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Misinformation abounds regarding the hygiene of the intact penis. In the United States, especially, doctors tend to be ignorant, misinformed, or simply uninformed concerning the hygienic care of intact men and children, and this happens for a variety of reasons. As of now, America is primarily a country where circumcision is prevalent, and thus intact male genitals are unfamiliar to many Americans. Many American medical doctors, are ignorant of the subject because they are themselves circumcised, wives to circumcised men, and/or mothers to circumcised children. Additionally, care of the intact male genitals is rarely mentioned in medical school. The foreskin and the proper care for intact genitals tends to be absent in pediatric literature.<ref name="osborn1981">{{REFjournal
|last=Osborn
|firstinit=LM
|author-link=
|last2=Metcalf
|first2init2=TJ
|author2-link=
|last3=Mariani
|first3init3=EM
|author3-link=
|etal=no
Boys are born with a non-retractable [[foreskin]].<ref>{{REFjournal
|last=Simpson
|first=Errol T . |init=ET
|author-link=
|last2=Barraclough
|first2=Phillip
|init2=P
|author2-link=
|etal=no
}}</ref> The foreskin is self-cleaning, so no further cleaning is necessary. The first person to retract a boy's foreskin should be the boy himself.<ref>{{REFjournal
|last=Wright
|firstinit=J EJE
|author-link=
|etal=no
The information provided by supposed authorities regarding when the foreskin of a boy becomes retractable is usually wrong. The foreskin may be become retractable after a few years, but it usually does not. Thorvaldsen & Meyhoff (2005) conducted a survey of young men in Denmark where boys are preserved intact. They found that the average age of first foreskin retraction is 10.4 years.<ref name="thorvaldsen2005">{{REFjournal
|last=Thorvaldsen
|firstinit=M AMA
|author-link=
|last2=Meyhoff
|first2init2=H
|author2-link=
|etal=no
|title=Patologisk eller fysiologisk fimosePathologic or physiologic phimosis? |trans-title=Patologisk eller fysiologisk fimose?
|language=Danish
|journal=Ugeskr Læger
By the onset of puberty, most, but not all boys, have a retractable foreskin. Boys with a retractable foreskin should retract and wash their foreskin when they bathe. Use of soap, shampoo, and body wash on the mucosa inside the foreskin should be avoided because it dries the oils from the mucosal tissue.<ref>{{REFjournal
|last=Birley
|firstinit=HDL
|author-link=
|last2=Luzzi
|first2init2=G AGA
|author2-link=
|last3=Bell
|first3init3=R
|author3-link=
|etal=no