Foreskin Dangerous on Males But Could Help Others

The foreskin is obviously a source of dirt and danger to the normal male, but it apparently does have some scientific value that is likely to grow in the decades ahead.

Have you ever wondered what happened to your foreskin? Probably not. But it is nice to think that this worthless piece of tissue when disfiguring (and harming) the male penis may have some positive benefits in collagen and skin repairs.

Here's what the alternative San Diego CityBeat wrote about this topic:

The $140-million foreskin
How San Diego biotech benefits from circumcision
By Dave Maass

In the bio-tech industry, the term “neonatal fibroblast” is often code for “baby foreskin,” or at least the cells derived from one.

Much like embryonic stem cells may revolutionize treatments for a wide range of chronic and genetic disorders, the neonatal fibroblast has changed how medical and cosmetic doctors heal the skin.

San Diego doctors have appreciated the potential of the foreskin as far back as the 19th century.

As Dr. Peter Charles Remondino wrote in 1891 in The History of Circumcision, “for skin-transplanting there is nothing superior to the plants offered by the prepuce of a boy.”

What Remondino couldn’t have foreseen is how San Diego County’s bio-science industry would develop foreskin technology. For example, Invitrogen Corp., a subsidiary of Carlsbad-based Life Technologies Corp., offers neonatal fibroblasts for $339 per 500,000-cell vial.

Asked where the foreskins come from, spokesperson Tim Ingersoll responded via e-mail: “Life Technologies produces research-use only products using neonatal foreskins discarded from circumcisions with full, informed consent.”

Foreskin research is more closely associated with La Jolla-based Advanced Tissue Sciences. In the early ’90s, the company invented a way to grow and use the fibroblast cells in a skin overlay that could produce collagen and other biological elements to heal wounds.

ATS eventually became financially insolvent and spent the past decade liquidating its assets. Co-founder Dr. Gail Naughton is now dean of the SDSU School of Business Administration.

The foreskin formula also stayed local. Advanced BioHealing, a Connecticut-based company with a 70,000-square-foot manufacturing facility in La Jolla, currently uses ATS’s “Dermagraft” treatment, which is applied primarily to diabetic foot ulcers. Carlsbad-based SkinMedica also employs ATS’s fibroblast process but discards the cells and uses only the protein-rich culture in its skin-cream products.

According to the corporate-analysis firm Hoovers, SkinMedica has a staff of 160 employees and reports $60 million annually in sales. Advanced BioHealing estimates that it pulled in $80 million in sales in 2009 and grew its workforce to 250 employees.

Neither company has acquired a prepuce in nearly 20 years: Advanced BioHealing and SkinMedica’s cells lines are both derived from a single foreskin.

Technically, a fibroblast can be made from any skin tissue, old or young, but the healing properties of infant skin are superior. The fibroblast can come from the skin of any body part, but circumcision means there’s already a surplus of infant skin that would otherwise be destroyed.

“It comes down to the availability of tissue,” Charlie Hart, chief scientific officer for Advanced BioHealing, says. “Collecting tissue from a different site would be an abnormal surgical procedure and there would be a lot of ethical issues with that.”

SkinMedica has been questioned for using the foreskin culture in its Oprah-endorsed anti-aging products.

“Initially, there was a misunderstanding and people thought we were actually grinding up the foreskin,” SkinMedica founder Dr. Richard Fitzpatrick says. “So, there was a lot of snickering and laughing about people putting this foreskin product on their face.”

How did SkinMedica put the urban legend to rest?

“We stopped mentioning it,” Fitzpatrick says.

Circumcise Newborns is Most Effective Strategy

Sometimes it just takes a little common sense to do what is right. But it never hurts to have an academic study back up your point of view. Common sense dictates that circumcising baby boys is the most cost-effective way to achieve the benefits of circumcision even if that boy is not likely to engage in sexually risky behavior until later in life. The anti-circ fanatics often rail against newborn circumcision, saying "baby boys don't have sex, don't circumcise them until later in life." Now comes still another study that establishes the obvious -- newborn circumcision is cheaper and safer and less complicated than adult circumcision. So let's do the obvious -- every baby boy should leave that foreskin behind when he comes home with mommy!

Check out this story below, and share your comments.


