Hi,
I found this forum some time back while searching for tight foreskin information. I discovered that my condition is known as Phimosis and took advantage of some of the advice offered to other users.
I apologise up front for the long post but I thought the full story would help both myself, to share my frustration with someone, and possibly Jim and Paul, who will hopefully be able to offer some advice and support.

I have had varying degrees of success but failed several times to obtain a permanent result. And now I am back to square-one. However, I am sure of the reason for failure which I will explain shortly.

About 3 years ago I started to get a little sore around the frenar band. I tried various creams to try and clear it up. Over a period of a few weeks it was becoming increasingly more difficult to retract my foreskin.
Small cuts would appear following intercourse so I would apply some anti-septic cream and wait for it to heal. Each time this happened the frenar band would become tighter to a point where I could no longer retract.
The cuts healed, there was no evidence of infection but I had noticed that the colour of the frenar band and outer foreskin distinctly lighter than the rest of my penis, almost white in fact. Eventually my Phimosis became ‘pin-hole’.

Following advice I found on this forum I was able to do something about it with stretching. Although extremely difficult at first because the opening was so small. By using a ‘clean’ set of circlip pliers (similar to long nose pliers but when squeezed they open instead of close) I was able to insert and stretch. After some weeks I started to get a result. As I was finding it difficult to stretch for any more than a few minutes I made some rings of various sizes and would insert them in the foreskin for ever longer periods of time. Sometimes through the night and occasionally all day. It was great being able to pee without spraying everywhere.
My problem was I would try to insert a ring, which was a little too big, and end up with small cuts from the tension. I would then have to wait until it healed, sometimes not waiting long enough and opening the tears again, and start all over.
At one point I managed to retract while flaccid, even though a little painful, enough to wash under the glans. Even though I used Cotton Buds and the jet of the shower to clean under the foreskin best I could, I was surprised to find such a build-up of ‘Cheesy’ stuff (sorry, don’t know the real name).

Anyway, after the last failure I had run out of patience and stopped stretching. It had been around 12-months since the last ‘regime’ of stretching and I decided to give it another shot about a month ago.
I had contemplated circumcision on a few occasions but decided I liked my foreskin too much.

This time I decided to take more time and be a little more careful. I started using a little baby oil gel and was able to get the tip of my little finger into my foreskin. I would leave my finger in there, keeping tension on, for up to an hour each evening. Each evening I would push it in a little further until it was up to my knuckle. All was fine and after just a few minutes the uncomfortable tension would ease. I then changed to my forefinger but while trying to ‘force’ it in have managed to create a tear, which though very small, did sting. That was last week. It’s now pretty much healed and I’m back to my little finger again.

I have a very busy life so my only opportunity to stretch is in the evening. I usually stretch for 30 – 45 minutes just before sleep.

After so many failures my concern now is making progress to a point where I can retract only to find that within no time I’d be back to square one.
I know I expect too much too soon.

Any advice on technique/method would be greatly appreciated.

I believe you may have a case of Candida Albicans infections. Candida is a common yeast that can take over when an imbalance of protective bacteria is disturbed. You may have been washing too well, or you may have been given some antibiotics that killed off the bacteria.

First think I'd do is to use nothing but clear water to wash. Go to the pharmacy and purchase an over the counter yeast treatment cream that is merchandized with the women's intimate goods such as tampons. Follow the directions on the label. Keeping the area dry and changing cotton underwear frequently is very importan. You may have to change your diet for a while too by eliminated all sources of yeast and sugar that you can. This includes beer, wine, sodas, milk, bread, pasta, pastries and candy. Yes, you will be hungry as a bear, but as a sidenote, your thinking will be extremely clear! Carry with you some celery sticks to curb your appetite in between meals, and eat as many non-startchy vegetables as you can. Meats should be limited to those which are not cured such as luncheon meats and ham. In the area of dairy, you may have butter and yogurt. Be sure the yogurt has live cultures.

