If you’re here, you’ve probably been dealing with the very uncomfortable condition known as Balantis Xerotica Obliterans, also known as Lichen Sclerosus, or BXO.
I know how that feels, because I’ve been dealing with it too. But I’ve also spent a lot of time researching it, and hopefully, I can help!
Let’s go back to the beginning of my BXO journey and see if it’s similar to yours.
When I first saw the redness on my penis, I thought it was just a harmless rash. I’d had those before. I have eczema, so I had steroid creams just lying around the house. I put some steroid cream on it and it went away.
But then it came back.
When it started to feel a little itchy, I figured it might be a yeast infection. I’d been having yeast infections regularly for around five or six years (I’m 32), so I was familiar with the treatment. I treated it the usual clotrimazole cream, and it cleared up after a few days.
But then it came back.
But even more alarming was, every time it came back, it came back worse. The rash was angrier and deeper, and took longer to go away.
I finally visited my doctor who did a swab for yeast and bacteria, which came back negative. He referred me to a dermatologist.
The dermatologist took one look at it and said “This is a condition called balantis xerotica obliterans.”
I already knew what balantis was, because Dr Google is always my first port of call. Any time something pops up on my body I head straight to the internet and search for the symptoms. So obviously when I searched for things like “red rash on penis glans”, “red rash on foreskin”, “dry shiny skin on glans”, “peeling on foreskin and glans” and any other description I could think of, balantis came up often.
But this condition – balantis xerotica obliterans – was something I’d never heard of before.
The dermatologist prescribed me with a steroid cream and told me to use it “sparingly but often” until the condition cleared up.
The first thing I did was go home and read everything I could on BXO. It was an interesting condition, one that seemed to be common, but without much research or discussion. I spent most of the night reading about it, mostly on blogs and a few small websites and forums.
The standard treatment seemed to be this: First, use a steroid cream. However, you can’t use a steroid cream forever, it’s very bad for the skin. Most people who stopped using the steroid cream eventually had the rashes return. When that happened, the prescribed treatment was circumcision. That, seemed to clear the condition permanently.
It seemed odd to me. Circumcision is a very painful and irreversible procedure, particularly as an adult. As an uncircumcised male, I quite liked my foreskin and all the extra nerve endings it provided. I had no desire to get it chopped off any time soon. A lump formed in my stomach. Was I really going to need a circumcision?
As I am with most things health-related, I was determined to find a better way. I searched for all the natural cures I could find information on and read through all the studies. Most studies were shallow or inconclusive, but there was one study that I found through this blog where I found my breakthrough.
The first thing was, BXO is almost exclusive to uncircumcised men. It is practically non-existent in men without foreskins. Therefore, it was reasonable to surmise that BXO is somehow related to the foreskin and its interaction with the skin of the glans. This was also confirmed by the fact that when men get circumcised, BXO disappears.
The second thing was, BXO occurred in older men, usually over 50. It was very rare for children or younger people to have it.
The third thing was, it was common in men with urine incontinence. This is when men can’t empty their bladder or urethra fully when going to the toilet, so sometimes urine dribbles out after they leave the bathroom.
So these three things – age, foreskin and urine incontinence were the three big identifiers.
It was this study that pieced them all together, and concluded that BXO “is not primarily an autoimmune condition. It is likely that an interaction between the irritant effects of urine and other pathogenic factors, such as chronicity, occlusion and as yet undetermined differential epithelial susceptibility, or reaction, to injury, are necessary for the development of MGLSc [Male Genital Lichen Sclerosus].”
So the logical conclusion was, men with incontinence are prone to getting urine trapped under the foreskin, which holds it in contact with the glans and causes the skin irritation. Of course, men who are circumcised have no foreskin, therefore any urine incontinence is caught and dried by underwear.
This seemed to also fit with my description. Even though I’m young, I have also had bladder problems for the past few years. And I’m uncircumcised.
So here were the three things I was going to try…
Time to self treat! The plan
- Circumcise myself. By that I don’t mean actually get out a razor and cut my foreskin off. All it meant was I was going to keep my foreskin retracted as often as I could, and I could keep my penis in that state for most of the day, which removed the foreskin from the glans. So in a way, I was circumcised without actually being circumcised.
