Lichen Sclerosus In Men
In males, lichen sclerosus affects the foreskin and end of the penis. It is less common than in women, affecting around 1 in 100,000 men. It is more common in young boys and also adult men. Lichen sclerosus in males is sometimes also called balanitis xerotica obliterans.
White spots develop on the foreskin and end of the penis. These can be sore. In time, the changes to the affected skin may cause difficulty in retracting the foreskin and in passing urine. Erections may become painful. The anal skin is rarely affected in men.
Sometimes small patches of lichen sclerosus occur on other parts of the body. These look like small pearly white areas on the skin. Sometimes they occur in people who also have genital lichen sclerosus. Sometimes they occur without genital problems.
The cause is possibly an autoimmune response. This is when the body's immune system attacks a part of the body. This causes inflammation and damage to the affected part of the body. In people with lichen sclerosus the genital area of skin may be attacked by some parts of the immune system which then causes inflammation. However, this has not been proved and it is not known what triggers lichen sclerosus to develop.
The itch and discomfort may cause much distress. The changes to the genital skin may cause sexual difficulties or problems in passing urine.
In men there is a small increased risk of developing cancer of the penis. The exact risk is unknown but it is thought that around 8 in 100 men with lichen sclerosus develop this cancer
The appearance is often fairly typical, in which case no further tests are needed. If the diagnosis is in doubt, a small sample (biopsy) of affected skin may be taken under local anaesthetic. The sample of skin is put under the microscope to look at the structure of the skin cells and tissues. This can confirm the diagnosis and rule out other disorders which can sometimes mimic this condition.
A strong steroid ointment or cream (topical steroid) is the main treatment (dermovate aka clobetasol or mometasone). Steroids reduce inflammation. It is usual to use the ointment or cream regularly for three months (see Lichen Sclerosus Treatments) Keep on with treatment for as long as advised. Irritation tends to ease after two weeks or so, but the skin may take about three months of treatment to look and feel better.
The skin may return to normal if lichen sclerosus is diagnosed and treated with a topical steroid at an early stage. However, if the appearance of the skin has already changed a lot, the changes may not reverse much with topical steroid treatment, even though symptoms of itch and soreness are often relieved.
After the initial regular treatment for about three months, you may then only need to use the ointment or cream once or twice every 1-2 weeks to keep symptoms away.
Use a moisturising (emollient) cream or ointment instead of soap to clean the genital area. This is also soothing. Avoid bubble baths, scented soap, detergents, perfumes, etc, to the genital skin.These may irritate the skin and make symptoms worse. Lubricants are useful during sex if having sex is painful.
In the small number of cases where topical steroids do not help, a skin specialist may advise other medicines to reduce inflammation.
Foreskin removal (circumcision) may be needed in some affected men or boys. Some men may need other operations to improve the narrowing and scarring of the water pipe (urethra) caused by this condition.
There is no permanent cure for lichen sclerosus. However, treatment with a topical steroid usually controls the symptoms of itch and soreness, and often prevents the condition from getting worse.
As mentioned above, cancer of the genital skin (penis) of men is an uncommon complication. Therefore, it is best to get into the habit of checking your penis about once a week to look out for any signs of early cancer. As a rule, the earlier any cancer is detected, the easier it is to treat. To check your penis, use a hand-held mirror to see your penis and use your fingers to feel your penis. Get to know what your penis looks and feels like, and see a doctor if any changes occur. For example, if you detect any thickening, warts, lumps, ulcers, blisters or sores.
White spots develop on the foreskin and end of the penis. These can be sore. In time, the changes to the affected skin may cause difficulty in retracting the foreskin and in passing urine. Erections may become painful. The anal skin is rarely affected in men.
Sometimes small patches of lichen sclerosus occur on other parts of the body. These look like small pearly white areas on the skin. Sometimes they occur in people who also have genital lichen sclerosus. Sometimes they occur without genital problems.
The cause is possibly an autoimmune response. This is when the body's immune system attacks a part of the body. This causes inflammation and damage to the affected part of the body. In people with lichen sclerosus the genital area of skin may be attacked by some parts of the immune system which then causes inflammation. However, this has not been proved and it is not known what triggers lichen sclerosus to develop.
The itch and discomfort may cause much distress. The changes to the genital skin may cause sexual difficulties or problems in passing urine.