As long as no cracking appears, I suggest continuing the stretching, but be gentle. Your practice of using a device is quite sound as long as there is no irritation from whatever it's made from. Check it regularly. Yes, be patient! I fully understand, for I also want instant results.

Hello there Davo.

Your description is certainly of classical phimosis, what is called "secondary" phimosis, as it evidently wasn't there to start with; you apparently had a normally functioning foreskin. It also follows that it has a cause, though exactly what that is in this particular condition, is somewhat of a "black art". The point is, that doctors in general don't seem to know much about what is really going on in this condition, and I am sure that most doctors would consider what you describe to have all the hallmarks of "LSA" or "Lichen Sclerosis et Atrophicus", often given the "sexist" name of "BXO" (Balanitis Xerotica Obliterans) - and I say "sexist" as you see the condition is in fact, rather more common in women!

Jim has indicated that your problem is likely a yeast or fungal infection. The trick is, this is often hard to determine; it is actually difficult to test for - partly because the yeast is relatively common even when it does not cause a problem. So, treating firstly for yeast, with a proprietary antifungal and the dietary measures he suggests, is certainly a good initial step.

While on the one hand, we advise patience, I do feel that you are entitled to some expectation of improvement within a reasonable timeframe. If therefore, things do not improve with those measures, then I think you perhaps should proceed to get help from a competent doctor.

Note however, that I "threw in" a little adjective there - you need to see a doctor with competence in treating LSA, which is most unlikely to be a "urologist" - you need to see either a dermatologist, or a General Practitioner (or "Family Physician") with experience in that field. It's not actually all that difficult, but if whichever doctor it is, starts making suggestions that sound like circumcision, then you immediately know he (or she) has "lost the plot" and is giving you the run-around.

The treatment for LSA is a potent steroid in ointment form. Again, if the doctor indicates that certain such steroids are "too strong" to use in this area, then they don't know about treatment of LSA, because it involves selection of the most potent, generally a "fluorinated" steroid. I have made comments on which one, and why an ointment, before, and invite you refer to those comments, as I trust you would have seen them here.

Such principles will be known to a genuinely competent dermatologist - you use the most potent steroid, applied to exactly the affected area and no other, until the condition settles (which would be while you are achieving stretching), and for just a little longer, then stop using it, but keep it to re-apply for a shorter period if the problem appears to start again.

Because the steroid suppresses your natural immune protection against yeasts and fungi, there certainly is a rationale for using the antifungal (or even the "high-powered" oral version) whilst using it.

In short, you certainly realise at this point that the problem is non-trivial to sort out, and whilst it might be nice to hope it could be done without reference to a doctor, I think it might be worth the effort and trauma of finding a doctor with the necessary competence - which may indeed, not be easy (for the USA, there are as I understand, some lists of such doctors published by "NOCIRC" or other such groups).

You are possibly aware that the circlip pliers you reference are very similar indeed, to the "glansie" device you will find advertised in the Google syndicated advertising on this site and many others mentioning circumcision. As long as they do not contain nickel, they probably work quite well, though the use of plastic "grommet" devices - or as you note, your fingers - is probably just as effective and more convenient.

The "cheesy" stuff is called "smegma". Women get plenty of it too (as I just reminded myself at work today!).

Please do not use "antiseptic" creams (or indeed, soaps or detergents), particularly on your genitals. I won't mention brand-names, but they figure all to often when we encounter women with really weird and difficult-to-treat chronic genital irritations, and take a while to figure out (because it doesn't come naturally to mind for us) just what they are doing ...

Jim, Paul, many many thanks for your advice.

A few things I obviously need to get under control. As Jim has suggested, I need to look at my diet. My problem is that I have a very busy lifestyle. And eat the wrong things at the wrong time. I don’t have breakfast and rarely eat during the working day. I have not so much fast-food but convenience meals in the evening, often quite late, and then go to bed. My diet consists of bread, potatoes, a little meat, but not much in the way of veg (not a big lover of veg really). I drink lots of coffee during the day and tea in the evening and got to admit I have a bit of a sweet tooth.

