Smegma is an accumulation of oil, dead cells, and fluids in the genital area causing thick, white, sticky, secretions with a foul odor.
Smegma can be caused by poor hygiene and can build up under the foreskin of the penis and in the folds of the vulva. It can also affect babies, especially those with a condition called phimosis, which makes it difficult to retract the foreskin, allowing smegma to build up underneath.
Smegma is not a sexually transmitted infection and can be treated and prevented with good hygiene practices. It can, however, cause pain and redness in the genital area. In this case, it is a good idea to consult your pediatrician, gynecologist, or urologist for proper guidance.
Common symptoms
Smegma buildup may cause the following symptoms:
- Thick, white, sticky secretions;
- Foul odor;
- A cheesy-looking substance;
- Irritation or redness, in some cases.
Symptoms generally occur under the foreskin in men and people assigned male at birth (AMAB) and in the folds of the vulva or around the clitoris in women and people assigned female at birth (AFAB).
In the case of excessive smegma buildup, the smegma may harden and cause the foreskin to become stuck to the penis, or the clitoral hood to adhere to the clitoral glans, leading to pain and discomfort.
In men, smegma buildup may also lead to infections of the foreskin and result in balanitis, a condition involving pain, redness, and swelling of the glans (head) of the penis.
Confirming a diagnosis
Smegma is a clinical diagnosis made by a pediatrician, urologist, gynecologist, or primary care provider based on symptoms, hygiene practices, and a physical exam.
There are typically no special tests required to confirm the diagnosis, however a doctor or other healthcare provider may recommend collecting a sample of the secretions to be analyzed at the lab if there is any concern for sexually transmitted infections (STIs).
Possible causes
Smegma is caused by poor hygiene habits that allow for the accumulation of fluids, sebum, and dead skin cells under the foreskin or in the folds of the vulva and around the clitoris.
It is a natural secretion produced by the body, however an accumulation of smegma can result from improper hygiene.
Different types
Smegma can be classified into three types, which are:
1. Smegma in children
Smegma affects babies and children and occurs most commonly in males. This is due to difficulty cleaning under the foreskin of the penis due to phimosis, a condition that prevents retraction of the penis and is normal in babies and young boys before the foreskin loosens and naturally separates from the head of the penis.
Phimosis can be identified when it is difficult to manually retract the skin covering the glans (head) of the penis. It may also cause difficulty urinating in more severe cases.
See phimosis treatments.
2. Smegma in men
Smegma occurs more commonly in men who are not circumcised because of smegma buildup under the foreskin, which is the skin that covers the head of the penis.
3. Smegma in women
Smegma in women can appear in the folds of the vulva or around the clitoris, which are regions that produce more sebum and therefore are more prone to buildup.
Smegma buildup around the clitoris can lead to the formation of clitoral adhesions, which can cause the clitoral hood to stick to the glans (head) of the clitoris. Adhesions can be mild, moderate, or severe and cause significant pain.
Treatment options
Treating smegma involves good hygiene practices in order to prevent buildup of sebum, dead cells, and fluids in the genital area.
Recommended practices for adequate genital hygiene include:
1. Male hygiene
Adequate hygiene for men, boys, and male babies who are not circumcised should involve washing under the foreskin of the penis with warm water and mild soap at least twice a day, making sure to dry well afterward. Do not pull back the foreskin of a baby if it has not yet separated from the penis.
For those who are circumcised, it is important to wash with mild soap and water around the head of the penis, especially in the region called the corona, which is the rim that separates the head of the penis from the shaft.
It is important to be careful not to scrub the head of the penis too hard and to avoid pulling too much on the foreskin of an uncircumcised penis in order to prevent damaging the skin and increasing the risk for infections.
2. Female hygiene
Female hygiene should involve the use of water and mild soap, two times a day at the most, making sure to rinse well and dry after washing. Ask your gynecologist or women's health care provider about any feminine care products you are using.
To wash the genitals, gently separate the labia and wash the vulva and clitoris with warm water and a small amount of mild, unscented soap. Rinse well and dry afterward.
To prevent irritation, it is important to avoid scrubbing the vulva too hard and using soaps in the vagina. Rinsing well with warm water also helps remove soap completely and prevent irritation.
Prevention measures
The best way to prevent smegma buildup is good hygiene habits.
For boys and men, a pediatrician or urologist may recommend phimosis surgery in order to make cleaning under the foreskin easier and prevent the buildup of smegma.
It is also recommended for people of all genders to wear cotton underwear and avoid wearing tight-fitting pants in order to prevent excess production of sebum and fluids that can lead to an accumulation of smegma.
When to see a doctor
It is important to consult your primary care provider, gynecologist, urologist, or pediatrician for the following:
- Worsening of smegma despite adequate genital hygiene;
- Hardened smegma;
- Redness or swelling of the head of the penis, vulva, or clitoris;
- Genital itching or burning;
- Difficulty urinating;
- Vaginal or penile discharge.
Your doctor or other advanced practice provider will evaluate your symptoms in order to identify a cause and arrange for the most appropriate treatment.