The effectiveness of topical steroid application in relieving phimosis
was studied in 63 boys treated with local application of steroid oint
ment to the foreskin. Betamethasone valerate 0.05% (42 patients), hydr
ocortisone 1% (18 patients), or hydrocortisone 2% (3 patients) was app
lied three times daily for 4 weeks. Thirty-seven of the patients treat
ed with 0.05% betamethasone valerate ointment (half-strength Betnovate
) showed an initial improvement and circumcision was performed on 5 no
n-responders. Six patients showed initial improvement but later redeve
loped phimosis: they were given a further course of treatment, resulti
ng in 2 satisfactory responses and 4 failures requiring circumcision.
Two patients using 2% hydrocortisone and 16 using 1% hydrocortisone oi
ntment showed improvement, but 2 of the latter group ultimately requir
ed circumcision. Overall, a permanent improvement was achieved in 51 o
f the 63 patients, with the ability to retract the foreskin after one
or more treatments. The remaining 12 boys required circumcision. Local
application of steroid ointment to the foreskin results in resolution
of phimosis in the majority of cases, but if the foreskin has a circu
mferential white scar, it is slightly less likely to respond. Followin
g cessation of steriods, phimosis re-develops in a proportion of patie
nts.