The decision to circumcise or not is an increasingly controversial call among parents. But medical professionals agree that one significant factor to consider when leaving kids uncircumcised is the need to maintain meticulous child foreskin hygiene. “Foreskin makes the area around the tip of the penis dark, warm, moist,” Dr. Damon Davis, a Baltimore-based urologist, told Fatherly. ”The perfect breeding environment for yeast, ”
“Fungi like dermatophytes and yeast thrive in dark, humid, and warm environments,” New Jersey-based physicist Dr. Mikhail Varshavski elaborated, in a recent discussion with Men’s Health. “They need the moisture to reproduce and feed themselves, as they are very simple organisms and are unable to adapt well to other environments.”
Circumcision rates in the US have declined from 83 percent in the 1960s to 77 percent in 2010, according to the Centers for Disease Control and Preventionsuggesting a higher risk of penile yeast infections than ever before. Yeast infections throughout the body are caused by an overgrowth of candida, a fungus that is usually present in small amounts all over the body. However, moist environments like the mouth, armpits, and genitals make it easier for candida to multiply and spread. The foreskin is a perfect petri dish.
When candida spreads and infects the glans, or head of the penis, men may experience itching, burning, white and shiny patches or a red rash, and thick white discharge beneath the foreskin. A number of over-the-counter antifungal creams can treat most penile yeast infections but, in extreme cases, it could require a prescription for oral medication.
Penile yeast infections can also lead to full-blown balanitis, an infection of the penis which causes narrowing of the urethra, urine retention, and a backflow of urine toward the kidneys known as vesicoureteral reflux. This is, ironically, treated with circumcision.
Most uncircumcised men contract penile yeast infections through unprotected intercourse with a woman who has a vaginal yeast infection, so parents can rest assured that their younger sons have a while to wait before that. However, prolonged use of antibiotics, sweat, poor diet, obesity, and diabetes can cause them as well. Varshavski recommends uncircumcised men and their sons stick to cotton underwear to reduce these risks.
“Cotton is an excellent fabric for reducing the chance of getting a fungal infection,” he explains. “It is breathable, which will allow your body not to overheat, and it is moisture-wicking so it will absorb the water away from your skin, therefore reducing the fungi’s ability to grow on your skin.”
Regardless, healthy habits start early. It’s important for dads to teach their sons how to clean their foreskin long before they’re sexually active or exposed to any other risk factors, Davis warns. “Fathers need to teach sons good general hygiene,” he says. “Including retracting the foreskin, washing not too vigorously and, most importantly, drying the penis before replacing the foreskin.”