Difference between revisions of "Keratinization"

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[[Image:Keratinization intact vs circumcised.JPG |thumbnail|right|200px| The glans and mucosa of intact and circumcised human penises in adult males.]]
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[[Image:Keratinization_intact_vs_circumcised.JPG |thumbnail|right|200px| The glans and [[mucosa]] of intact and circumcised human penises in adult males.]]
  
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'''Keratinization''' is the process whereby the surface of the [[glans]] and remaining [[preputial mucosa| mucosa]] of the circumcised penis become dry, toughened and hard. Normally, the glans is covered by the [[foreskin]], which moisturizes the area by [[transudation]], keeping the surface of the glans and inner mucosa moist and supple. After circumcision, however, the glans and surrounding mucosa become permanently externalized, and they are exposed to the air and the constant abrasion of clothing. These areas dry out, causing layers of keratin to build, giving the glans and remaining mucosa a dry, leathery appearance.
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'''Keratinization''' is the process whereby the surface of the [[glans]] and remaining [[preputial mucosa|mucosa]] of the [[circumcised]] [[penis]] become dry, toughened, hard and relatively insensitive by a layer of [[keratin]].<ref>{{REFweb
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|url=https://medical-dictionary.thefreedictionary.com/keratinization
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|archived=
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|title=Keratinization
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|trans-title=
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|language=
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|last=
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|first=
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|author-link=
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|publisher=Medical Dictionary for the Health Professions and Nursing
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|website=
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|date=2012
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|accessdate=2021-03-17
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|format=
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|quote=
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}}</ref> Normally, the [[glans]] is covered by the [[foreskin]], which moisturizes the area by [[transudation]], keeping the surface of the glans and inner [[mucosa]] moist and supple. After [[circumcision]], however, the glans and surrounding [[mucosa]] become permanently externalized, and they are exposed to the air and the constant abrasion of clothing. These areas dry out, causing layers of keratin to build, giving the glans and remaining [[mucosa]] a dry, leathery appearance and reducing sensation.
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The color of the [[glans penis]] in Caucasian males will vary. In [[intact]] males, the color of the glans penis is likely have a purple tint, while in [[circumcised]] and keratinized males the oolor is likely to be pinkish or flesh colored.
  
 
== Keratin as "Protection" ==
 
== Keratin as "Protection" ==
  
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It was hypothesized in the past that the layers of keratin resulting from circumcision provided a barrier of protection against sexually transmitted diseases. In 1986, [[Aaron J. Fink]] invented the idea that circumcision could prevent the transmission of HIV, arguing that the hard and toughened glans of the circumcised male resisted infection, while the soft and sensitive foreskin and glans mucosa of the intact male were ports of entry.<ref>Fink, Aaron J. "A possible Explanation for Heterosexual Male Infection with AIDS." ''New England Journal of Medicine'' 315, 18 (1986): 1167</ref>
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It was hypothesized in the past that the layers of [[keratin]] resulting from [[circumcision]] provided a barrier of protection against [[Circumcision and Sexually Transmitted Diseases (STD's)| sexually transmitted diseases]]. In 1986, the late circumcision-advocate [[Aaron J. Fink]] invented the idea, without any evidence, that circumcision could prevent the transmission of [[HIV]], arguing that the hard and toughened glans of the [[circumcised]] male resisted infection, while the soft and sensitive foreskin and glans [[mucosa]] of the [[intact]] male were ports of entry.<ref>{{REFjournal
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|last=Fink
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|first=Aaron J.
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|init=AJ
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|author-link=
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|title=A possible Explanation for Heterosexual Male Infection with AIDS
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|journal=NEJM
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|date=1986
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|volume=315
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|issue=18
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|pages=1167
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|url=
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|accessdate=2020-09-04
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}}</ref>
  
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Recent studies have shown this hypothesis to be false. One study found that there is "no difference between the keratinization of the inner and outer aspects of the adult male foreskin," and that "keratin layers alone were unlikely to explain why uncircumcised men are at higher risk for HIV infection."<ref>{{REFjournal
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Recent studies have shown this hypothesis to be false. One study found that there is "no difference between the keratinization of the inner and outer aspects of the adult male foreskin," and that "keratin layers alone were unlikely to explain why [[intact]] men were formerly believed to be at higher risk for [[HIV]] infection, however keratinization of the glans penis was not measured."<ref>{{REFjournal
 
  |last=Dinh
 
  |last=Dinh
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  |first=MH
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  |init=MH
 
  |last2=McRaven
 
  |last2=McRaven
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  |first2=M.D.
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  |init2=MD
 
  |last3=Kelley
 
  |last3=Kelley
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  |first3=Z.
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  |init3=Z
 
  |last4=Penugonda
 
  |last4=Penugonda
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  |first4=S.
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  |init4=S
 
  |last5=Hope
 
  |last5=Hope
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  |first5=T.J.
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  |init5=TJ
 