I will now however commit to taking Jims’ advice on diet best I can. Sorry Jim, celery is definitely out, can’t stand the stuff J
But point taken. I’m not a beer drinker but I do take sugar in Tea and coffee, I’ll try to knock this on the head.
I’ll also get hold of a yeast treatment as you suggest.

While looking for information on Candida Albicans I found a product called Threelac, which is supposedly a natural remedy for Candida overgrowth etc. Have you come across this and would it be an aid to clearing up any deficiency?

As a sidenote I do occasionally suffer a fungal type irritation between my toes on one foot, which results in some soreness, and skin tearing. Could this possibly be an indication that a general deficiency in ‘good bacteria’ exists?



Lichen Sclerosis et Atrophicus, very interesting and a bit of a mystery it seems in terms of causes. I’ve looked on the net and while there is quite a bit of information on the subject there is little in terms of images to gain a comparison. Is it possible to post a picture here so as you have a better idea of what I am trying to describe?


In terms of doctors I’m afraid I have grown to have little faith ‘generally’ in our health care system here in the UK. While I have been fortunate in as much as I have only found the need to see a GP once in 20 years, I have accompanied both my wife and daughter for various health reasons and it seems more about a GP rushing numbers through the door to meet government targets than to offer diagnosis for anything other than a cold or ear infection. I have always been mad to feel guilty for wasting his/her time.
I have more confidence in a pharmacist at the local Chemists that a GP, however, there is difficulty in obtaining many treatments without a prescription.

I have some ‘Diprosone’ which I believe is Betamethasone 0.05%, Would this be suitable to treat the affected area and should stretching be continued during treatment?

I found the circlip plier idea suitable for initial stretching for pinhole phimosis because of being able to get into the very small opening. The problem is that it stretches in a fashion that the opening resmbles a narrow ‘slit’ and is uncomfortable. I found the use of my own finger, once the opening is large enough, much more tolerable and stretches more evenly and circular.
Out of interest what is the consequence of the material containing nickel. As it happens these particular pliers appear to be chrome plated but I had put some ‘shrink sleeving’ over. This was more to do with the almost pointed ends than anything else.

I have previously used antiseptic creams but take note of your advice and avoid their use in this case.

Jim, Paul, thanks again for your advice. I will keep you posted on progress.

Regards.

Of course, that doesn't mean it isn't good. Give it a try. I used a product called Caprinex and cured myself. The doctor I was seeing at the time misdiagnosed it and prescribed Tagamet. After a little reading, I figured the situation out and went to the health food store to buy what I needed. A few months later when I ran into him at church, I told him of my discovery, and, naturally, being the informed man he is, he shrugged it off and told me he was right! I took only one of the Tagamet, so obviously, what I did worked when the symptoms disappeared. The problem you have between the toes is probably related. The best remedy for that is Lamisil cream. Other remedies don't seem to have much effect anymore for me.

Candida can cause problems just about anywhere in the body, so if you change your diet, you'll probably notice something else clearing that you might not have even been aware of. One noticable change you'll see within a week is the clearer thinking. It's probably related very closely to the lower intake of sugar, but with Candida, anything can be effected from what I've read about it.

You have absolutely nothing to lose with this diet but a few pounds, so in the event the problem with the foreskin is more serious, at least you have ruled out Candida. Then you can speak more intelligently with a dermatologist about what it might be.

Hello Jim, Paul,
Sorry, this is going to be a long one again and I hope some may benefit from the read.

Unfortunately, I had another relapse and was back to square one with the pinhole Phymosis. I'm convinced that my condition is a result of/accompanied with LSA.

I said ‘was’ because of late I have made ‘real’ progress lately and after all the help/advice you guys have given I owe you an update.

I decided to give the Threelac a go, cut down on sugar and got some additional exercise. Given my hopelessness at keeping to a regime, I have to say it didn’t last long.

