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Go to the emergency room. Ask for a sedative or a painkiller (if needed). Allow access the operation site. Ask for a local anesthesia. Ask to cover the area with mineral oil. Allow the doctor to release the skin from the zipper. Talk to the doctor if an elliptical skin incision or emergency circumcision is needed (only if necessary).
If you cannot release the skin from the zipper at home or if you feel unqualified to do so, seek medical attention. If the patient is hysterical, ask the doctor to provide adequate sedation or pain medication to calm the patient enough that the injury can be treated. If the patient is calm enough, sedation may not be needed and local anesthesia may be enough (see below). In order to treat the injury, the doctor may need to cut off the pants, leaving only the zipper around the skin. This will allow a better view of the entrapment and minimizes further injury, such as the weight of the pants pulling on the skin. A local anesthetic (such as lidocaine) or a topical anesthetic (such as EMLA cream) may be applied to numb the skin locally and facilitate its release from the zipper.  Dorsal penile block can also be used but is typically saved for difficult entrapments only or those involving a large area of skin. Note: the benefits of a local anesthetic should be weighed against the injection itself and any additional pain resulting from that. This helps reduce friction and can ease the release of the skin. Let the oil soak for about 15 minutes. The skin may be removed in a few different ways depending on where the skin is entrapped.  When skin is caught between the teeth, the doctor may cut the zipper above or below the site where the entrapment is and gently pull the teeth apart to release the skin. If the entrapment is within the sliding part of the zipper, the skin is released by cutting the median bar (the small bridge between the anterior and posterior faceplates) to allow the faceplates to fall apart and the entrapped skin to be released. If the skin cannot be freed otherwise, the use of an elliptical skin incision or an emergency circumcision will be performed by an urologist under general anesthesia.