Could The Whitening On My Glans Be BXO If It Isn’t An STI?

Posted on Mon, 11 May 2020

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 11 May 2020 Answered on

5 days ago Last reviewed on

Question : I have been to the doctors about the slight whitening and discoloration of my penis glans, the very tip is slightly white with some reddish markings. the affected area looks slightly crinkled and is shiny. The doctor said it is Okay and not an STI and is not genital warts. I believe it is balanitis xerotica obliterans BXO, also termed lichen sclerosis. I have no symptoms with this other than it looks scarred which i don't like. Is there anything i can do to return the skin to normal colour? I am worried what a sexual partner might say, because the skin is not perfect, i am also worried that if i don't do anything the affected area might get worse or go whiter. The doctor said a steroid cream thins the skin. I have normal sensation, it just looks a funny colouring, i would really love to be able to have normal skin again there - is there anything i can do?
I found this on the internet, should i try that
https://www.perrinnaturals.com/content/natural-treatment-lichen-sclerosus

Answered by Dr. Asmeet Kaur Sawhney (42 minutes later)

Brief Answer:
Topical steroid, Tacrolimus Ointment

Detailed Answer:

Hi,

Welcome to 'Ask a Doctor' service. I have gone through your query and understand your concern.

You seem to be having lichen sclerosis et atrophicus (LSA) which is a very resistant and difficult condition to treat.

I have also seen the link you have sent and I don’t think this cream will be effective in the treatment of your condition. At the most, it can be used as an adjuvant to the main treatment.

Usually topical steroid are the first line treatment for lichen sclerosis. To avoid atrophy a mid potent steroid is applied on the affected area once daily for 3-4 weeks and then tapered off. Along with this, you can apply Tacrolimus ointment once daily for 10-12 weeks. This will help in improving your condition. These are prescription drugs and you need to see the doctor in person to get them.

I hope this helps. Let me know if you have further questions. Take care.

Regards,
Dr. Asmeet

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Asmeet Kaur Sawhney (9 hours later)

Hi
Hello,
Thank you for your reply.

"You seem to be having lichen sclerosis et atrophicus which is a very resistant and difficult condition to treat"

1) What causes this? (I clean regularly)

2) What is it?

"To avoid atrophy a mid-potent steroid is applied on the affected area once daily for 3-4 weeks and then tapered off.
Along with this you can apply tacrolimus 0.1 percent ointment once daily for 10-12 weeks.This will help in improving your condition"

3) Is the skin getting attacked by a bacteria, that's what it looks like?

4) The doctor said a steroid cream would thin the skin? Could a steroid cream do this/make it worse?
With it being a sensitive area he wasn't sure i think, he said it didn’t look bad.

5) What will ointment do? How does it ‘improve the condition’, will it return the affected area to normal colour?

6) Will it get worse? Can it be reversed?

Answered by Dr. Asmeet Kaur Sawhney (5 hours later)

Brief Answer:
Details given below

Detailed Answer:

Hello,

Lichen sclerosis is a chronic immune mediated disorder of the skin. It doesn’t have an infective etiology.

Steroids and tacrolimus have anti inflammatory and immunomodulatory actions and that’s why they are recommended in the treatment of lichen sclerosis. There is no bacteria or virus involved in the causation of this condition.

Steroidal cream won’t thin if it is applied for small periods of time and under supervision. It will be beneficial. Both steroid and Tacrolimus will improve texture and color of the skin.

It can’t be reversed completely in most of the individuals but definitely shows improvement in appearance and color.

Take care. I hope this helps. Thank you.

Regards

Above answer was peer-reviewed by : Dr. Kampana