If the tone of this page is less serious than the other ones, it's because I honestly believe that the hygiene issue is the most overblown part of the whole circumcision debate. It is based on facts, but anecdotes and appeals to common stereotypes, and it is offensive to every man who knows how to clean himself properly. People have created a whole mythology around the uncleanness of the intact penis and how much cleaning it needs to avoid infection and foul odor that they never bother to check into the reality of the situation.
The belief behind the hygiene argument goes like this; parents must retract their son's foreskins and clean underneath is prevent infections starting at some arbitrary point (maybe from birth or when he turns 1 or 2 or 3) and if they don't he will be inflicted with infections. When he gets older he'll have to wash under his foreskin once every day and parents will have to inspect him to make sure he does, and if this doesn't happen then he will get lots of infections are will be surrounded by an inescapable odor. Even if he does wash himself once a day hygiene will still be extremely difficult and his foreskin is still likely to be dirty and foul smelling.
Where these beliefs originated I'm not sure, but there is only a small kernel of truth behind this and the rest of it is based on myths and half-truths. I will proceed to examine all of these common myths and stereotypes surrounding hygiene of the intact penis. Information from the American Academy of Pediatrics is taken from their page on Care of the Uncircumcised Penis and will appear in italics.
Do parents need to clean under their son's foreskin?
No. Keeping the intact penis clean during infancy is simple, only the outside must be washed. The AAP says:
"Foreskin retraction occurs when the foreskin can be pulled back away from the glans toward the abdomen. This process happens on its own. When it happens is different for every child. It may take a few days, weeks, months, or even years. This is normal. Most boys will be able to retract their foreskins by the time they are 18 years old. Some foreskins retract soon after birth. Separation can even occur before birth, but it is rare. As a boy becomes more aware of his body, he will most likely discover how to retract his own foreskin."
Cleaning under the foreskin won't become necessary until he turns 5 or 6, and at this point he should be able to do it himself. I've seen some people go as far as to say that parents should retract their son's foreskins at every diaper change. If parents are being told this, no wonder their sons are getting infections. The AAP also has to say:
"Foreskin retraction should never be forced. While the foreskin is still attached to the glans of the penis, do not try to pull it back, especially in an infant. Forcing the foreskin to retract before it is ready may harm the penis and cause pain, bleeding, and tears in the skin."
In a sad way, the intact penis has become a self-fulfilling prophecy. Parents are told how difficult it will be to keep clean when in reality it's nothing special, and as a result they focus so much special attention on cleaning their son's foreskin that they may be giving him infections. When the foreskin is torn this provides an easy entry point for infection causing bacteria. It's also been shown in Birley's study that balantitis, an infection commonly blamed on lack of circumcision can be caused by excessive washing. Then the infections are blamed on the foreskins simple presence and they're told this wouldn't have happened if he had been circumcised. That's partially true, because if he were circumcised he most likely would not have been subjected to the fanatical cleaning.
Is smegma produced by the intact penis harmful?
No. In the 19th century when doctors were looking for medical justifications for circumcision using methods that any good scientist would recognize as flawed today they thought smegma may be a carcinogen, but this has since been proven false, despite how occasionally it may resurface in a pro-circumcision article. The AAP has this to say about smegma:
"When the foreskin separates from the glans, skin cells are shed. This begins in childhood and continues through the teen years. New skin cells regularly replace the ones that are shed. Since this shedding takes place in a closed space - with the foreskin covering the glans - the shed skin cells work their way along the penis through the tip of the foreskin. These discarded skin cells may look like whitish lumps, resembling pearls, under the foreskin. These whitish lumps are called smegma. Specialized glands, called Tyson's Glands, located under the foreskin are largely inactive in childhood. At puberty, Tyson's Glands produce an oily substance, which, when mixed with skin cells, make up adult smegma. Adult smegma serves as a protective lubricator for the glans."
Smegma only becomes a problem when you allow it to build up for a long time, and this is easily avoided by good hygiene. Contrary to what is commonly believed, an uncircumcised male is not going to be full of smegma his entire life, most of it is produced during childhood when the foreskin is retracting and shedding lots of skin cells. Girls and women also produce smegma (more of it than intact males in fact) but it's never thought of as such a problem with them. Just as women are not dripping smegma from their genitals there entire lives that they have such a difficult time cleaning up, any intact male most likely will not have the same problem.
How easy is the intact penis to keep clean?
We've already established that parents do not need to retract their son's foreskins to clean under when he's a baby and toddler and that he should be the first to retract his own foreskin and then he can wash it himself. But those in the pro-circumcision camp still try to say that it is too difficult for a boy to keep himself clean once he becomes old enough. Again, the AAP says:
"The uncircumcised penis is easy to keep clean. When your son is an infant, bathe or sponge him frequently and wash all body parts, including the genitals. You do not need to do any special cleansing, such as with cotton swabs or antiseptics. Simply wash the head of the penis and the inside fold of the foreskin with soap and warm water. Remember, do not try to forcibly retract the foreskin."
Now that it's been shown that the intact penis is easy to clean, circumcision supports have abandoned the science and turned to anecdotes and stereotypes. They say that despite how easy intact penile hygiene may be, it's still damn near impossible to get any little boy to clean himself, making circumcision the easiest option. This image appeals to people because just about everyone has the image of the little boy who loves getting dirty and hates taking baths, and I'm not going to deny that these types of boys exist. But despite how much resistance some boys might have to bathing, the foreskin still remains just as easy to clean.
Some circumcision supporters argue that act as if a boy's penis must be washed every day if he's intact. Little boys are usually bathed no more than a few times a week, and that's only as much cleaning as the penis needs, whether circumcised or intact. Some little boys may resist bathing but parents are still able to get them to do it, even if they need to be prodded a little. Once you get them in the bathtub it shouldn't be that difficult to get them to wash their penises, most boys enjoy handling their penises anyway. All they need to do is retract it in the tub and let some water get underneath whenever they bathe and that's all it takes. It's much simpler than surgery.
When they get older and reach their teen years, than it becomes important that they wash underneath their foreskin once a day, just as it's recommended that you shower and wash every body part once a day. The foreskin needs no special treatment as it's commonly claimed, it just needs the same washing as the rest of the body. By the times they're teens your son should already know the importance of good hygiene and won't need to be reminded, as long as he showers once a day, retracts his foreskin and rinses underneath it will work.
Circumcision advocates have sometimes asked what he'll do if he goes camping or hiking for a week and doesn't have access to the proper facilities to wash under his foreskin. This comes from taking instructions that the foreskin should be washed daily too far. Remember that it's not only the foreskin that they recommend be washed once a day, but every body part. But even though taking daily showers it considered an important for hygiene, but if you can still survive without them for an amount of time. This applies equally the women as much as to intact men. Women are also told they should wash their genitals daily and have enough folds of skin between their legs that bacteria can got caught in but they can get along just fine without access to the proper facilities for a period of time.
Pro-circumcision sources will often make a big deal about how even anti-circumcision sources stress how important hygiene is for intact males. The truth is it's only them making such a big deal about this. They recommend circumcision as a remedy for penile hygiene and in response, we try saying how simple it is. Hygiene simply would not be an issue if it weren't made one. You treat it and keep it clean the same way that you would any other body part that you don't cut off. In the end, it's an insult to any male's intelligence to tell him that his body is so dirty that he can't be trusted to practice good hygiene and clean it himself.
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