Balantis xerotica obliterans, or BXO for short, is a chronic, inflammatory dermatitis of the penis.
It actually has many names, you might see it called lichen sclerosus, penile lichen sclerosus, or male genital penile sclerosus. All these conditions are the same thing.
The way the condition works is the skin becomes inflamed, usually around the penis head and on the foreskin. This leads to a build up of inflamed skin and scarring, which can lead to other problems such as narrowing of the urethral opening, tightening of the foreskin and pain around the penis head.
The appearance of BXO is quite unique. Often it starts as a regular looking rash. The skin becomes quite raw and can even break open. It almost looks like bad sunburn in some cases. As the condition progresses the skin starts to crust or become wrinkly. One telling sign of BXO is the skin starts to turn shiny or scaly, particularly when dry. You might notice after you pull the foreskin back and let the skin dry completely, it appears very shiny, almost like cellophane wrap.
What causes BXO? Until recently doctors believed BXO was an auto immune disease. It was also thought that HPV (the virus that causes genital warts), Hepatitis C or EBV (Epstein Barr Virus) might be to blame also. However studies haven’t really shown this to be the case.
Because no real cause could be pinpointed, the standard treatment since the disease was discovered has been steroid creams. This acts to reduce inflammation, but does little to address the root cause. When steroid creams fail to keep it under control, the next recommendation by the medical community has been circumcision.
Finally in 2012, there was a breakthrough.
This 2012 study and this 2015 study explored the idea that the most likely culprit of BXO was a reaction to prolonged urine contact. When the skin on the penis glans and foreskin is in constant contact with urine, it causes an inflammatory reaction and progresses to BXO.
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. (source)
This was backed up by the fact that BXO is almost exclusively a condition in uncircumcised men (because the foreskin holds the urine against the skin) and men with urine incontinence (dribbling after going toilet).
Post-micturition dribbling or microincontinence has been proposed to play a central role in the etiopathogenesis of MGLSc. Many men presenting with MGLSc confess to dribbling post-micturition. A recent study by our group has shown that 91-100% men with MGLSc have dribbling compared to 14% controls implicating the role of post-micturition microincontinence in MGLSc. (source)
This also explains why circumcision has a high cure rate for BXO. When the foreskin is removed, no urine is able to be trapped against the glans, which relieves the symptoms over time.
This forms the basis of healing BXO naturally. Avoiding prolonged urine contact with the skin is the key measure. When that is under control, you can start making progress with healing the skin that has already been damaged.
Head to the next page, Healing BXO Naturally, for my write up on how I managed to do this, 100% naturally, from the comfort of my own home.