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Expert Q&A:
How do I care for my 18-month-old son's uncircumcised penis?

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Answered by Anthony Mancini M.D.
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Dr. Mancini received his undergraduate and medical educations at the University of Arizona, and trained in pediatrics, pediatric dermatology, and dermatology at Stanford University. He is currently Associate Professor of Pediatrics and Dermatology at Northwestern University's Feinberg School of Medicine and Head of the Division of Dermatology at Children's Memorial Hospital in Chicago, Illinois.



Dr. Mancini has served as a member of the AAP Executive Committee, Section of Dermatology since 2001. He is a member of the AAP Super CME Planning Group and the AAP Pedia Link Pediatric Dermatology Project Team, and is Secretary-Treasurer of the Society for Pediatric Dermatology. His teaching accomplishments include the Faculty Excellence in Education Award from the Department of Pediatrics at Northwestern, which he has received for the last eight years. Dr. Mancini is a peer reviewer and/or sits on the editorial board for several academic journals, and has published over 75 peer-reviewed articles, abstracts, and book chapters. He is co-author of Hurwitz Clinical Pediatric Dermatology, 3rd edition, and is an associate editor for the comprehensive dermatology textbook Dermatology. His special interests include infectious skin diseases and exanthems of childhood, vascular malformations and hemangiomas, and neonatal skin maturation and skin disorders.



Dr. Mancini is a Fellow of the American Academy of Pediatrics and the American Academy of Dermatology. He and his wife, Nicola, a neonatal intensive care nurse, have three children (Mallory, Christopher, and Mackenzie) and reside in Evanston, Illinois.
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Question


How do I care for my 18-month-old son's uncircumcised penis? I've been slightly pulling his foreskin down to clean, but when I took my son to his 18-month visit, his pediatrician pulled his foreskin all the way down to the base and said I should do this from now on. The next day, I noticed my son's penis was red and had cuts near the top. But my friend's son's pediatrician said to just leave the foreskin alone.

Answer


In the first few months to years of life, the foreskin may adhere to the glans, or head, of the penis and should not be forcefully retracted. As a boy ages, the foreskin gradually separates from the glans and from that time on gentle retraction and cleansing can, and should, occasionally be done. Your pediatrician should be able to guide you depending on your son's stage of development. Remember, however, that aggressive cleansing of the penis is unnecessary. The white cheesy material you may occasionally see is the residue of shedding cells and is generally harmless.
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