Why does my foreskin hurt
Executive summary
Pain in the foreskin commonly reflects inflammation, tightness, infection, or an acute mechanical problem; common diagnoses in adults include balanitis/balanoposthitis (inflammation or infection of the glans and/or foreskin), phimosis (a tight foreskin), and paraphimosis (a trapped, painful foreskin) [1] [2] [3]. Risk factors and causes cited across clinical and patient-facing sources include poor hygiene, diabetes, fungal or bacterial infection, skin conditions or scarring, and recent trauma or forced retraction [4] [1] [5].
1. Common causes: inflammation and infection — the clinical front‑runners
Inflammation of the glans (balanitis) or both the glans and foreskin (balanoposthitis) is a frequent cause of pain or swelling under the foreskin; symptoms typically include redness, pain, swelling and sometimes discharge or a foul smell, and these conditions affect a measurable share of men (balanitis ~3–11% lifetime; balanoposthitis more common in uncircumcised men) [1]. Medical sources say fungal (yeast) or bacterial infections, and irritants like soaps, are common triggers; diabetes and poor hygiene raise the risk [6] [4] [7].
2. Tight foreskin (phimosis) — a mechanical reason for pain
A foreskin that is too tight (phimosis) can make retraction painful, cause tearing or scarring, and lead to recurrent infections or painful erections; clinicians note phimosis is a common reason for adult circumcision if conservative treatments fail [8] [9] [10]. Phimosis can be congenital, age‑related, or develop after chronic inflammation or scarring from repeated infections [5].
3. Emergency problem to watch for: paraphimosis
If the foreskin is retracted and cannot be returned over the glans (paraphimosis), swelling and pain can progress rapidly and may restrict blood flow; primary‑care and family‑medicine guidance treats this as an urgent issue requiring immediate treatment to reduce swelling and restore normal position [11] [2]. Health pages explicitly warn paraphimosis can occur after cleaning, sexual activity, or medical procedures like catheterization if the foreskin is not replaced [11].
4. Hygiene, debris and posthitis — everyday drivers of discomfort
Accumulation of smegma, sweat, dead skin cells, urine and bacteria under an unretracted foreskin can irritate skin and produce posthitis (inflammation of the foreskin); clinicians recommend regular, gentle washing and avoiding harsh soaps because irritation itself can cause pain and increase infection risk [7] [4] [1]. Where hygiene is a factor, conservative measures and topical treatments are typically first‑line [7].
5. Skin diseases and scarring — when topical therapy won’t fix it
Dermatologic conditions such as lichen sclerosus (BXO) can cause white scarring, tightening and pain of the foreskin and glans; these conditions may not respond to antibiotics or antifungals, and surgical options like circumcision or other procedures can be considered if symptoms persist [9] [10]. Sources note diabetes and overweight status are associated with some persistent inflammatory changes [9].
6. What to try first — self‑care and when to see a clinician
Trusted patient guidance recommends avoiding forced retraction, using warm soaks and gentle hygiene, and abstaining from sexual activity until pain and swelling improve; topical antifungal or antibacterial creams and short courses of topical steroids are common next steps if infection or inflammation is suspected [3] [5] [7]. However, persistent pain, inability to pass urine, worsening swelling, signs of systemic infection, or a foreskin that won’t return to normal position require prompt medical evaluation [2] [11] [12].
7. Testing and treatments clinicians use — from creams to surgery
Clinicians diagnose by exam and sometimes swabs; they may prescribe antifungal creams for yeast balanitis, antibiotics for bacterial infection, topical steroids for inflammatory tightening, or perform mechanical or surgical procedures (dilatation, dorsal slit, circumcision) for severe or recurrent phimosis or scarring [7] [5] [9]. Sources emphasize individualized care: many cases resolve with conservative management, while others need specialist referral [1] [9].
8. Diverging perspectives and limitations in available reporting
Patient‑facing sites and clinical reviews agree on major causes (infection, phimosis, paraphimosis) and core treatments, but they vary in incidence estimates and thresholds for surgery; for example, lifetime prevalence ranges and the frequency of balanoposthitis differ across reviews [1] [6]. Available sources do not mention your specific symptoms, exam findings, or history, so a definitive diagnosis cannot be made from these materials alone — only a clinician can correlate your exam and tests with these possibilities (not found in current reporting).
If your foreskin pain is mild and tied to irritation, try gentle cleansing and avoid forceful retraction; seek urgent care if you can’t pull the foreskin forward again, have severe swelling, trouble urinating, or fever [2] [11] [12].