Penis-Scrotum Symptoms  
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This Care Guide Covers:

  • Symptoms of the male genitals (penis or scrotum)
  • Not caused by an injury

If not, see these topics
When to Call Your Doctor

Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Scrotum is painful or swollen
  • Scrotum changes to a blue or red color
  • Foreskin pulled back and stuck (child not circumcised)
  • Can't pass urine or can only pass a few drops
  • Severe pain
  • Pain or burning with passing urine with fever
  • Red rash or red foreskin with fever
  • You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen, but not urgently
  • Pus or bloody discharge from end of penis
  • Pus from end of foreskin (child not circumcised)
  • Swollen foreskin (child not circumcised)
  • Pain or burning with passing urine (without fever)
  • Rash is painful
  • Rash has tiny water blisters
  • Looks infected (such as draining sore, spreading redness) without fever
  • You are worried about a sexually transmitted disease (STD)
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Itching lasts more than 3 days
  • Small lump or warts
  • All other penis or scrotum symptoms. (Exceptions: mild rash for less than 3 days, smegma or foreskin retraction questions)
Parent Care at Home If
  • Mild rash or itching of penis or scrotum present less than 3 days
  • Purple head of the penis and healthy child. (Reason: This is a normal color.)
  • Foreskin retraction, questions about
  • Smegma (whitish material) under the foreskin, questions about
Causes & Health Information

Symptoms

Types of Foreskin Retraction Problems

CARE ADVICE FOR MILD PENIS OR SCROTUM SYMPTOMS

Treatment for Mild Rash or Itching of Penis or Scrotum
  1. What You Should Know:
    • Rashes can be caused by skin irritants. Hand-to-penis contact is normal when passing urine. Therefore, the rash is most likely from an irritant that was on the hands.
    • Examples are a plant (such as an evergreen) or chemicals (such as bug repellents). Fiberglass, pet saliva or even food can also be irritants.
    • Most small rashes can be treated at home.
    • Here is some care advice that should help.
  2. Cleansing:
    • Wash the area once with soap to remove any irritants.
  3. Steroid Cream:
    • For itchy rashes, use 1% hydrocortisone cream. No prescription is needed.
    • Do this 2 times per day for a few days.
  4. Antibiotic Ointment:
    • For any cuts, sores or scabs that look infected, put on an antibiotic ointment. No prescription is needed.
    • Use 2 times per day until seen.
  5. What to Expect:
    • Small rashes from irritants should go away in 1 to 2 days with treatment.
  6. Prevention:
    • Teach your son to wash his hands if they are dirty.
    • Have him clean his hands before touching his penis.
  7. Call Your Doctor If:
    • Rash spreads or gets worse
    • Rash lasts more than 3 days
    • Fever occurs
    • Your child becomes worse
Advice for Foreskin Retraction Questions
  1. What You Should Know About the Foreskin:
    • At birth, the foreskin is attached to the head of the penis (glans). It is attached by a layer of cells.
    • Over time, the foreskin will separate from the head of the penis. This is a natural process and occurs over 5 to 10 years. It slowly loosens up (retracts) a little at a time.
    • Normal erections during childhood cause most of the change by stretching the foreskin.
    • If your boy has a normal urine stream, any foreskin movement is normal.
    • There should be no rush to achieve full retraction. This always occurs on its own by puberty.
    • Here is some care advice that should help.
  2. Cleansing Before Age 1 Year:
    • During the first year of life, only clean the outside of the foreskin.
    • Don't make any attempts at retraction.
    • Don't put any cotton swabs into the opening.
  3. Foreskin Retraction:
    • Begin gentle partial retraction at 1-2 yrs of age.
    • It can be done once per week during bathing.
    • Gently pull the skin on the shaft of the penis backward towards the stomach.
    • This will make the foreskin open up. You will be able to see the end of the glans (tip of the penis).
    • Be gentle. Retraction should never cause pain or crying.
  4. Cleansing After Age 1 Year:
    • As the foreskin becomes able to retract on its own, cleanse beneath it. This helps to prevent infections.
    • Wash the exposed part of the glans gently with warm water. Then, dry it.
    • Do not use soap or leave soapy water under the foreskin. This can cause redness and swelling.
    • Wipe away any whitish material (smegma) that you find there.
  5. Reposition:
    • After cleansing, always pull the foreskin forward to its normal position.
  6. Avoid Forceful Retraction:
    • This can cause bleeding or tears of the tissue.
    • It also may cause the foreskin to become stuck behind the head of the penis.
    • Retraction is too hard if it causes any pain or crying.
  7. Teach Child:
    • By age 5 or 6, teach your son to retract his own foreskin.
    • Teach him to clean beneath it once a week during bathing.
    • This will help to prevent poor hygiene and infection.
  8. Pain Following Recent Attempt at Retraction:
    • The attempt to retract the foreskin has probably caused a small cut or tear. Raw surfaces are painful.
    • Cover the raw area with a layer of antibiotic ointment.
    • If you don't have one, use petroleum jelly.
    • Once the raw surface is protected from the air, the pain should go away. The pain should slowly improve over a few hours.
    • Continue twice a day until healed. This takes about 1 or 2 days.
  9. Call Your Doctor If:
    • Pain lasts more than 24 hours
    • Foreskin looks infected
    • Other foreskin problems occur
Advice for Smegma Questions
  1. Smegma - General Information:
    • Smegma is the small pieces of whitish material found under the foreskin. It can build up under the foreskin. This happens if the foreskin is not pulled back and cleaned regularly.
    • Smegma also can occur before the foreskin becomes retractable. It lies under the foreskin that is still stuck to the head of the penis. It can't be removed.
    • Smegma is made up of dead skin cells. These cells are shed from the lining of the foreskin and the penis. It becomes trapped under the foreskin.
    • Smegma is normal and harmless. It is not a sign of an infection. It is produced in small amounts throughout life.
  2. Smegma Before Age 1 Year:
    • Sometimes, smegma can be seen through the foreskin. It looks like small whitish lumps.
    • If it lies beyond the level of foreskin retraction, it should be left alone.
    • Wait until normal separation exposes it.
    • During the first year of life, do not make any attempts at foreskin retraction.

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/13/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.