BXO is a thin, white, wavy patch on the foreskin. It can be troublesome if this is not treated. This causes tight foreskin in children and adults. This is also known as lichen sclerosis atrophicus Csillag’s or white spot disease.
BXO is a disease affecting uncircumcised males ranging from young boys to adolescents and adults. This is the most common cause of tightening of the foreskin (BXO phimosis)
The exact cause of BXO is not known. Sometimes, it is associated with diseases in which the body’s immune system attacks normal tissues. Despite the tendency to affect the genital skin, BXO is not an infection – the condition is not contagious, so sexual partners cannot pick it up. Rarely, BXO can occur in relatives.
Many patients have none, but itching is the most common symptom of BXO. As a rule, the patches on the foreskin itch can also hurt if the skin breaks down or cracks. In the genital area, the scar-like process can tighten the skin, interfering with sexual intercourse in affected men. BXO can make the foreskin tight and difficult to retract and even partly block the urine flow.
On the main areas of the foreskin, the spots of BXO look like small ivory-coloured, slightly raised areas, which can form white patches. Some have tiny yellowish horny plugs within the pale areas. After a while, the surface of the spots can look like wrinkled tissue paper. The most common sites are the bends of the wrists, the upper trunk, around the breasts, the neck and armpits. Sometimes, this causes no symptoms, and they may not even know it exists.
The white, thin, fragile areas, sometimes surrounding the foreskin in a figure of eight patterns, have a wavy surface; their fragility may lead to easy bruising and erosions. Later, the foreskin opening can shrink, leading to pain with intercourse. Less often, BXO can develop in children. It can make a retraction of the foreskin difficult and interfere with passing water and sexual activities. BXO can be confused with thrush infection.
The diagnosis of BXO can usually be made from the typical appearance of the condition. This will be confirmed after examining the foreskin skin (a biopsy) under the microscope.
No treatment is likely to reverse the changes of BXO completely, but the symptoms and signs of the disease can usually be well controlled with a steroid application.
A variety of treatments are available for BXO. Your symptoms can be relieved by the use of steroid creams or ointments. Bland moisturisers help to soften and protect the skin. In adults, tightening of the foreskin will often respond to steroid ointments; if not, a circumcision may be worth considering. In children, circumcision is usually required.
The fragile skin of BXO may be more susceptible than normal skin to infection with Candida yeasts (thrush) or bacteria and may split or even bleed. We will treat these problems if they arise.
Cancer of the penis may be a little more likely to occur in BXO that has been present for many years than in normal skin. If you have any lumps or non-healing sores in that area, you should ask your doctor to look at them.
It is vital to follow up with your GP or Urologist if BXO persists even after circumcision and treatment.
The price for adult circumcision with frenuloplasty is £625 with Glue and biopsy £130 in case of BXO.
Adult circumcision in London is the best circumcision clinic for managing tight foreskin with penile BXO.
Please get in touch with us for specialist and professional opinion.
PS: This information is only for guidance. This is not a replacement for professional medical advice. Please, Dr Khan, for free telephone advice at +447527314081 without any obligation