Dr Tom Smith 

Doctor, doctor

Dr Tom Smith answers your questions
  
  


My five-year-old son has had a second episode of balanitis (inflammation of the foreskin) in six months and my GP says if it happens again, we should consider circumcision. I worry that this is a traumatic option. What other remedies, apart from good hygiene, are there?

My own feeling about circumcising small boys is that we shouldn't do it unless it's absolutely necessary. Repeated balanitis is very sore, but it should be possible to treat it with the correct antibiotics, repeatedly if needed. As the penis develops (the prepuce - foreskin - takes some time to separate from the glans) up to the age of around eight, the problem should go away. However, if it becomes scarred, so that the opening of the prepuce becomes rigidly narrowed and it can't peel back over the glans, then a small operation could help. I favour a small 'dorsal slit' rather than a complete circumcision, so the healed foreskin continues to be a cover for the glans, thereby retaining its sensitivity.

Is it harmful to click your fingers sporadically or continually? Could it cause arthritis in the long run?

I don't know of any studies that have shown that always clicking your fingers causes harm - but then I don't suppose it has attracted much research attention. My gut feeling is that it won't do any harm. However, I would ask why you are doing it? Is it a nervous problem? If so you may have to consider your reaction to stress. If it is just a safety valve, I don't see what harm it does, except that it may be embarrassing in company.

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