ScienceDaily (Jan. 21, 2010) — Circumcising newborn boys as a way to prevent HIV infection in later life is more cost-effective than circumcising adult males, finds a new Rwandan study in PLoS Medicine.

It has already been conclusively shown, from three randomized clinical trials in Uganda, Kenya, and South Africa, that adult male circumcision (MC) roughly halves the HIV transmission rate from women to men. Many African countries hit hard by HIV are therefore offering men the procedure as way to control the epidemic. Rwanda is one such country -- about 3% of adults in Rwanda are infected with HIV but only 15% of men are currently circumcised.

But performing the operation in adolescents and adults is linked with a higher risk of complications than circumcising newborns. And the operation is quicker and simpler to perform in newborns. The new study, by Agnes Binagwaho (Rwanda Ministry of Health) and colleagues, therefore set out to compare three different strategies as applied to Rwanda: circumcising newborns (neonates), adolescents, or adults.

The researchers used a technique called "cost-effective analysis," which looks at the balance between the costs of a medical intervention and its benefits. They estimated that each neonatal MC would cost just US$15 whereas each adolescent or adult MC would cost US$59. They found that neonatal MC would in fact save more money than it costs, because the operation is cheap to perform and would prevent HIV infections that are expensive to treat.

The study findings, say the authors, "suggest that Rwanda should be simultaneously scaling up circumcision across a broad range of age groups, with high priority to the very young."

In an expert commentary on the new study, Seth Kalichman (University of Connecticut) says: "The cost-savings of neonatal MC are compelling and suggest that implementation is economically feasible in developing countries hit hardest by HIV/AIDS. Neonatal MC should therefore be considered a priority in comprehensive HIV prevention plans for southern Africa."

Removal of Foreskin Rids Penis of Bad Bacteria, Study Shows

In another exciting study just released, medical researchers have confirmed that the removal of the foreskin allows the clean-cut penis to shed bad bacteria that can harm both the male and his female partners.

Here's the article from New Scientist

"A flap of foreskin isn't the only thing missing after a circumcision. Microbes that call the penis home disappear, too, which could explain why the procedure reduces a man's chance of contracting HIV.

"The microbes change dramatically," says Lance Price, a microbiologist at the Translational Genomics Research Institute in Flagstaff, Arizona, whose team identified thousands of microbes on the penises of 12 HIV-negative men. All had participated in a clinical study in Uganda which showed that circumcision halves the chances of getting the virus.

"The team discovered a total of 38 families of bacteria on the men's penises before circumcision, and 36 a year after. But the make-up of these communities had swung. Gone were a diverse population of bacteria intolerant of oxygen and linked with vaginal infection; now there was a more homogenous air-loving lot, more typical of other patches of skin.

"Price thinks that some of the expelled bacteria provoke an immune reaction on an uncircumcised penis, causing specialised immune cells to shuttle HIV throughout the body.
Residents of the penis

"Even where religion, culture or costs prevent widespread circumcision, Price says the work could be a first step in delivering the benefits of the procedure without surgery. "The really interesting thing about this study is the potential to modify somebody's risk for HIV."

"His team next plans to determine which microbes are most common on the penises of men who go onto to acquire HIV. Targeting these bacteria with antibiotics – while leaving harmless or even helpful residents of the penis alone – could stem the spread of HIV, he says.

"Martin Blaser, a microbiologist at New York University, says the new study is the most comprehensive look yet at the microbes living on the penis. But given that microbial populations on other parts of the body shift over time, he wonders whether the pre-circumcision bacteria will return. "I expect it will stay changed," he says.

New Calls for AAP to Embrace Newborn Circumcision

What a terrific way to begin 2010 that to see medical doctors call on the American Academy of Pediatrics to replace its so-called "neutral" policy on newborn male circumcision with an affirmative statement on the clear benefits of this procedure to the male, his partners, and society as a whole.

That's the focus of an article and editorial in the January 2010 issue of the Archives of Pediatric and Adolescent Medicine. Here are some excerpts from Fran Lowry's story in Medscape Medical News:

“During the past 4 years, substantial new data have been published on the health benefits of circumcision,” write Aaron A. R. Tobian, MD, from Johns Hopkins University School of Medicine, Baltimore, Maryland, and colleagues. “While the historical evidence strongly suggests that male circumcision reduces urinary tract infections and penile inflammatory disorders in infants, we reviewed the more recent evidence with regard to effects on sexually transmitted infections (STIs) in adulthood.”