I sat down one evening and reviewed exactly where I was with this situation, the failures I had experienced and what my plan would be going forward. I also reviewed a lot of the threads on this forum again (so much fantastic information). Well worth going over again.

Even though I was pretty certain that I did not have any yeast infection, no symptoms, only that if I was too vigorous I would tear. I concluded that this tearing was occurring too easily and MUST be as a result of an infection.

Here’s what I did - Firstly I ordered some Dermovate cream from the internet. While waiting for this to arrive I got my wife to get me a course of Thrush treatment from the Pharmacy. This consisted of an Oral dose and some cream. I followed this course through and continued with the cream for around a week after. I used a cotton bud to get the cream inside and worked it well in.

The Dermovate arrived and I started applying around the edge of the opening which I believed was where the tight ring was. I did this about an hour before going to bed. Then I applied some lubricant and pushed in the end of my little finger. I would leave it there for as long as I could and often fell asleep with it there. After a couple of nights I could get my little finger in up to the Knuckle. I did the same thing with the forefinger, middle finger and eventually my thumb. I also made sure that the finger would slide in easily before progressing to the next, so it took me a few weeks to get to the thumb stage.
At the end of each week I applied the Thrush treatment cream just to make sure the yeast infection didn’t return. I no longer experienced the skin tearing. This progress gave me the motivation to carry on.
On a few occasions I would catch the Frenulum when inserting my finger. This made it sting. I would be more careful for a couple of days then I would go do it again. At some point this stopped happening and I never gave it further thought. I had also stopped the Thrush treatment cream by this time.

Having got to the thumb stage I swapped over the plastic rings. (It may be useful to know that the rings were made from the plastic center tubes from cash register rolls. Cutting almost an inch off and filing a slight, curved groove around the center to form like a grommet).
I would leave one of these rings in for an hour or so but they did tend to leave me sore. I left one in overnight once and it was really sore the next day. I initially thought this was a reaction with the plastic but thought I would use the Thrush cream again just in case. I found that the soreness went away and I am now at the point where I leave the ring in most of the time only removing it to shower. One very noticeable thing is that recently the the colour of the frenar band and outer foreskin has almost returned to normal. I am hoping this is a sign that the LSA is starting to go.


Both the highlight and shock for me was a couple of days ago. I managed to roll my foreskin back all the way while flaccid. If I pull back about half way the phymotic ring is very clear and very easy to get the Dermovate cream exactly where it’s needed.

The shock, well my Frenulum had disappeared. All I have is a smooth reddish line where it was. I can only guess that when catching it during stretching I must have damaged it in some way!! I can’t say I’m sorry about it but I am sure pleased about the retraction.

I am going to continue with wearing the ‘stretching rings’ but will also spend some time manual stretching too. Hopefully, next time I report in. I will be ‘Phymosisless’.
Regards
Davo.

(Copied ahead to this thread on current page.)

Hello again Davo.

Persistence must be rewarded - not just by us, but in terms of "getting the job done". It's usually the missing element when things don't work.

It's sounding good. The Dermovate® (ointment would have, I feel, been preferred) sounds most likely to be effective. That the "Thrush" treatment seems to be a pre-requisite is not surprising - you should continue to use it at least as long as you use the Dermovate®.

Whether you have merely a persistent Candidal problem or actual Lichen Sclerosis is hard to say - it might be hard to say even if you went and had a biopsy, and it really doesn't matter so much as both conditions actually respond to the steroid (plus or minus the Candida treatment).

I can't quite envisage what the next "step" from the cash register roll hubs will be, but of course, film canisters generally are one such "step" - you may need something intermediate in the meantime. I anticipate you will want to stretch well - in time and diameter beyond the point of easy "fit" to achieve any sense of permanence in the process.

One thing fascinates me - and I have not found reference to it in your posts as far as I can see but having mentioned her in passing, what does your wife think about all this? I trust she is supportive, but what observations has she made on the process, and the effects of the phimosis?