Lichen sclerosus (LS) is a long-term inflammatory skin condition that can affect the genitals. In men, it most often involves the foreskin and head of the penis (glans) and can scar over time. It’s not contagious or sexually transmitted.
Who gets it
- Can occur at any age but is most common in uncircumcised men.
- May be linked to autoimmunity, friction, or urine trapping under a tight foreskin.
Signs and symptoms
- White, shiny or thin patches on the foreskin or glans.
- Itching, burning, or soreness; painful sex.
- Cracks, tiny tears, or bleeding.
- Tight foreskin (phimosis) or painful erections.
- Spraying or weak urine stream if the opening narrows.
Why it matters
- Untreated LS can cause scarring that tightens the foreskin and narrows the urine opening (meatal/urethral stricture).
- There’s a small increased risk of skin cancer (squamous cell carcinoma) in the affected area over years. Good treatment and follow-up help reduce this risk.
Diagnosis
- Usually based on appearance and symptoms. A small skin biopsy is sometimes done if the diagnosis is uncertain or to check a stubborn or thickened area.
Treatment
- First-line: strong prescription steroid ointment (e.g., clobetasol) applied as directed for several weeks, then slowly reduced to a maintenance schedule.
- Gentle care: fragrance-free cleansing, daily bland ointment (petrolatum) to protect skin; avoid harsh soaps and friction.
- If the foreskin is very tight or LS keeps returning, circumcision can be curative for many men.
- If the urine opening is narrowed, a urologist may need to treat the stricture.
- Alternatives if steroids aren’t tolerated: calcineurin inhibitors (tacrolimus/pimecrolimus) under medical guidance.
Follow-up and self-checks
- Regular checkups (for example, every 6–12 months) once controlled.
- See your clinician promptly for any new persistent sore, thickened area, or color change.
Everyday tips
- Urinate after sex to rinse urine from under the foreskin; gently dry the area.
- Use plenty of lubricant for sex and masturbation to reduce friction.
- Avoid adhesives or harsh cleansers on the area.