  |title=Keratinization of the adult male foreskin and implications for male circumcision
 
  |title=Keratinization of the adult male foreskin and implications for male circumcision
 
  |journal=AIDS
 
  |journal=AIDS
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  |pages=899-906
 
  |pages=899-906
 
  |url=http://www.ncbi.nlm.nih.gov/pubmed/20098294
 
  |url=http://www.ncbi.nlm.nih.gov/pubmed/20098294
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  |quote=We found no difference between the keratinization of the inner and outer aspects of the adult male foreskin. Keratin layers alone are unlikely to explain why uncircumcised men are at higher risk for HIV infection.
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  |quote=
 
  |pubmedID=20098294
 
  |pubmedID=20098294
 
  |pubmedCID=
 
  |pubmedCID=
 
  |DOI=
 
  |DOI=
 
  |date=2010-03-27
 
  |date=2010-03-27
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  |accessdate=
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  |accessdate=2020-06-07
 
}}</ref> Another study found that "no difference can be clearly visualized between the inner and outer foreskin."<!-- <ref>{{REFcontribution
 
}}</ref> Another study found that "no difference can be clearly visualized between the inner and outer foreskin."<!-- <ref>{{REFcontribution
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  | contribution=HIV-1 Interactions and Infection in Adult Male Foreskin Explant Cultures
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  |contribution=HIV-1 Interactions and Infection in Adult Male Foreskin Explant Cultures
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  | quote=No difference can be clearly visualized between the inner and outer foreskin.
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  |quote=No difference can be clearly visualized between the inner and outer foreskin.
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  | url=http://retroconference.org/2009/PDFs/502.pdf
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  |url=http://retroconference.org/2009/PDFs/502.pdf
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  | title=16th Conference on Retroviruses and Opportunistic Infections
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  |title=16th Conference on Retroviruses and Opportunistic Infections
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  | author=Minh H Dinh; Sheila M Barry, Meegan R Anderson, Scott G McCoombe, Shetha A Shukair, Michael D McRaven, Thomas J Hope
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  |author=Minh H Dinh; Sheila M Barry, Meegan R Anderson, Scott G McCoombe, Shetha A Shukair, Michael D McRaven, Thomas J Hope
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  | publisher=
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  |publisher=
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  | place=Montreal, Canada
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  |place=Montreal, Canada
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  | pages=
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  |pages=
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  | date=2009-12-06
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  |date=2009-12-06
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  | accessdate=2011-06-28
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  |accessdate=2011-06-28
 
}}</ref>--> Be that as it may, this hypothesis continues to be popular among researchers who advocate for circumcision as STD prevention.
 
}}</ref>--> Be that as it may, this hypothesis continues to be popular among researchers who advocate for circumcision as STD prevention.
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Higher incidence of [[Circumcision and HIV|HIV infection]] is found in [[circumcised]] men who lack the [[Immunological and protective function of the foreskin| immunological protection]] of the [[foreskin]] and its [[Langerhans cells]].<ref name="rosenberg2018">{{REFjournal
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|last=Rosenberg
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|first=Molly S.
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|init=MS
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|author-link=
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|last2=Gómez-Olivé
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|init2=FX
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|author2-link=
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|last3=Ronr
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|first3=Julia K.
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|init3=JK
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|author3-link=
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|last4=Kahn
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|first4=Kathleen
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|init4=K
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|author4-link=
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|last5=Bärnighausen
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|first5=Till W.
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|init5=TW
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|author5-link=
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|etal=no
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|title=Are circumcised men safer sex partners? Findings from the HAALSI cohort in rural South Africa
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|trans-title=
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|language=
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|journal=PLOS ONE
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|date=2018-08-01
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|volume=13
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|issue=8
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|page=e0201445
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|url=https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201445
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|quote=
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|pubmedID=30067842
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|pubmedCID=6070310
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|DOI= https://doi.org/10.1371/journal.pone.0201445
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|accessdate=2019-10-20
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}}</ref>
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==De-keratinization treatment==
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[[Dekeratinization]] is the reversing of that process.
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The [[foreskin]] provides moisture and oils to the [[glans penis]] by [[transudation]]. [[Foreskin restoration]] by non-surgical means has been found to reduce keratinization and to improve appearance and sensation. When the [[glans penis]] is consistently covered and protected by a regrown [[foreskin]] the moisture and oils cause the keratinization to come off gradually.
 +
Since [[skin]] is constantly dying naturally (apoptosis) and being replaced, once the friction and irritation is replaced with the warm, moist, snug protection of the foreskin, the new cells aren't shoved into the harsh outside world, so they stay soft and pink and sensitive, the way they were intended to be. The surface of the glans penis gradually becomes softer, smoother, more glossy, and  increased sensation has been reported by many restored men.
 +
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As the glans becomes more and more sensitive, restored men come to depend upon their [[restored foreskin]] for protection and comfort.
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{{SEEALSO}}
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* [[Immunological and protective function of the foreskin]]
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* [[Preputial sac]]
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{{LINKS}}
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* [https://damagefromcircumcision.blogspot.com/p/keratinization.html The Damage from Circumcision: Keratinization]
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* {{REFweb
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|url=http://www.intactaus.org/information/functionsoftheforeskin/
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|title=Functions of the Foreskin
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|trans-title=
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|language=
 +
|last=Helard
 +
|first=Lou
 +
|author-link=Lou Helard
 +
|publisher=Intact Australia
 +
|website=http://www.intactaus.org
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|date=2014-08-01
 +
|accessdate=2020-06-05
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|format=
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|quote=
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}}
  
