Primary prevention

Primary preventative measures are not generally considered necessary. However, circumcision protects men from balanoposthitis.[33][34]​​​​

Pre- and post-exposure adjunctive vaccination against human papillomavirus (HPV) vaccination should be considered.[35][36]​​ For guidance on the UK-recommended vaccination schedule for HPV see: Human papillomavirus (HPV): the green book Opens in new window​ For guidance on the US-recommended vaccination schedule for HPV see: CDC: Immunization schedules Opens in new window

Obesity, genital piercing, and surgical procedures are risk factors for lichen sclerosus.[37][38][39]

Secondary prevention

Advise patients to pay attention to personal hygiene. With regard to the genital area, they should:[1]

  • Avoid irritants (e.g., soiling with urine, long pubic hair, antibacterial soaps) and over-washing (i.e., with vigorous use of washcloths)

  • Avoid common allergens (e.g., perfumes, fragrant soaps, detergents, and fabric softeners)

  • Use soap substitutes (e.g., aqueous cream, emulsifying ointment) once or twice daily and emollients (e.g., petroleum jelly, aqueous creams, lotions) when needed

  • Use a lubricant during sexual intercourse to ameliorate dyspareunia.

In patients with established carcinoma in situ/penile intraepithelial neoplasia (PeIN), or those at risk (e.g., people with immunosuppression [HIV or iatrogenic]), adjuvant human papillomavirus (HPV) vaccination can be considered.[35][36]​ For guidance on the UK-recommended vaccination schedule for HPV see: Human papillomavirus (HPV): the green book Opens in new window For guidance on the US-recommended vaccination schedule for HPV see:​​​​[36]​​[56]​​ CDC: Immunization schedules Opens in new window

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