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The question: Can you give me some advice on how to teach my four-year-old son to clean his penis and foreskin properly? He's of the age where he wants to do everything himself, but it's important it gets done regularly and properly. Any tips?

The answer: Fortunately, at this age, the foreskin and penis are relatively "self-cleaning" and don't require much care. At 4, a boy's foreskin (the loose skin at the end of the penis) may or may not retract easily. This is not a concern. Most tight foreskins will gradually loosen over time and will be easily retractable by the end of puberty.

If your child is showing interest in cleaning, then he can certainly be shown how to gently retract the foreskin, wipe the area with a facecloth and then return the foreskin to its natural position. Foreskins should never be retracted forcibly.

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Many boys will not be able or interested in doing this procedure until they are older, and attempts to force your child are likely to be fruitless and may be counterproductive. Often, young boys will be resistant to letting their parents do the cleaning, and this is not a serious concern either. Simply soaking in the tub regularly will get the job done.

If your child is prone to redness and irritation of the foreskin or penis, or if their foreskin won't retract by the time they go to high school, then a visit to your physician for evaluation would be prudent.

Send pediatrician Michael Dickinson your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail website. Your name will not be published if your question is chosen.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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