Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

The response of phimosis to local steroid application


The effectiveness of topical steroid application in relieving phimosis was studied in 63 boys treated with local application of steroid ointment to the foreskin. Betamethasone valerate 0.05% (42 patients), hydrocortisone 1% (18 patients), or hydrocortisone 2% (3 patients) was applied three times daily for 4 weeks. Thirty-seven of the patients treated with 0.05% betamethasone valerate ointment (half-strength Betnovate) showed an initial improvement and circumcision was performed on 5 non-responders. Six patients showed initial improvement but later redeveloped phimosis: they were given a further course of treatment, resulting in 2 satisfactory responses and 4 failures requiring circumcision. Two patients using 2% hydrocortisone and 16 using 1% hydrocortisone ointment showed improvement, but 2 of the latter group ultimately required circumcision. Overall, a permanent improvement was achieved in 51 of the 63 patients, with the ability to retract the foreskin after one or more treatments. The remaining 12 boys required circumcision. Local application of steroid ointment to the foreskin results in resolution of phimosis in the majority of cases, but if the foreskin has a circumferential white scar, it is slightly less likely to respond. Following cessation of steriods, phimosis redevelops in a proportion of patients.

This is a preview of subscription content, log in to check access.


  1. 1.

    Annuziato D, Goldblum LM (1978) Staphylococcal scalded skin syndrome. A complication of circumcision. Am J Dis Child 132: 1187–1188

  2. 2.

    Caterall RD, Oates JK (1962) Treatment of balanitis xerotica obliterans with hydrocortisone injections. Br J Dermatol 64: 620–627

  3. 3.

    Cooper GG, Thomson GJ, Raine PA (1983) Therapeutic retraction of the foreskin in childhood. Br Med J 286: 186–187

  4. 4.

    Dagher R, Selzer ML, Lapides J (1973) Carcinoma of the penis and the anti-circumcision crusade. J Urol 110: 79–80

  5. 5.

    Gairdner D (1949) The fate of the foreskin. Br Med J 2: 1433–1437

  6. 6.

    Gee WF, Ansell JS (1976) Staphylococcal scalded skin syndrome. A complication of circumcision. Am J Dis Child 132: 1187–1188

  7. 7.

    Griffiths DM, Atwell JD, Freeman NV (1985) A prospective survey of the indications and morbidity of circumcision in children. Eur Urol 11: 184–187

  8. 8.

    Kalcev B (1964) Penile hygiene in school-boys. Med Officer 112: 171–173

  9. 9.

    Kaplan GW (1977) Circumcision — an overview. Curr Probl Pediatr 7: 1–33

  10. 10.

    Kirkpatrick BV, Eitzman DV (1974) Neonatal sepsis after circumcision. Clin Pediatr 13: 767–768

  11. 11.

    Poynter JH, Levy J (1967) Balanitis xerotica obliterans: effective treatment with topical and sublesional corticosteroids. Br J Urol 39: 420–425

  12. 12.

    Preston EN (1970) Whither the foreskin? A consideration of routine neonatal circumcision. JAMA 213: 1853–1858

  13. 13.

    Rickwood AMK, Walker J (1989) Is phimosis over-diagnosed in boys and are too many circumcisions performed in consequence? Ann R Coll Surg Engl 71: 275–277

  14. 14.

    Stenram A, Malmfors G, Okmian L (1986) Circumcision and phimosis — indications and results. Acta Paediatr Scand 75: 321–323

  15. 15.

    Sussman SJ, Schiller RP, Shashikumar VL (1978) Fournier's syndrome. Report of three cases and review of the literature. Am J Dis Child 132: 1189–1191

  16. 16.

    Tan HL (1985) Foreskin fallacies and phimosis. Ann Acad Med Singapore 14: 626–630

  17. 17.

    Taylor PK, Rodin P (1975) Herpes genitalis and circumcision. Br J Venerol Dis 51: 274–277

  18. 18.

    Warner E, Strashin E (1981) Benefits and risks of circumcision. CMA J 125: 967–976, 992

Download references

Author information

Additional information

Correspondence to: S. W. Beasley

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kikiros, C.S., Beasley, S.W. & Woodward, A.A. The response of phimosis to local steroid application. Pediatr Surg Int 8, 329–332 (1993).

Download citation

Key words

  • Circumcision
  • Phimosis
  • Steroids