In men there is a small increased risk of developing cancer of the penis. The exact risk is unknown but it is thought that around 8 in 100 men with lichen sclerosus develop this cancer
The appearance is often fairly typical, in which case no further tests are needed. If the diagnosis is in doubt, a small sample (biopsy) of affected skin may be taken under local anaesthetic. The sample of skin is put under the microscope to look at the structure of the skin cells and tissues. This can confirm the diagnosis and rule out other disorders which can sometimes mimic this condition.
A strong steroid ointment or cream (topical steroid) is the main treatment (dermovate aka clobetasol or mometasone). Steroids reduce inflammation. It is usual to use the ointment or cream regularly for three months (see Lichen Sclerosus Treatments) Keep on with treatment for as long as advised. Irritation tends to ease after two weeks or so, but the skin may take about three months of treatment to look and feel better.
The skin may return to normal if lichen sclerosus is diagnosed and treated with a topical steroid at an early stage. However, if the appearance of the skin has already changed a lot, the changes may not reverse much with topical steroid treatment, even though symptoms of itch and soreness are often relieved.
After the initial regular treatment for about three months, you may then only need to use the ointment or cream once or twice every 1-2 weeks to keep symptoms away.
Use a moisturising (emollient) cream or ointment instead of soap to clean the genital area. This is also soothing. Avoid bubble baths, scented soap, detergents, perfumes, etc, to the genital skin.These may irritate the skin and make symptoms worse. Lubricants are useful during sex if having sex is painful.
In the small number of cases where topical steroids do not help, a skin specialist may advise other medicines to reduce inflammation.
Foreskin removal (circumcision) may be needed in some affected men or boys. Some men may need other operations to improve the narrowing and scarring of the water pipe (urethra) caused by this condition.
There is no permanent cure for lichen sclerosus. However, treatment with a topical steroid usually controls the symptoms of itch and soreness, and often prevents the condition from getting worse.
As mentioned above, cancer of the genital skin (penis) of men is an uncommon complication. Therefore, it is best to get into the habit of checking your penis about once a week to look out for any signs of early cancer. As a rule, the earlier any cancer is detected, the easier it is to treat. To check your penis, use a hand-held mirror to see your penis and use your fingers to feel your penis. Get to know what your penis looks and feels like, and see a doctor if any changes occur. For example, if you detect any thickening, warts, lumps, ulcers, blisters or sores.
Penile cancer
Penile cancer is a rare type of cancer that occurs on the skin of the penis or within the penis. In the UK between 2014-2016 there was 639 new cases diagnosed and 139 deaths. Around 68% of those diagnosed live 10+ years so the survival rate is quite high with around 68% of cases being preventable as long as it is detected early. Statistics from Cancer research UK. Penile cancer was found in men as young as 25 with the most common age group being between 65-69 year olds.
There are several types of penile cancer, depending on the type of cell the cancer developed from.The most common types include:
Symptoms include:
The cause can be a number of factors including:
•HPV
•Lichen Sclerosus
•Weakened immune system
•Treatment for psoriasis
•Age
Treatment for penile cancer depends on the size of the affected area and the rate at which the cancer has spread.For example, in most cases of carcinoma in situ (CIS), where only the skin cells of the penis are affected, treatment usually involves either using a chemotherapy cream or having laser surgery to remove the affected area of skin.
You'll usually have a skin graft after surgery.
The main treatments for later-stage penile cancer are:
There are several types of penile cancer, depending on the type of cell the cancer developed from.The most common types include:
- squamous cell penile cancer – this accounts for more than 90% of cases and starts in the cells that cover the surface of the penis
- carcinoma in situ (CIS) – a particular type of squamous cell cancer where only the cells in the skin of the penis are affected and it hasn't spread any deeper
- adenocarcinoma – cancer that starts in the glandular cells of the penis that produce sweat
- melanoma of the penis – this is where the cancer develops in the skin cells that give the skin its colour
Symptoms include:
- An area of skin becoming thicker.
- Changes in the skin color.
- A lump.
- An ulcer (sore) that might bleed.
- A reddish rash under the foreskin.
- Small, crusty bumps.
- Flat, bluish-brown growths.
- Smelly discharge (fluid) or bleeding under the foreskin.
The cause can be a number of factors including:
•HPV
•Lichen Sclerosus
•Weakened immune system
•Treatment for psoriasis
•Age
Treatment for penile cancer depends on the size of the affected area and the rate at which the cancer has spread.For example, in most cases of carcinoma in situ (CIS), where only the skin cells of the penis are affected, treatment usually involves either using a chemotherapy cream or having laser surgery to remove the affected area of skin.
You'll usually have a skin graft after surgery.
The main treatments for later-stage penile cancer are:
- Surgery
- Radiotherapy
- Chemotherapy
