Why Isn't the Foreskin Usually Retractable Until the Teenage Years?

by Paul M. Fleiss, M.D., Frederick M. Hodges

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There is no need for the foreskin to be retractable until puberty. Only then are humans biologically programmed to become sexually mature. In babies and young children, the natural attachment of the foreskin to the glans protects the immature glans from injury and dirt. The firmly attached foreskin provides a natural protective barrier for the urinary tract. This is especially important in infancy and during the diaper-wearing years. Of equal importance, the attachment of the foreskin to the glans protects and preserves the head of the penis, allowing it to complete its development.

Is It Necessary For The Foreskin To Be Retractable In Adulthood?

No. Many adults enjoy the comfort and security of a glans that is covered most or all of the time-even during erection. At this stage of life, the foreskin almost always has fully separated from the head. Full retraction is sometimes avoided if the lips of the foreskin (the preputial orifice) resist stretching wide enough to permit the passage of the glans. There is nothing wrong with this, even though many old-fashioned textbooks and many uninformed doctors (most of whom are circumcised) think that this is a problem called “phimosis.”

Contrary to medical myth, a narrow preputial orifice does not make hygiene difficult. On the contrary: Important studies have found that the penis with a narrow foreskin opening is perfectly clean. Urination through the foreskin actually helps keep the penis clean and fresh. It is a beautifully designed system that functions with perfect efficiency.

Special Moisteners and Emollients in the Foreskin

All skin surfaces of the body require the constant moisturizing and soothing action of sebum - natural skin oil. Without it, the skin would dry out, crack, and bleed. To prevent this from occurring, the skin of the body is richly supplied with sebaceous glands. The natural secretion of skin oil gives the skin a healthy luster and enables it to do its job protecting the internal structures of the body from the external environment. Like skin, mucous membranes also require constant moistening. The mucous membranes of the eyes, for instance, are constantly bathed in moistening tears and other lubricating secretions from sebaceous glands in the inner eyelid. Similarly, the surfaces of the penis also require lubrication and moistening.

Preputial Sebum (Smegma) and Its Important Antibacterial Properties

Preputial sebum, or smegma, is the creamy white emollient that can sometimes be found coating the inner lining of the foreskin. It is a combination of secretions from many glands around the penis and urethra.

Smegma is probably the most misunderstood, most unjustifiably maligned substance in nature. Smegma is clean rather than dirty. It is beneficial and necessary. It moisturizes the glans and keeps it smooth, soft, and supple. Its antibacterial and antiviral properties keep the penis clean and healthy. All normal male and female mammals produce smegma. Dr. Thomas J. Ritter underscored its importance when he commented, “The vertebrate animal kingdom would be depleted without smegma.”

Children produce very little smegma. During adolescence, the production of smegma markedly increases as the glands of the penis develop, perhaps in response to elevated testosterone levels. In adulthood, much less smegma is produced. It is natural that smegma would be most abundant during adolescence and young adulthood, since this is the time when males are at their peak of sexual drive and when human males are biologically programmed to engage in mating. Smegma is most needed at this time to facilitate the smooth operation of the penis.

Apart from its lubricating function, smegma has antibacterial effects, most especially during infancy. Antibacterial substances are passed from mother to child during breast-feeding and are secreted in the baby's urine. Breast-fed babies receive substantial amounts of beneficial compounds called oligosaccharides. When ingested, these compounds are secreted in the urine where they prevent certain types of bacteria from adhering to the urinary tract and the inner lining of the foreskin. Animal experiments have found that special cells called plasma cells in the inner fold of the foreskin secrete a compound called immunoglobulin. These secretions protect the penis against harmful bacteria. It is interesting to note that these antibacterial secretions increase in response to bacterial invasion.

About the Author

PAUL M. FLEISS, M.D., lives in Los Angeles, California.

FREDERICK M. HODGES, D.Phil, lives in New Haven, Connecticut.