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Physiological phimosis can be divided into three main categories - symptom-free, in need of therapy and in need of surgery.
From a medical standpoint, an otherwise symptom-free [[phimosis]], even after dissolution of preputial adhesions, does not require any treatment before the child enters puberty. The widespread notion that full retractability has to be achieved by a certain age, derives from obsolete assumptions and studies which only covered children's development until they entered school, but not beyond that point.
Even though the data from Jakob Øster's studies (see above) have been known for 45 years, some check lists for school doctors‘ examinations still erroneously refer to physiological phimosis as an abnormality.
stretching exercises, if needed with the aid of corticosteroid cream. Depending on the active
substances, success rates of 80-90% have been documented.
<ref>Orsola A, Caffaratti J, Garat JM. Conservative treatment of [[phimosis ]] in children using a topical steroid.Urology2000;56(2):307-10.</ref><ref>Ashfield JE, Nickel KR, Siemens DR,et al. Treatment of [[phimosis ]] with topical steroids in 194 children. J Urol2003;169(3):1106-8.</ref>
<ref>Pileggi Fde O, Vicente YA. Phimotic ring topical corticoid cream (0.1% mometasone furoate) treatment in children. J Pediatr Surg. 2007 Oct;42(10):1749-52.</ref>
<ref>Ghysel C, Vander Eeckt K, Bogaert GA.Long-term efficiency of skin stretching and a topical corticoid cream application for unretractable foreskin and [[phimosis ]] in prepubertal boys.Urol Int. 2009;82(1):81-8.</ref>
<ref>Reddy S, Jain V, Dubey M, Deshpande P, Singal AK.Local Steroid Therapy As The First Line Treatment For Boys
With Symptomatic [[Phimosis ]] - A Long Term Prospective Study.Acta Paediatr. 2011 Nov 21. [Epub ahead of print]</ref>
Should those therapies not yield the desired outcomes, there is a surgical option, namely a preputioplasty.
In pathological phimosis, the foreskin cannot be retracted over the glans without injury, due to a lack of elasticity caused by scarring or hardening.
Repeated infections of the tight foreskin cause this scarring. Also, forceful attempts to retract the foreskin cause tearing with subsequential scarred [[phimosis]]. Lichen sclerosus, that first leads to adhesion and then to shrinking, can also be the cause of [[phimosis]]. This rare, non-contagious chronic skin disease is partly genetically caused and considered incurable.
<ref>http://de.wikipedia.org/wiki/Lichen_sclerosus_et_atrophicus</ref>