Lichen Sclerosus (BXO)

BXO now known as Lichen sclerosus is a skin condition that affects the penis in men and vulva in women. Symptoms include itching, soreness and changes in the appearance of affected skin.

Birmingham Prostate Clinic offers a specialist lichen sclerosus treatment service for men. Please note that we are unable to treat women with this condition.

The condition affects the foreskin and end of the penis, but can occur at any age, including childhood. Lichen sclerosus in males used to be called Balanitis Xerotica Obliterans or BXO.

What are the symptoms in men?

The first sign of the condition is the appearance of white spots on the foreskin and end of the penis. These may itch and can be sore. Over time, the changes to the affected skin may cause difficulty in retracting the foreskin and in passing urine. Erections may become painful. Sometimes small patches of lichen sclerosus occur on other parts of the body.

What are the causes?

The cause of lichen sclerosus is not fully understood. Some experts believe it may be an inflammatory disease, but it is not clear why it occurs. It has also been suggested that the disease may be an autoimmune disorder, when the body’s immune system attacks its own tissues. There are possible links to bacterial infections, but no causal link has been conclusively agreed.

However, lichen sclerosus is not infectious and cannot be passed from person to person by touch or through sex.

How is it diagnosed?

An experienced urologist is normally able to identify lichen sclerosus by a physical examination. The diagnosis may be confirmed by taking a small biopsy of affected skin under local anaesthetic. The sample of skin is put under the microscope to look at the structure of the skin cells and tissues. The biopsy will enable the urologist to rule out other disorders which may have a similar appearance.

Lifestyle practices to help with the condition

These lifestyle tips may help, whether you are undergoing treatment or not:

  • Apply lubricant (petroleum jelly, A and D ointment, Aquaphor) to the affected area
  • Gently clean the area with soap and dab dry. Try to avoid using perfumed soaps on the affected area
  • Ease burning and pain by sitting in warm shallow water or use ice packs or cool compresses
  • Wear cotton or silk underwear
  • Use a lubricant if sex is uncomfortable


Below are some of the most common forms of treatments which your doctor will discuss with you during your consultation.

Topical steroids

Topical steroids are the topical forms of corticosteroids. These have anti-inflammatory properties which are designed to help reduce irritation of the infected area.


Circumcision is the removal of the foreskin from the penis.

Glans resurfacing

Glans resurfacing is a procedure that involves removing some skin from the head of the penis. It can be carried out on the area of concern for either benign or cancerous reasons.  This will be discussed with you at your consultation.


Treatments for Lichen Sclerosus (BXO)