Lichen sclerosus is a chronic inflammatory skin condition that mainly affects the skin of the genitals but it can also affect any part of the skin.

In men is usually often seen on the foreskin and tip of the penis. In some patients, lichen sclerosus also affects the skin elsewhere on the body, where it can cause whitish patches of skin, but usually no discomfort is reported. It can affect boys or men of any age.

What causes a male genital lichen sclerosus?

Currently, the causes of lichen sclerosus are not fully understood. It almost never occurs in men who have been circumcised early in their life. Lichen sclerosus is not caused by an infection, even though the genital area is affected, it cannot be passed onto a sexual partner.

Lichen sclerosus can affect some men with auto-immune diseases such as diabetes or thyroid disease. It may also be linked to atopic conditions such as asthma, eczema and hay fever. Damage or friction to the skin can bring out lichen sclerosus and make it worse. Some men dribble a small amount of urine after passing water, and it is thought that the trapping of urine under the foreskin may cause male genital lichen sclerosus.

In rare cases there is sometimes a link between lichen sclerosus and penis cancer. Although undergoing a circumcision may reduce the risk, it does not prevent penis cancer.

What are the symptoms of male genital lichen sclerosus?

Symptoms of lichen sclerosus can be as follows:

  • The skin may tear and bleed during sexual intercourse.
  • The affected skin may feel uncomfortable, sometimes itchy, burning, and sore, especially during or after sex.
  • Often the foreskin gets tighter and more difficult to retract, leading to painful erections.
  • When the opening in the tip of the penis is affected, the urine may spray.

However, some men do not experience any symptoms.

What does male genital lichen sclerosus look like?

Usually, the affected skin of the penis can appear red, with little cracks, sores, bleeding points or small blood-blisters. When the skin has been inflamed for some time, it can turn white and become thinned. Sometimes, thickening of the skin may be seen. Scarring can develop and change the appearance of the foreskin or tip of the penis. When the tightened foreskin is retracted, it may draw in around the shaft of the penis like a tight band.

 Sometimes the foreskin may be too tight to withdraw, making it impossible to clean the tip of penis. If this happens it is important to seek advice from a doctor as there may be an increased risk of cancer if this problem is left untreated.

How is male genital lichen sclerosus diagnosed?

A small skin sample may be taken and checked under the microscope to confirm the diagnosis, especially if there is an open sore or a thickened area of skin. This is known as a skin biopsy and requires a local anaesthetic injection and possibly stitches to close the wound, leading to a small scar.

Can male genital lichen sclerosus be cured?

Although circumcision can cure lichen sclerosus in some patients, in others the condition may continue or change after surgery. Lichen sclerosus will not go away on its own but may not cause any symptoms when the correct treatments are used.

How can male genital lichen sclerosus be treated?

Treatments can include:

  • Strong steroid ointments which are used to stop the inflammation and soften the affected skin. This reduces the need for surgery. After the initial treatment period, a maintenance treatment plan may be required. This may include the regular use of moisturisers and intermittent use of steroid creams, which may be less strong.
  •  If the foreskin becomes too tight to function properly and is not softened by creams, referral to a urologist for circumcision or other surgery may be necessary. This may cure the lichen sclerosus, even on the shaft and tip of the penis.
  •  If the opening at the tip of the penis becomes so narrow that urine cannot pass through it easily, the urologist may recommend gently stretching it and / or apply steroid ointments to the area and, failing this, consider surgery. It is therefore important that you seek advice if you have any problems passing water.

 What can I do at home?

  • If you are a smoker, stop smoking to reduce the risk of penis cancer.
  • Carefully dry yourself after passing urine to reduce the contact of urine with your skin.
  • Avoid washing with soap and instead use an emollient soap substitute/ cream to wash. Many different non-perfumed creams can be used, however aqueous cream can lead to irritation in some men and should be avoided.
  • Keep pubic hairs trimmed so they do not get trapped between the foreskin and the penis.
  • A lubricant for sex will reduce excessive friction.
  • Using a moisturiser or yellow soft paraffin (such as Vaseline) as a barrier cream can protect your skin from exposure to urine.
  • Lifelong regular self-examination is very important for all men who have or have had genital lichen sclerosus. If any skin changes develop which do not respond to steroid creams, in particular any persistent skin thickening or soreness, it is important to tell the doctor without delay. A skin biopsy may be necessary to test for skin cancer.

If you would like to speak to our team about Lichen sclerosus, please call us on 0161 327 1269 or email us at

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.