Dead skin cells and sebum oils combine under the foreskin of the penis and appear as small white bumps. This is known as smegma. While it can be alarming when first noticed, it comes naturally and helps promote lubrication between the glans and foreskin. Smegma should be removed through normal washing processes, but in some cases where hygiene is poor or washing under the foreskin is difficult, smegma can build up and cause problems later on. Regular washing, penile health creams, and medication to control smegma may be required.

Symptoms

Smegma is present under the foreskin of all men, as it is constantly produced by the skin, but it is not always obvious. When it becomes visible, smegma appears as moist white materials that form into small balls between the glans penis and the foreskin. Although smegma is odorless, in some cases where hygiene is very poor the smegma can harden into “smegma stones” which can be very uncomfortable. Eventually, the hardened smegma can cause bacteria cultures to build up under the foreskin and increase the risk of infection and disease. If the smegma appears with other symptoms such as itching, inflammation or pain, see your doctor to rule out sexually transmitted diseases or candidiasis.

Causes

Hygiene: Why don’t all men experience smegma? It depends on differences in hygiene habits, as washing under the foreskin will remove exfoliated skin cells before they can accumulate sebum oils and become visible smegma. According to a review of research published in The Journal of the European Academy of Dermatology and Venerology in 2006, researchers determined that smegma is made up of dead skin cells, fat, prostate secretions, sex hormones, and white blood cells. Doctors used to believe that smegma could cause diseases such as prostate cancer, but now scientists understand that smegma is common in adolescents and adult men. It helps lubricate the space between the head of the penis and the foreskin, and may even have antibacterial and antifungal properties.

Phimosis

Men who have experienced difficulty retracting their foreskin and exposing the head of the penis may have a condition known as phimosis. In most cases, congenital phimosis can also be caused by trauma, infection, or scarring. Due to the difficulty in retracting the foreskin, hygiene and cleanliness is very difficult in many cases, making the presence of smegma more likely. According to a study published in The Journal of Urology in 1973, men with phimosis are almost twice as likely to experience smegma as men without phimosis. If cleaning the space under the foreskin is too difficult and does not properly remove the smegma, then full or partial circumcision may be required to avoid discomfort and the onset of diseases.

Treatment

Washing: Smegma is a natural lubricant and antibacterial agent, but it can build up if penile hygiene is not done regularly. Regular cleaning of the glans penis under the foreskin with soap and warm water helps remove exfoliated skin cells and prevents them from building up. This good hygiene practice should be done every day, especially in men with a tendency to develop smegma, as a preventative measure.

Medications: In some cases, antibiotics can have a regulatory effect on the sebaceous glands in the skin and can benefit cases of multiple smegma accumulation when the causes are not due to phimosis or poor hygiene. Antibiotics are commonly used for severe cases of acne, although they take several months to take full effect on the sebaceous glands. Antibiotics can cause side effects in some cases, such as poor immune function, gut dysbiosis, and digestive problems. Check with your doctor to find out if antibiotics are right for you.

Creams: Penile health creams can help balance the oil glands under the foreskin and keep the skin on the penis hydrated. Many men experience dry skin on the penis, glans, and foreskin due to the large amount of soap they have to use to remove smegma buildup. Specialized topical formulations (most health professionals recommend Man1 Man Oil) containing nutrients such as Vitamin E, C, A, B3, and Shea Butter can support normal skin regeneration, soften dry smegma that has hardened and keep the skin of the penis healthy.