- Keep the penis dry. Every time I went to the toilet, I would wash and dry my penis religiously. That meant making sure my bladder was fully empty, then washing the glans and foreskin of my penis well, and drying it so it wasn’t left damp. This made certain that there was never any exposure of the skin to urine for more than a few seconds.
- Heal. The final thing was to support the skin to regenerate. One thing that seems to be common for BXO sufferers is that keeping the skin dry is paramount. The reason is because this encourages the skin to peel. When the skin peels, the “BXO skin” falls away, and if this happens enough, you’ll have nice, new, non-BXO skin eventually emerge underneath. To encourage this process, it was important to let the skin peel, then help it heal with things like aloe vera and moisturizer, and then initiate the peel once again. It was an arduous process, but obviously to have a healthy and strong penis again was more than worth it!
The first 2 days
During the first few days I did actually use a steroid cream. The cream I used was called Elocon. I decided to use this because my skin was actually very red and angry, so I wanted to settle it down as fast as possible. However, after the skin returned to semi-normal, I put the steroid cream to the side and moved to natural treatments. There are many accounts of people using steroid creams in the long run who only end up damaging the skin even further. If you do use it, keep it to the first few days just to settle the skin down. Then move to a more suitable long term treatment.
The peeling stage
This is where long term treatment starts: To try to encourage peeling of the damaged BXO skin.
In the morning, the first thing I would do is go to the toilet, then wash and dry the foreskin and glans fully. Then, I would put a little hydrogen peroxide on the skin. I used this 3% hydrogen peroxide spray. I would leave that on for about an hour, and leave the foreskin naturally to hold it against the glans. After an hour I would wash it off, then repeat again 1-2 more times during the day.
Why hydrogen peroxide, you might ask? Well, hydrogen peroxide encourages peeling of the skin. Also if you look at the science of it, hydrogen peroxide is simply made up of hydrogen and oxygen – the same elements as water. As long as you use it responsibly, it’s one of the safest solutions out there. Since we’re only using the 3% solution, it’s very safe to use on the skin. I made sure to only leave it on for an hour at a time, then let the skin rest.
For night time, I’d use something different (because I don’t like leaving hydrogen peroxide on the skin for many hours). After showering, I would use a mixture of tea tree oil and a plain moisturizer. The reason I did this was because tea tree oil is full of healthy regenerative properties, some people even call it first aid in a bottle. But the main reason was because tea tree oil also peels the skin. I know this from my years of self-treating many sports injuries – instead of using alcohol wipes I always use tea tree oil to disinfect the area. Back when I first started using it, I never used to dilute the tea tree oil, and it would always cause peeling on the skin after a few hours.
Because the penis skin is highly sensitive, it’s important to dilute it with something. I just use a single drop of tea tree oil, and a little blob of moisturizer (maybe the size of a blueberry), mix it together and then apply it to the skin.
If you do this, after a few days (or maybe even less) you should notice the skin starting to peel. It will probably just look like dry skin flaking off. That’s what you want!
The healing stage
Once the skin has done a good peel, you might find some red/raw skin underneath. This skin can be itchy and even painful. It’s important to help this skin heal as quickly as possible, so you can continue your treatment. Also remember to not peel the skin yourself! Let it peel and fall away on its own.
So what do you do from here?
IF the skin is just red, it’s best to heal it with natural creams. By far, the absolute best cream I found was Perrin’s Creme Complete.
In fact, if you Google Balantis XO, or “lichen sclerosus” as it’s also called, sometimes this exact cream comes up as a treatment. There were some forums where people were claiming it was nothing more than snake oil, but some bloggers seemed to use it with some success. At fifty bucks it isn’t the cheapest cream, but I was more than happy to give it a try.
When the Creme Complete package arrived, they actually had a full page letter about BXO enclosed. They claimed that the product was never intended to be a BXO treatment, but many people had found success with healing their skin with it, and that they hoped it would work for me too. Nice touch!
So I started using that during both the morning and night.
