Foreskin Cracking and Bleeding: 7 Causes (Balanitis, Phimosis, Lichen Sclerosus, Diabetes) and When to See a Doctor

Foreskin fissures/bleeding indicate underlying pathology:

1. Balanitis: Glans inflammation (hygiene, Candida, irritants). Treat: hygiene, topical antifungals/steroids.
2. Phimosis: Non-retractile foreskin → tearing during retraction/erection. Treat: topical steroids, stretching, circumcision.
3. Lichen sclerosus (BXO): White, sclerotic plaques; progressive scarring, stenosis. Treat: ultra-potent topical steroids; circumcision often curative.
4. Trauma: Zipper injury, vigorous sex, masturbation.
5. Infections: HSV (ulcers), syphilis (chancre), candidiasis.
6. Diabetes: Microvascular disease, immune impairment → recurrent balanitis, poor healing.
7. Medications: Chemotherapy, retinoids → skin fragility.

See a urologist/dermatologist for persistent/recurrent fissures. Biopsy if LS suspected. Circumcision resolves most structural/recurrent issues.