A penile adhesion is a common condition in circumcised males where the inner skin of the penile shaft re-attaches to the glans (head of the penis). This fusion occurs during the natural healing process following circumcision. Adhesions vary in severity, ranging from a small, temporary spot to a more developed, persistent connection.
How to Identify Penile Adhesions
The most noticeable sign of a penile adhesion is the visual attachment of the shaft skin to the glans, often appearing as a pale or slightly shiny area of fusion. This adhered skin can sometimes partially cover the coronal margin, which is the ridge that separates the head of the penis from the shaft. When the skin is pulled back gently, the area of attachment will remain fixed to the glans.
In cases where the adhesion is more established, it may develop into a thicker, band-like connection known as a skin bridge. This is a more permanent attachment that creates a visible band of skin spanning the distance between the shaft and the glans. The adhesion can sometimes interfere with the urinary opening (meatus), causing it to become partially obscured.
A white, cheese-like discharge called smegma may also become visible beneath the adhered skin. Smegma is a collection of shed skin cells and naturally occurring oils that accumulate under the trapped skin. This accumulation is not a sign of infection, but rather an indication that dead skin cells cannot be naturally sloughed away due to the adhesion.
Why Penile Adhesions Develop
Adhesions form as part of the body’s natural healing process after a circumcision. The raw edges of the remaining penile shaft skin are prone to fusing with the moist surface of the glans during the initial recovery period. This occurs because the natural separation previously provided by the foreskin is no longer present to prevent the two surfaces from touching.
Insufficient separation of the skin surfaces, especially in the weeks following the procedure, is a primary contributing factor. When the skin is not routinely retracted or lubricated, the newly healed surfaces adhere easily. Anatomical factors, such as a prominent pubic fat pad, can also push the penile skin forward. This increases contact and subsequent fusion of the skin layers.
Treatment and Prevention Strategies
Minor adhesions frequently resolve on their own as the penis grows and spontaneous erections naturally stretch and separate the attached tissues. For more persistent or widespread adhesions, a common non-surgical approach involves the application of a topical steroid ointment, such as betamethasone. This ointment is typically applied twice daily for several weeks to soften the adhered tissue and increase its elasticity.
Softening the tissue allows for the gentle separation of the adhesion by a clinician in the office or sometimes through gradual separation during routine hygiene. For thicker, more established skin bridges, a brief, in-office procedure called lysis of adhesions may be necessary, where a medical professional separates the tissue, often with a topical anesthetic.
Prevention centers on consistent, gentle post-circumcision care. Applying a thin layer of petroleum jelly or an antibiotic ointment during the first few weeks helps keep the area moist and prevents direct skin-to-glans contact. In older infants and children, gentle, non-forceful retraction of the penile skin, as instructed by a healthcare provider, can prevent re-adhesion.