"To evaluate the effect of circumcision on HIV prevention, the researchers analyzed 3 randomized controlled trials of more than 10,000 men from South Africa, Kenya, and Uganda.
The trials enrolled HIV-negative men to circumcision on enrollment or after 21 to 24 months, and all 3 trials demonstrated that male circumcision significantly decreased male heterosexual HIV acquisition by 53% to 60%, despite differences in age eligibility criteria, urban or rural settings, and surgical procedure.

"Because of this new evidence, the World Health Organization (WHO), together with the Joint United Nations Program on HIV/AIDS (UNAIDS), recommended that male circumcision be provided as an important intervention to reduce heterosexually acquired HIV in men, the study authors report.

"The trials also found that male circumcision decreased herpes simplex virus type 2 (HSV-2) acquisition by 28% to 34% and the prevalence of human papillomavirus (HPV) by 32% to 35% in men.

"Among female partners of circumcised men, bacterial vaginosis was reduced by 40% and Trichomonas vaginalis infection was reduced by 48%, the study authors write.

"The study authors note that the rates of neonatal circumcision complications are between 0.2% and 0.6% of operations performed. The most common complications are bleeding and local infection, which are controlled with pressure and wound care or antibiotics. Other complications, such as phimosis and concealed penis, adhesions, fistula, meatitis, meatal stenosis, and injury to the glans, are extremely rare.

"They add that there was no evidence of change in sexual behavior after circumcision in the African randomized controlled trials. “Thus, there are risks to neonatal circumcision, but serious long-term complications are extremely rare,” the study authors write.

“The rare short-term risks of neonatal circumcision need to be weighed against the potential benefits accrued in infancy and childhood (eg, reduction of urinary tract infections), the longer-term benefits that may accrue in adolescence and adulthood (eg, reduced risks of HIV, HSV-2, and HPV), as well as possible benefits to female sexual partners of circumcised men (eg, reduced bacterial vaginosis and trichomonas),” Dr. Tobian and colleagues write.

"Medicaid does not cover the cost of male circumcision in 16 states, and the lack of coverage particularly affects disadvantaged minorities, who have the highest risk for HIV and sexually transmitted diseases. “These socioeconomically disadvantaged groups could benefit most if Medicaid covered the costs of neonatal circumcision. Thus, the AAP’s policy has important implications for the health of disadvantaged minorities,” they write.

"They conclude that it is time for the AAP policy to fully reflect current data.

"In an accompanying editorial, Michael T. Brady, MD, from Nationwide Children’s Hospital in Columbus, Ohio, writes that the study authors have provided a very objective review of the available data. Although the 3 randomized trials were performed in Africa, “it is clear that circumcision does offer health benefits, even in the United States,” he notes.

"The current evidence on the health benefits of circumcision is adequate enough to include circumcision in medical coverage provided by Medicaid or commercial insurance providers, Dr. Brady points out. “This is particularly relevant since over the past decade many state Medicaid programs have discontinued payment for circumcision.”

Feast of the Circumcision

Happy New Year!

This new year -- 2010 -- promises to be one of the best ever for advocates of a foreskin-free world. The medical evidence continues to grow on the health benefits conferred by circumcision, and 2010 will bring even more studies by reputable scientists and world health organizations to validate the life-long advantages of early circumcision.

Led by strong government policies in many countries, some nations especially in Africa will move closer to the goal of 100% circumcision, thereby reducing the threat of HIV, STDs, HPV, cancer, and all sorts of other deadly ailments. In the USA, we expect the Centers for Disease Control (CDC) and the American Academy of Pediatrics (AAP) to resist the hyperbolic pressure of the anti-circumcision fanatics by embracing a clear health-based call for the circumcision of all male newborns. Of course, they will insist that it's "voluntary" but the message will be clear: circumcision confers clear health benefits for the male, his sexual partners, and society as a whole.

The year 2010 will also see an uptick in the number of American males who are circumcised. The message has gotten through to parents via a generally positive US media that most anti-circs are shrill, beligerant, penis obsessed nuts who want to deny parents the right to care for their children in the most medically responsible way. Moreover, the average American knows that it's better to be circumcised than not.

