The penis advice columnDear Marilyn:

I read your response to Katherine in Canada in which you said the doctor was wrong to prescribe a steroid to retract a boy’s foreskin when it was likely that the boy had a yeast infection. The question is timely because I’m facing a similar situation with my fourteen-year-old son, whose foreskin has not yet retracted.

Several weeks ago, my son began to feel a burning sensation when he peed and he wasn’t able to urinate much. We went to his pediatrician. We thought it was a UTI, but the pediatrician noticed an irritation on the tip of his penis, so she prescribed a topical antibiotic and an oral antibiotic. Neither worked, so we were referred to a pediatric urologist.

The urologist said that the fact that he couldn’t retract the foreskin could be the root of the issue. Then, without warning, she pulled his foreskin off his glans. I didn’t know what she was doing until I heard my son scream. I couldn’t believe it! Doctors tell you that it’s going to pinch when they give you a shot, and this was much worse.

The urologist prescribed a steroid for my son to use on his foreskin, and since using it he has been able to pull his foreskin further back and clean better. His pain and the urge to urinate has subsided a little bit.

One of the doctors also suggested that because my son was experiencing constipation, his full bowels were pushing on the walls of his bladder and that may have caused some of the discomfort, too.

My question after reading your response to Katherine in Canada is whether or not my son should continue to use the steroid. He’s still not 100% better. What can I do?

— Leslie, Connecticut

Dear Leslie:

I’m happy to know that you kept your son intact. It won’t be long until he understands you’ve given him a wonderful gift. In the meantime, there’s an easy solution to your son’s irritation. A reddened foreskin is usually caused by yeast overgrowth; some soaps, shampoos, bubble baths, or chlorine in pools or hot tubs can disturb the balance between the normal bacteria and yeast that live on our bodies. Antibiotics also can kill healthy bacteria as well as harmful bacteria, so it is counterproductive for a doctor to prescribe antibiotics to heal a reddened foreskin, unless there are other indications an antibiotic is needed.

You can treat yeast yourself by restoring the body’s healthy bacteria. I recommend you purchase a liquid probiotic (acidophilus culture works well) and have your son apply it six times a day. He can pour a tablespoon or so of the liquid into the palm of his hand, hold it for a moment to warm the solution, and then dip his foreskin into the solution and use his fingertips to rub the liquid onto the affected area. He doesn’t need to retract his foreskin because the bacteria will multiply and fill whatever empty tissue there is. You should notice an improvement in three days

You also asked about whether your son should continue to use a steroid cream. The doctor prescribed a steroid to prematurely retract the foreskin, which I’ve already said is not necessary when treating excess yeast. Your son should stop using the steroid cream and let nature take its course. His foreskin might tighten after steroid treatment stops, but the foreskin will loosen up with time . (Some men find their foreskins do not retract fully until their mid-twenties because men do not complete their sexual development until then.) Right now, as long as your son is urinating normally, he doesn’t need to fuss with his foreskin.

To prevent a yeast reoccurrence, don’t use cleansing products that harm good bacteria. If your son swims or uses hot tubs, have him apply non-petroleum jelly on his foreskin prior to going into chlorinated water. After swimming, he should shower to remove the chlorine from his body and then gently wipe away the protective cream from his foreskin.

I’m sorry you were misled by your doctors. As more and more boys are kept intact, health professionals need to learn to respect the foreskin and it treat it properly.

— Marilyn