Creme Complete is great because it has all sorts of regenerative properties – cocoa butter, biotin, vitamin E, aloe vera and a looong list of others. It’s an all-star team of healing ingredients. I would take a small dip of the cream on my finger and then rub it around the foreskin and glans. It smells a little funky, a bit like all kinds of weird herbs, but it’s nothing foul-smelling. Make sure you use a very thin application of the cream, as it’s quite potent.
To get some Creme Complete, you can just order it off Amazon by clicking here.
I also used to cycle it with a basic aloe vera gel, just whenever I felt the skin could use something lighter/different. Any organic aloe vera gel should be fine. This is the aloe vera gel I was using.
Now, if your BXO is quite bad, you might experience cracking or breaking of the skin after a peel. This only happened to me once, and I used a wound gel to make sure it healed as fast as possible. The wound gel I used was this medihoney wound gel. I actually just had this lying around the house as I used it when I had some moles cut out a few years ago.
The wound gel keeps the wound moist, which contrary to popular thought, actually accelerates would healing and reduces scarring to almost nothing! I’ve used it to heal up staph infections and surgical scars, and the results are amazing. For BXO, I had a small crack just under the glans, and it literally healed it up within 24 hours like it was never there. Pretty amazing stuff. You can get the medihoney wound gel on Amazon by clicking here.
After you feel like the skin has healed and is ready for another peel, simply go back to the hydrogen peroxide or tea tree oil and start the peeling phase again.
That’s it – this is the entire treatment! All it does is keep urine off the skin, and then encourages the body’s natural skin shedding/regenerating process to work faster. The damaged BXO skin gets removed, and new healing skin emerges underneath. Simple but effective.
I’m surprised myself to actually say, yes, this simple treatment does work very well. Today my penis is back to 95% healthy, and in fact, that’s healthier than it was before I started this treatment. I always seemed to have on-and-off skin problems down there, perhaps minor cases of BXO before I knew what it actually was. My skin now is pink, healthy and strong.
Of course, that didn’t come so easily. The information above took me several months to research and compile before I was confident in the treatments I was using. I stopped using tea tree oil and hydrogen peroxide for a while, and started using different steroids, I also stopped using my moisturizers and tried other things like emu oil and coconut oil. And there were a few other things I trialed as well. But what I’ve listed in the article above gave me the best results.
Because I caught my BXO rather early, it seems my healing time wasn’t too long. Overall it took about 3-4 months before I “felt” normal again, and maybe 5-6 months before getting to the point I am today. I know that does sound like a long time. However, it is far better than using steroid creams, which tend to not work in the long run anyway, and certainly better than a circumcision. Also, to be honest it doesn’t cause any great inconvenience to your life. It can be cumbersome to wash and dry yourself every time you go to the toilet, but it becomes a habit and doesn’t take long at all. Even in public, you can just wet a piece of toilet paper and give it a wipe, then dry it off and you’re done. It’s not that hard.
Summary: A self-treatment plan for BXO
Here’s the summary of the full treatment plan I’ve described in the post above:
- Keep the foreskin pulled back and glans exposed as much as possible, preferably 24/7.
- Always wash and dry the penis head thoroughly after using the bathroom. Make sure that the skin is never left exposed to urine.
- Encourage peeling of the skin using hydrogen peroxide and/or tea tree oil mixed with a moisturizer.
- When the skin has shown peeling, help it to heal by using Perrin’s Creme Complete, or an aloe vera gel.
- If the skin is cracked/bleeding, use a wound gel to help it heal as fast as possible.
- Once the skin has regenerated and is looking somewhat healthy, go back to step 3 and repeat!
If you follow these steps, I really believe you will take control of your BXO and will notice significant improvement within a few weeks. Don’t take your doctors word that you must use a steroid cream and get circumcised. There are better natural ways that work if you do your homework. How long it takes to heal fully will depend on you and your condition, but as long as you’re making progress, you can be sure you will get there eventually!
I really hope this is helpful for any of you out there suffering from this condition! The information on the internet is sparse but every time someone comes out and writes about their experience we have more collective info to help each other deal with this horrible thing called BXO. Please don’t be shy to leave a comment and let us know what your experience is. I’m sure it will be helpful to all of us.
Best of luck and wishing you a quick return to health.