Keratinization and Circumcision Status
(NSFW)
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Illustration 1, above. The intact penis of a 71 year old Caucausian male pictured above shows preservation of child-like thin, smooth, and shiny purple glans surface tissue substantially unlike shaft skin on the same penis.
Illustration 2, above. The circumcised penis of a 40 year old Caucasian male pictured above shows keratinization in the change of glans surface tissue to rougher, pink, normal body skin similar to shaft skin on the same penis.
The bullet (Illustration 1) and helmet (Illustration 2) shaped glans of the models are two normal variations in glans shape unrelated to circumcision status. It was intended to show the models in substantively the same state of tumescence for fair comparison.
Keratinization: Etiology and Relationship to Age
Etiology — The glans (head) of the penis is a genital structure that is normally protected from external contact by the foreskin of the natural penis. When the penis is modified by amputation of the foreskin, then this natural protection is lost and a process called keratinization proceeds to protect the delicate glans surface tissue from drying and the abrasion of the external environment. In other words, the normally delicate and smooth glans external membrane becomes calloused, or keratinized.
Relationship to Age — Although keratinization is an expected age-related change in the circumcised penis, it is not a manifestation of normal aging in the intact penis, as shown in the illustrations above. We document this fact using men of substantially different ages and opposite circumcision status as models. There is no evidence of keratinization in the 71 year old intact penis, and obvious keratinization in the 40 year old circumcised penis.
Effects of Keratinization
Delayed Clinical Presentation — Although the adaptation of glans surface tissue to exposure to the external environment necessarily begins soon after the trauma of circumcision, the process of keratinization progresses for decades and is rarely, if ever, seen as a source of presenting complaints by the OB-GYN or pediatrician who performs the circumcision surgery.
Loss of Glans Sensitivity — However, there are clinical problems due to keratinization that present long after childhood. This is because in protecting the unnaturally exposed glans, keratinization decreases its sensitivity. Research has documented that many different areas of the intact penis are more sensitive than the most sensitive area of the circumcised penis – which is the circumcision scar itself (see Sorrells, M, et al, ‘Fine touch pressure thresholds in the adult penis.’ The full text of this scientific publication is available: http://www.nocirc.org/touch-test/touchtest.php ). Thus, there is no question that the glans of the circumcised penis is a less sensitive structure than that of the intact penis.
Sex Partner Complaints — Not only has decreased glans sensitivity been associated with complaints of decreased sexual pleasure in men, their partners also suffer consequences of circumcisions. Anecdotal evidence includes complaints of pounding sex, dry unpleasant sex, and vaginal abrasion or lesions that are commonly heard from older women sex partners of circumcised men. The etiology of these complaints involves loss of penis sheath mobility and loss of glans sensitivity in the circumcised penis.
Erectile Dysfunction — Decreased glans sensitivity has also been associated with erectile dysfunction (ED). Men have complained that sexual stimulation during intercourse has been insufficient for them to maintain an erection firm enough for coitus, and have sought relief through the use of prescription medications for treatment of ED.
Foreskin Restoration
The National Organization of Restoring Men (NORM) lists more than 16 physical attributes of the foreskin and adjacent structures, including the frenulum, that are commonly destroyed by circumcision (The “Lost List”: http://www.norm.org/lost.html ). Among those that NORM considers restorable are glans color and texture, which is a restoration result that reverses keratinization. Thus, NORM cites foreskin restoration results that “… closely mirror natural glans coloration and smooth glossy appearance of the glans seen in intact men.’ In conjunction with this reversal of keratinization, the gliding action of the skin sheath of the penis, which is lost in the circumcised penis and is consequently a common source of sex partner complaints, can be regained as one of the primary benefits of foreskin restoration, providing “… greater levels of comfort and pleasure during intercourse.” For ongoing discussion of foreskin restoration please see http://www.uncutting.tumblr.com and http://www.restoringtally.tumblr.com .
Keratinization: Etiology and Relationship to Age
Etiology — The glans (head) of the penis is a genital structure that is normally protected from external contact by the foreskin of the natural penis. When the penis is modified by amputation of the foreskin, then this natural protection is lost and a process called keratinization proceeds to protect the delicate glans surface tissue from drying and the abrasion of the external environment. In other words, the normally delicate and smooth glans external membrane becomes calloused, or keratinized.
Relationship to Age — Although keratinization is an expected age-related change in the circumcised penis, it is not a manifestation of normal aging in the intact penis, as shown in the illustrations above. We document this fact using men of substantially different ages and opposite circumcision status as models. There is no evidence of keratinization in the 71 year old intact penis, and obvious keratinization in the 40 year old circumcised penis.
Effects of Keratinization
Delayed Clinical Presentation — Although the adaptation of glans surface tissue to exposure to the external environment necessarily begins soon after the trauma of circumcision, the process of keratinization progresses for decades and is rarely, if ever, seen as a source of presenting complaints by the OB-GYN or pediatrician who performs the circumcision surgery.
Loss of Glans Sensitivity — However, there are clinical problems due to keratinization that present long after childhood. This is because in protecting the unnaturally exposed glans, keratinization decreases its sensitivity. Research has documented that many different areas of the intact penis are more sensitive than the most sensitive area of the circumcised penis – which is the circumcision scar itself (see Sorrells, M, et al, ‘Fine touch pressure thresholds in the adult penis.’ The full text of this scientific publication is available: http://www.nocirc.org/touch-test/touchtest.php ). Thus, there is no question that the glans of the circumcised penis is a less sensitive structure than that of the intact penis.