Finally, for centuries the Christian church celebrated January 1st as the Feast of the Circumcision, the day Jesus was circumcised in accordance with the traditions of the time. The "good news" today is that, all over the world, circumcision has become the tradition of the 21st century. Whether a church embraces the date or not, we should bring back the Feast of the Circumcision on New Years Day, a way to honor the scientists, the doctors, and the parents who have made circumcision as popular as it is. May 2010 be the year that circumcision is embraced by all. Happy New Year!

Alleluia! Jesus Was Circumcised! Alleluia!

Merry Christmas! And Happy Hannukah, too! As Christians celebrate the birth of Jesus in Bethlehem this Christmas, it's also great to recall that He, too, was circumcised at birth. That was in accord with Jewish practice at the time, but it is also a reminder that there is something "holy" about circumcision for practicing and believing Christians. To be Christ-like in mind, body, and soul -- for many Christians -- means following the example of Jesus with this simple ritual.

Now regular readers of this blog know that I stress the medical and health advantages of universal newborn circumcision, but there is nothing wrong when other traditions, values, and customs lead you to the health-saving grace of circumcision. For many Christians, being circumcised is another way to be at one with Christ. After all, if the little baby Jesus could be a perfect God-in-man on earth without His foreskin, then so can our sons.

Merry Christmas, readers. Alleluia! Jesus Was Circumcised! Alleluia!

2009 Turning Point: Momentum to Circumcise Grows Worldwide

As the year 2009 draws to a close, history may judge this year as the "turning point" in the movement to achieve universal circumcision -- a world in which the foreskin no longer poses a health threat to a male, his partners, or society as a whole.

Aided by one medical study after another this year, more governments than ever have embraced the goal of 100% male circumcision, knowing that this simple health procedure can reduce the risk of HIV by 60% and dramatically curb the spread of STDs, HPVs, cancers, and other ailments that afflict society.

When the data is finally collected for the year 2009, it will show that more males world-wide are circumcised now than ever before in world history. To be circumcised is not only the "norm" in the USA, it has become the desired norm across the world simply because "the cut" is healthy.

Even in those countries where governments have been reluctant to embrace circumcision (i.e., many European countries), the populace as a whole is joining the circumcision movement. Men are opting for the cut, and parents are wisely choosing to circumcise their sons at birth, knowing this is the safest, most reliable, and inexpensive way to protect their boy for life.

We have also seen a growing appreciation of the value of circumcision in Asia and the Indian subcontinent. I would bet, once the data is in, that more Japanese, more Indians, more Chinese are circumcised than ever before -- joining their counterparts in Korea, Philippines, and Indonesia who are already clean-cut. The best news on that front this year have been reports that Chinese health officials may encourage universal circumcision in the near future. The world's largest country could set a powerful example if it would promote newborn circumcision as an important health measure.

The year 2009 also saw the growing hysteria of the anti-circumcision fanatics, as they try to pressure governments to ignore the medical science and to scare parents against this life-preserving procedure. In my view, the fanaticism of these groups only marginalizes them among the mainstream. That is certainly true in the USA where, despite millions of anti-circ dollars spent on lies and mischaracterizations, I have no doubt that more baby boys were circumcised this year than last year.

Just ask the normal person on the street here in the Midwest about circumcision and the answer is always the same. "Of course. It's the healthy thing to do." -- a statement usually coupled with "Yeah, it prevents AIDs." The latter is not quite accurate -- it reduces the risk of AIDs -- but the public is getting the basic message.

Even those who may be confused on the issue because of anti-circ propaganda usually return to the basics. "It's cleaner. It's easier." -- with the variation "If it was so bad, why does everyone do it?" They do it because, deep down, nobody really wants a filthy foreskin that can cause so much medical havoc.

If 2009 becomes the turning point in the medical goal of achieving universal circumcision, there is still one disappointment which can be remedied in the remaining weeks of this year. Where is the American Academy of Pediatrics? Where is the CDC, Centers for Disease Control? We began the year with hope that -- based on medical science alone -- the AAP and CDC would declare that every male should be circumcised. While insiders say they want to do this because they know it is medically right, pressure from the anti-circs have delayed action. Nothing would complete 2009 more as the "Year of Circumcision" than a strong backbone at the AAP and CDC and a year-end statement encouraging ("voluntarily") the circumcision of males!

So what do you think? Do you agree that, in general, this has been a terrific year for circumcision? I welcome your thoughts.