In his absurdly candid memoir, Spare, Prince Harry tells the public much, much more than the public actually wants to know, from the time he watched Meghan Markle’s sex scene on Suits, to the way he lost his V-card to an older woman who treated him like a “young stallion.” Perhaps the most, er, sensitive revelation? That on a trip to the North Pole ahead of Prince William’s wedding, he failed to properly insulate his crown jewels, and wound up with a case of frostbite on his “todger.”
For a time, Harry writes, the appendage in question was “oscillating between extremely sensitive and borderline traumatized,” and he even tried home remedies — read: Elizabeth Arden cream — before seeking medical care. In a distressing twist, he was reminded of his mother Princess Diana, an Elizabeth Arden fan, as he applied the moisturizer: “I found the tube and the minute that I opened it, the smell transported me through time. It felt as if my mother was right there in the room, and I took a smidge and applied it down there.”
When I learned of this admission, I was shocked — and not only because a man within spitting distance of the British throne had talked openly about his royal shaft. In my 28 years on Earth, it had never once occurred to me that a penis could get frostbite. And yet, it made so much sense! If fingers and toes are susceptible, why not a dick — the finger of the lower torso, as one might call it. Why, I wondered, were people not talking about this penis-threatening danger all the time?! Why weren’t they wearing insulated cups every time it dropped below 50 degrees?! Should I go on Shark Tank with an electric crotch warmer, to fill an obvious hole in the market?! (Harry sought a “bespoke cock cushion” to prepare for his trip North, which both raises the possibility that a seamstress somewhere has his measurements, and suggests that there’s not an off-the-rack option.)
I was consoled when I spoke to the very knowledgeable urologist Dr. Darren Bryk, a member of the Beli Medical Board who completed a residency at the Cleveland Clinic before joining the University of Virginia as an Andrology and Male Infertility Fellow. Penis frostbite is rare, I learned, and preventative measures can be taken — such as optimizing your health and quitting smoking ahead of an expedition, and wearing a sweat-wicking layer under an insulated material. I also learned that it’s common for young people to avoid seeking care for their packages, frostbitten and otherwise. As Dr. Bryk puts it, “You’re young, you’re healthy, you don't want to ruin that picture of yourself [and learn] that you may have an issue.”
Below, Dr. Bryk indulges me and my many questions about what happens to penises when they get too cold.
So, what exactly is frostbite?
It is a localized, cold-induced injury to the tissue that is affected. That’s probably the most simple way of describing it — that just the constant exposure to extreme cold damages the tissue and then that damage can be exacerbated once you've warmed it up, due to inflammation. The vessels try to open up to rewarm, and a there’s a reflex of them constricting and furthering the damage once you're no longer exposed to the severe cold temperatures.
It usually happens on places that are either not covered or are “end organs,” like your fingers and toes or your nose, where the blood flow may be slightly less expansive.
And does the penis count as one of those end organs?
Yeah, the penis is an end organ. It's something that we are always aware of when we operate on the penis because if you affect the blood flow, you can actually damage it. So it certainly does. I think it's less commonly involved because it's often very well-covered and protected in cold. And also, they talk about “shrinkage,” and that's because the penis and scrotum get smaller to stay closer to the body, to get some of that body’s warmth.
For a patient who has frostbite, what does it feel like to have that tissue damaged?
It varies on the severity of course, but I think initially, you feel cold and numb, or painful — kind of depends on how the nerves are affected. And there can also be color changes to that affected area. Once you rewarm or once you're no longer exposed, there can then be even persistent throbbing pain or throbbing color changes, and even intermittent numbness or tingling or weird sensations that can sometimes last a prolonged period.
This is probably an extremely stupid question, but I'm going to ask it anyway. Does it matter if the penis is circumcised?
It doesn't because the foreskin is not a protection for warmth, it's just a thin layer of skin that can often easily be pulled down. So it's essentially just extra skin, but it doesn't protect any part of the penis necessarily, in that way.
That's not a stupid question. It would make sense. It's kind of like a turtleneck for the tip of the penis. But no.
If a patient came into you with this condition, how would you advise that they handle it?
I guess it kind of depends on when they're coming in. From what I understand with Prince Harry, it sounded like he presented a little late, so maybe it wasn't as severe as it could have been, thankfully. But initially, in the immediate, if I'm with someone who's freezing cold and the immediate is to warm it up — place it in warm water, not hot, but warm water, that would be approximately the temperature of the human body, like 98 to a 100 degrees. And that will help prevent any further damage, increase blood flow to the area, may hurt a little bit, but that's probably the healthiest way to help it recover.
In the days that follow, there may be blistering, and you definitely would want to keep that clean and dry and monitor it for infection, if there is any evidence of infection. Potentially antibiotics, or if it's very severe and it gets deep into the tissue, then you may need some sort of surgical excision of the dead tissue, to allow the rest of it to heal.
Over time, even if there’s blistering or skin color changes or sloughing of skin, it should heal back to relatively normal. Maybe you have some mild longer lasting effects, but for the most part, you can have a close to a 100% or a 100% recovery.
What would the lasting effects look like? I imagine that's only in severe cases.
Yeah, I mean it definitely in severe cases, you can even have auto-amputation [the spontaneous falling of an appendage] or having to cut it off. I've read about that with fingers and toes. I've never really read about it with a penis. And again, it's probably because it's pretty rare to have incredibly severe for a penis. But if we are talking about genitals, if it affects sensation or if it causes pain, then it could have an effect on erectile function or even just sexual function, in general. If you're having pain, you're not going to want to have sexual activity. If it's causing pain, it could affect how your orgasm feels or how when you ejaculate. So there can be more effects in that regard. I think, and if it were severe that it's going deeper than the skin, it can affect the erectile bodies that can allow penis to have an erection, or the urethra where you pee from. So depending on how severe, I can foresee that that would be a possibility.
In his memoir, Harry says that before he sought actual medical treatment, he tried using moisturizing cream from the brand Elizabeth Arden as a home remedy. Was that advisable?
Probably not. It's probably not a dry skin kind of thing. What I imagine is he saw, maybe he saw a blister that had opened and he put that on to allow it to just get the nutrients that were in the moisturizing cream. So if he had a superficial frostbite that was not severe, I don't think that the cream is going to hurt him necessarily, though maybe it was painful.
I think the better part that was allowing him to heal was that he was no longer in the cold, and he’s probably also cleaning it and keeping it dry and taking care of it, like you would any kind of wound on your body. So that was probably what was better. So if he did see any improvement, I would say it might be a placebo effect.
This interview has been edited and condensed for clarity.