How to treat a cut or abrasion on the penis foreskin (prepuce)?

Treatment of Penis Foreskin Abrasions and Cuts

After thorough cleaning with large volumes of tap water, cover the wound with a topical antibiotic ointment and a clean occlusive dressing to promote moist wound healing and prevent infection. 1

Immediate Wound Care

• Irrigate the wound thoroughly with large volumes of warm or room temperature tap water until all foreign matter and debris are completely removed 1, 2

  • Tap water is as effective as (or better than) sterile saline for wound irrigation and reduces infection rates 1
  • Higher volumes (100-1000 mL range) are more effective than lower volumes 1
  • Room temperature or body temperature water is more comfortable than cold water 1

• Apply topical antibiotic after cleaning to keep the wound moist and prevent bacterial infection 1, 2

  • Options include bacitracin ointment applied 1-3 times daily 3
  • Silver sulfadiazine or other topical antibiotics with occlusive dressing are also appropriate 2

• Cover with a clean occlusive dressing that maintains moisture and prevents the wound from drying 1

  • Evidence demonstrates significantly shorter healing times for abrasions treated with occlusive dressings compared to no dressing 1
  • Change dressings frequently as needed 2

Additional Considerations for Preputial Injuries

• Apply white soft paraffin (petroleum jelly) to the affected area every 4 hours during the acute healing phase to maintain moisture and reduce friction 1

• Ensure the prepuce remains retractable in uncircumcised males by checking daily that the foreskin can be pulled back over the glans 1

  • This prevents adhesion formation during healing 1

• Consider topical corticosteroid (such as betamethasone 0.05% or clobetasol propionate 0.05% ointment) once daily to non-eroded areas if significant inflammation is present 1, 4

  • This reduces inflammation and may prevent scarring 1
  • Apply only to intact skin, not open wounds 1

When to Seek Further Medical Attention

• If signs of infection develop: increased redness, warmth, purulent discharge, or fever 2
• If the wound fails to heal within 1-2 weeks despite appropriate care 1
• If scarring leads to phimosis (inability to retract foreskin) after healing, as this may require topical steroid therapy or surgical intervention 1, 5
• If underlying conditions are suspected, such as lichen sclerosus (characterized by white, atrophic patches with hyperkeratosis), which requires specific treatment 1

Common Pitfalls to Avoid

• Do not use dry dressings alone - occlusive/moist dressings significantly improve healing compared to leaving wounds exposed to air 1
• Do not use cold water for irrigation if warm water is available, as it causes unnecessary discomfort 1
• Do not apply topical corticosteroids to open wounds or erosions - use only on intact inflamed skin 1
• Do not ignore persistent symptoms - failure to heal may indicate underlying pathology like lichen sclerosus or infection 1