Sex Partner Complaints — Not only has decreased glans sensitivity been associated with complaints of decreased sexual pleasure in men, their partners also suffer consequences of circumcisions. Anecdotal evidence includes complaints of pounding sex, dry unpleasant sex, and vaginal abrasion or lesions that are commonly heard from older women sex partners of circumcised men. The etiology of these complaints involves loss of penis sheath mobility and loss of glans sensitivity in the circumcised penis.
Erectile Dysfunction — Decreased glans sensitivity has also been associated with erectile dysfunction (ED). Men have complained that sexual stimulation during intercourse has been insufficient for them to maintain an erection firm enough for coitus, and have sought relief through the use of prescription medications for treatment of ED.
Foreskin Restoration
The National Organization of Restoring Men (NORM) lists more than 16 physical attributes of the foreskin and adjacent structures, including the frenulum, that are commonly destroyed by circumcision (The “Lost List”: http://www.norm.org/lost.html ). Among those that NORM considers restorable are glans color and texture, which is a restoration result that reverses keratinization. Thus, NORM cites foreskin restoration results that “… closely mirror natural glans coloration and smooth glossy appearance of the glans seen in intact men.’ In conjunction with this reversal of keratinization, the gliding action of the skin sheath of the penis, which is lost in the circumcised penis and is consequently a common source of sex partner complaints, can be regained as one of the primary benefits of foreskin restoration, providing “… greater levels of comfort and pleasure during intercourse.” For ongoing discussion of foreskin restoration please see http://www.uncutting.tumblr.com and http://www.restoringtally.tumblr.com .
Notice the shine on illustration 1, which is indicative of a textural difference. Upon having done some restoration for some time, I have discovered that my glans has taken on a thin crinkle-crepe-like smoothness reminiscent of a membrane rather than skin. The colour has deepened to a richer pink/purple as a result of the layers of keratinisation sloughing away. The sensitivity has increased considerably, and for this reason alone I continue to be hassled by the burden of wearing tape rings daily. I have to do this because the excessive loss on the ventral (underside) of my penis has pulled my scrotal tissue forward to compensate. There is little left with which to expand, and further proof that all "circumcisions" aren't equal. This should be outlawed for anyone under 18, and not by a vote of the people, but by executive order.
ReplyDeleteThis is amazing to me. Wow. Great post, I find it so interesting the effects on circumcision last a lifetime. A little snip and it's over as a baby? Think again america!
ReplyDeleteVery good pictures. They do a good job illustrating the difference between intact and circumcised.
ReplyDeleteBefore I started restoring my foreskin, my penis looked like the second picture: skin colored and dry. Now that my glans stays covered with my new restored foreskin, I look more like the first picture: healthy mucous membrane that is shiny and purple-colored.
Excellent article. Thanks for posting this!
ReplyDeleteI am a expecting mom and after reading this i am not going to put my Boy through that. My Husband is un cut and i love it lol.
ReplyDeleteIt is interesting to note the apparent policy in Japan, possibly other cultures too! Of not circumcising, but neither the less
ReplyDeletetraining the foreskin to keep retracted. Over time it appears the
foreskin does keep back from the glans. Thus the penis retains the nerves normally cut away, though the penis is then toughened up, to allow longer intercourse or masturbation sessions. Various devices are featured on the Internet ( e.g China & Japan) to
assist in training your foreskin.
Caution :- some are small and awkward to fit & retain. However
I'm not sure if using them say in one's teens they are easier to apply.
Like restoring one's foreskin after being cut, these devices take time to effect and produce your desired
profile.
Great study, though it focuses only on the undesired effects (cons) of circumcision.
ReplyDeleteOne big advantage supported by many studies is the fact that the keratinization from circumcision acts almost as a natural condom reducing the risk for HIV infection up to 50%, as the infection normally occurs in de-keratinized areas, like the inner section of lips, anal region, mouth, esophagus, etc. One of the studies made in Uganda, Africa observed two groups of adult sexually active males. 50 were circumcised and 137 were not, all of them were educated on the use of preservatives; after the study finished 30 months later 89% confessed not using condoms during the intercourse. No infections occurred on any of the circumcised men, and 40 of 137 circumcised men became infected.
Let us be cautious, as this is not proof 100% immunity to the virus, but just how ineffective the HIV virus is to be transmitted through keratinized skin.
Additional studies have evidence that the transmission rate is reduced by 50% on keratinized circumcised penis.
http://www.bmj.com/content/320/7249/1592
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0020393
http://www.scientificamerican.com/article.cfm?id=circumcision-and-aids
That's fine I grown men want to make that choice--trading a smoother, more sensuous glans and a degree of sexual pleasure for a POSSIBLE health benefit. But let's not force such a thing in children.
ReplyDeletei thought that keratinization was not normal
ReplyDeleteStudies show that the rough keratinized glans of circumcised mencauses vaginal erosion leading to greater infection rate to women who have unprotected reproductive sex with HIV+circumcised men. Also vaginal erosion leads to more histerectomies, studies show 1 in 3 US women married to circumcised men will need a total histerectomy before they turn 60 years old.
ReplyDeleteThere is no proof that keratinization blocks HIV, It's only an assumption that is presented/claimed as a fact by proponents of ritual, routine, and religious circumcision. HIV can enter anywhere on our epidermis organ where there is an open wound, not just the foreskin/prepuce like proponents of infant circumcision falsely claim. There is no proof, but procircs also claim that HIV enters through mucosal cells, that can be found in both sexes prepuces and urinary tracts, as well as the mouth, anus, sinuses, lungs.
Frederick Rhodes