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{{Construction SiteGraphicWarning}}[[Image:Keratinization intact vs circumcisedKeratinization_intact_vs_circumcised.JPG |thumbnail|right|200px| 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 [[preputial mucosa| mucosa]] of the [[circumcised ]] [[penis ]] become dry, toughened , hard and hardrelatively insensitive by a layer of [[keratin]].<ref>{{REFweb |url=https://medical-dictionary.thefreedictionary. com/keratinization |archived= |title=Keratinization |trans-title= |language= |last= |first= |author-link= |publisher=Medical Dictionary for the Health Professions and Nursing |website= |date=2012 |accessdate=2021-03-17 |format= |quote=}}</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. 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.

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 |last=Fink, |first=Aaron J. " |init=AJ |author-link= |title=A possible Explanation for Heterosexual Male Infection with AIDS." ''New England Journal of Medicine'' |journal=NEJM |date=1986 |volume=315, |issue=18 (1986): |pages=1167 |url= |accessdate=2020-09-04}}</ref>

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 [[intact]] men are were formerly believed to be at higher risk for [[HIV ]] infection, however keratinization of the glans penis was not measured."<ref>{{REFjournal

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| contribution=HIV-1 Interactions and Infection in Adult Male Foreskin Explant Cultures | quote=No difference can be clearly visualized between the inner and outer foreskin. | url=http://retroconference.org/2009/PDFs/502.pdf | title=16th Conference on Retroviruses and Opportunistic Infections | author=Minh H Dinh; Sheila M Barry, Meegan R Anderson, Scott G McCoombe, Shetha A Shukair, Michael D McRaven, Thomas J Hope | publisher= | place=Montreal, Canada | pages= | date=2009-12-06 | accessdate=2011-06-28

Higher incidence of [[Circumcision and Sexually Transmitted Diseases (STD)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 |last=Rosenberg |first=Molly S. |init=MS |author-link= |last2=Gómez-Olivé |init2=FX |author2-link= |last3=Ronr |first3=Julia K. |init3=JK |author3-link= |last4=Kahn |first4=Kathleen |init4=K |author4-link= |last5=Bärnighausen |first5=Till W. |init5=TW |author5-link= |etal=no |title=Are circumcised men safer sex partners? Findings from the HAALSI cohort in rural South Africa |trans-title= |language= |journal=PLOS ONE |date=2018-08-01 |volume=13 |issue=8 |page=e0201445 |url=https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201445 |quote= |pubmedID=30067842 |pubmedCID=6070310 |DOI= https://doi.org/10.1371/journal.pone.0201445 |accessdate=2019-10-20}}</ref> ==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. {{SEEALSO}}* [[Immunological and protective function of the foreskin]]* [[Preputial sac]]{{LINKS}}* [https://damagefromcircumcision.blogspot.com/p/keratinization.html The Damage from Circumcision: Keratinization]* {{REFweb |url=http://www.intactaus.org/information/functionsoftheforeskin/ |title=Functions of the Foreskin |trans-title= |language= |last=Helard |first=Lou |author-link=Lou Helard |publisher=Intact Australia |website=http://www.intactaus.org |date=2014-08-01 |accessdate=2020-06-05 |format= |quote=}}

[[Category:Penile disordersdisorder]][[Category:Foreskin anatomy]][[Category:Circumcision complication]]