Penile Lichen Sclerosus Treatment

Pollock Clinics offers treatment for male genital lichen sclerosus for boys and men. This common penile skin condition is also known as balanitis xerotica obliterans, or BXO.

Penile lichen sclerosus is a skin condition usually seen in uncircumcised men and boys.

It may appear as a scaly patch on the foreskin and can cause the skin to look cracked and feel sore.  Lichen sclerosus is the most common cause of an acquired tight foreskin.

Despite the tendency to affect genital skin, BXO is not an infection – the disease is not contagious, so sexual partners cannot pick it up. Rarely, BXO can be hereditary.

Platelet rich plasma injection and circumcision are the primary treatment methods employed at Pollock Clinics, as well as other options, including topical steroids as appropriate.

Please contact us to schedule a consultation for lichen sclerosus treatment.

No referral is needed.

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What is Male Genital Lichen Sclerosus?

Penile lichen sclerosus, also known as balanitis xerotica obliterans (BXO), is a skin condition (fibrosis) that can cause disease and scarring of the penile foreskin, glans and urethra. This can lead to phimosis and stenosis (narrowing) of the urethra.

Symptoms of BXO or Lichen Sclerosus

Men and boys with penile lichen sclerosus may have phimosis, an inability to retract the foreskin. The foreskin may harden and become inflexible, and the same can occur with the skin of the glans.

Men may also experience difficulty with urination, either because of severe phimosis or stenosis – a narrowing of the urethra. In some cases, the foreskin can adhere to the head of the penis due to chronic inflammation.

Lichen sclerosus can be asymptomatic, but is usually itchy. Other symptoms include:

  • A burning sensation
  • Bleeding
  • Fissuring
  • Painful urination
  • Painful erections
  • Painful sexual intercourse
  • Poor urinary stream (dribbling or spraying)

Early manifestations of lichen sclerosus may be more subtle, including discoloration of the skin, red or purple spots, and visible capillaries under the skin.

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Lichen Sclerosus Symptoms

If you have symptoms of BXO or penile lichen sclerosus please contact us.

Causes of Lichen Sclerosus or BXO

Lichen sclerosus is poorly recognised; reported figures likely underestimate the prevalence of this disease.

Lichen sclerosus can occur at any age, but it commonly peaks in childhood and again when men are in their forties and fifties. In studies of foreskins removed for phimosis, a majority are found to have lichen sclerosus.

The exact causes of lichen sclerosus are unknown. It is usually seen in uncircumcised men. Chronic infection and inflammation are suspected contributing factors. Obesity, anatomical abnormalities (such as hypospadias), and trauma (surgery, piercings) may also be factors. Lichen sclerosus does not occur in men who were circumcised at birth.

Lichen sclerosus on the penis may be due the long-term effect of occlusion of urine causing irritation and inflammation on the glans and prepuce.

It is not a sexually transmitted disease and is not transmitted to sexual partners of patients.

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Risks of Penile Lichen Sclerosus

Men with penile lichen sclerosus or BXO are at higher risk of developing penile cancer. In addition, the progression of the disease may result in urethral strictures, inability to urinate, and bladder and kidney damage.

While a circumcision is a treatment option for many patients it may not necessarily be curative on its own because the disease can reappear on the glans, urinary meatus and urethra, and that is why circumcision and PRP treatment are often employed together.

Circumcision alone is an effective option for patients who have phimosis.

The most common complications of lichen sclerosus include:

  • Phimosis, due to adhesion of the prepuce to the glans.
  • Paraphimosis, in which retraction leads to constriction of the penis shaft and atrophy of the glans.
  • Urinary retention.
  • Urethral stenosis, and altered flow.
  • Retrograde damage to the bladder and kidneys.

In the longer term, lichen sclerosus has been associated with penile cancer. Cancer may be more likely if lichen sclerosus does not receive treatment and there is ongoing active disease. One third to one half of all penile cancer is associated with lichen sclerosus with an incidence rate ranging from 0–12.5%.

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PRP Treatment of Balanitis Xerotica Obliterans

Treatment options for male genital lichen sclerosis include:

  • Platelet rich plasma (PRP) injections
  • Circumcision
  • Topical corticosteroids

PRP therapy and circumcision are the primary treatment methods offered for penile lichen sclerosus at Pollock Clinics.

How PRP Treatment Works

Platelet rich plasma injection is a simple and near painless procedure which uses platelet rich plasma (PRP) drawn from your own blood to treat penile lichen sclerosus. The injection of platelet-rich plasma appears to stimulate regeneration of blood vessels, nerves and tissues.

Blood platelets possess a variety of growth factors and substances with reparative and healing properties. There is promising scientific data that shows the potential ability and safety of PRP therapy in improving the health and functioning of penile tissue.

PRP therapy is a well-tolerated procedure that usually has no impact on your medications or health conditions.

The Lichen Sclerosus PRP Procedure

The platelet rich plasma injection is created from the patient’s own blood.

The blood goes through a proprietary process to separate the platelets into a concentrated plasma – Platelet Rich Plasma. These platelets are used for the PRP injection.

PRP therapy involves administering a series of superficial injections of tiny drops of platelet-rich plasma into the affected area. Once it enters the soft tissue, the platelet-rich plasma triggers the release of growth factors. These growth factors naturally stimulate the dermis of the skin. One of the growth factors (among the 20-plus currently known to researchers) found in platelet-rich plasma is vascular endothelial growth factor (VEGF).

The penile injection delivers several different growth factors which stimulate the cells, collagen and blood vessels to rejuvenate tissue.

What to Expect During Your Visit

When you arrive, our staff will take you to an examination room to draw your blood.

Patients will wait in the room while we process the plasma.

The entire process will take about an hour.

Patients will remove their clothing below the waist and lie on the table in preparation for the injections.

The doctor will use a local anaesthetic and once the area is frozen, the doctor injects the PRP in the affected areas of the penis.

The injections take about 5 minutes and the procedure is complete.

PRP treatments are simple injections using the patient’s own blood plasma.

FAQ

PRP therapy is a suitable treatment option for boys and men with a mild or moderate case of penile lichen sclerosus.

Platelet-rich plasma (PRP) therapy is an innovative and promising treatment that represents a major advance in regenerative medicine.

The therapy follows a standard procedure which consists of taking a blood sample from the patient and centrifuging the vial to isolate the platelet-rich plasma from the blood. When injected into the patient, the platelets, growth factors and other chemicals found in high concentration in the platelet-rich plasma allow the body to heal, repair or reject various tissues. Platelet-rich plasma has a powerful ability to regenerate tissue.

A temporary skin reaction at the site of the injections can sometimes occur. The PRP injection is derived from your own blood, so the risk of a negative reaction is minimal.
Generally, the patient attends five treatment sessions, with two to four intervening weeks between each session. Each treatment session lasts about 45 to 60 minutes.
You may begin to see results in three months. However, the primary benefits usually show up six months after the injections. These include improvements in skin quality and skin density.

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