Primary prevention

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

​​​Vaccination against human papillomavirus (HPV) provides pre-exposure protection against HPV-related disease, including genital warts and penile pre-cancers and cancers.[35]​ Routine HPV vaccination is recommended in many countries for adolescent boys, typically given at age 11-12 years, with catch-up vaccination until age 26 years. Some men aged 26 years and over at higher risk may be considered for vaccination up to age 46 years, taking into account increased risk of HPV infection (e.g., men with immunosuppression, men who have sex with men) and risk of new HPV infection. 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​

Post-exposure adjuvant vaccination against HPV can be considered (e.g., in the presence of HPV-driven undifferentiated penile intraepithelial neoplasia [PeIN]), although evidence is limited.[35][36][37][38]

Obesity, genital piercing, and surgical procedures are risk factors for lichen sclerosus.[39][40][41]

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/PeIN, or those at risk (e.g., people with immunosuppression [HIV or iatrogenic]), adjuvant HPV vaccination can be considered.[35] ​Evidence for post-exposure adjuvant vaccination is limited.[36][37][38]​​​ 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

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