Genital Reconstruction & Revision
A tight foreskin in adults: common causes, including lichen sclerosus, and when circumcision is the answer.
Written and reviewed by Shervin Badkhshan, MD · Last reviewed
November 2026
Part of:
Peyronie's and genital reconstruction
Outpatient
Recovery: 4–6 weeks
Fellowship-Trained Reconstructive Urology
AT A GLANCE
From symptoms to treatment
1. SYMPTOMS
• Foreskin won't pull back • Splitting or pain • Recurrent infections
Phimosis is a foreskin that's too tight to pull back over the head of the penis. In adults it usually comes from scarring, repeated infections, diabetes, or lichen sclerosus.
What you might notice
Difficulty cleaning, pain or splitting of the skin with erections or sex, recurrent infections, a white, scarred ring on the foreskin, or a spraying stream. A foreskin stuck behind the head (paraphimosis) is an emergency.
How I evaluate it
An exam is usually enough. If lichen sclerosus is suspected I check for urethral narrowing too, because it can affect the urethral opening.
Treatment
Mild cases may improve with a steroid cream. When the skin is scarred or symptoms keep coming back, adult circumcision is the reliable fix. It's an outpatient procedure, and most men return to work in a few days and to sex in about four to six weeks.
Related
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Your actual test results, visit notes, and messages with your care team are in your patient portal, the same one you use to book visits. Send questions through the portal or call the office at (516) 535-1900. For anything urgent, call the office or go to the nearest emergency room.