 
{{REF}}
 
{{REF}}
  
 
[[Category:Physiology]]
 
[[Category:Physiology]]
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[[Category:Penile disorder]]
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[[Category:Foreskin anatomy]]
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[[Category:Circumcision complication]]
  
 
[[Category:From Intactipedia]]
 
[[Category:From Intactipedia]]
 
[[Category:From IntactWiki]]
 
[[Category:From IntactWiki]]
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[[de:Keratinisierung]]

Latest revision as of 21:36, 22 November 2023

IntactiWikiGraphicWarning.png

The glans and mucosa of intact and circumcised human penises in adult males.

Keratinization is the process whereby the surface of the glans and remaining mucosa of the circumcised penis become dry, toughened, hard and relatively insensitive by a layer of keratin.[1] Normally, the glans is covered by the foreskin, which moisturizes the area by transudation, keeping the surface of the glans and inner mucosa moist and supple. After circumcision, however, the glans and surrounding mucosa become permanently externalized, and they are exposed to the air and the constant abrasion of clothing. These areas dry out, causing layers of keratin to build, giving the glans and remaining mucosa a dry, leathery appearance and reducing sensation.

The color of the glans penis in Caucasian males will vary. In intact males, the color of the glans penis is likely have a purple tint, while in circumcised and keratinized males the oolor is likely to be pinkish or flesh colored.

Keratin as "Protection"

It was hypothesized in the past that the layers of keratin resulting from circumcision provided a barrier of protection against sexually transmitted diseases. In 1986, the late circumcision-advocate Aaron J. Fink invented the idea, without any evidence, that circumcision could prevent the transmission of HIV, arguing that the hard and toughened glans of the circumcised male resisted infection, while the soft and sensitive foreskin and glans mucosa of the intact male were ports of entry.[2]

Recent studies have shown this hypothesis to be false. One study found that there is "no difference between the keratinization of the inner and outer aspects of the adult male foreskin," and that "keratin layers alone were unlikely to explain why intact men were formerly believed to be at higher risk for HIV infection, however keratinization of the glans penis was not measured."[3] Another study found that "no difference can be clearly visualized between the inner and outer foreskin." Be that as it may, this hypothesis continues to be popular among researchers who advocate for circumcision as STD prevention.

Higher incidence of HIV infection is found in circumcised men who lack the immunological protection of the foreskin and its Langerhans cells.[4]

De-keratinization treatment

Dekeratinization is the reversing of that process.

The foreskin provides moisture and oils to the glans penis by transudation. Foreskin restoration by non-surgical means has been found to reduce keratinization and to improve appearance and sensation. When the glans penis is consistently covered and protected by a regrown foreskin the moisture and oils cause the keratinization to come off gradually. Since skin is constantly dying naturally (apoptosis) and being replaced, once the friction and irritation is replaced with the warm, moist, snug protection of the foreskin, the new cells aren't shoved into the harsh outside world, so they stay soft and pink and sensitive, the way they were intended to be. The surface of the glans penis gradually becomes softer, smoother, more glossy, and increased sensation has been reported by many restored men.

As the glans becomes more and more sensitive, restored men come to depend upon their restored foreskin for protection and comfort.

See also

External links

References

  1. ↑ REFweb (2012). Keratinization, Medical Dictionary for the Health Professions and Nursing. Retrieved 17 March 2021.
  2. ↑ REFjournal Fink AJ. A possible Explanation for Heterosexual Male Infection with AIDS. NEJM. 1986; 315(18): 1167. Retrieved 4 September 2020.
  3. ↑ REFjournal Dinh MH, McRaven MD, Kelley Z, Penugonda S, Hope TJ. Keratinization of the adult male foreskin and implications for male circumcision. AIDS. 27 March 2010; 24(6): 899-906. PMID. Retrieved 7 June 2020.
  4. ↑ REFjournal Rosenberg MS, Gómez-Olivé FX, Ronr JK, Kahn K, Bärnighausen TW. Are circumcised men safer sex partners? Findings from the HAALSI cohort in rural South Africa. PLOS ONE. 1 August 2018; 13(8): e0201445. PMID. PMC. DOI. Retrieved 20 October 2019.
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