
- Dr Sanndher: Consultant Urologist
- Dr Khan: Paediatric Surgeon/Urologist
- Dr Safdar: Experienced Surgeon
London Circumcision Centre, Leyton and South Woodford Clinics, London