Primary prevention
Primary preventive measures are not generally considered necessary. However, circumcision protects men from balanoposthitis.[33][34]
Pre- and postexposure 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
In the UK, the vaccine is routinely offered to individuals ages 11-14 years in a two-dose schedule (6-24 months apart).[37] Men who have sex with men up to and including ages 45 years who attend sexual health or HIV clinics are also eligible for the vaccine.[37]
Obesity, genital piercing, and surgical procedures are risk factors for lichen sclerosus.[38][39][40]
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 overwashing (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][57] CDC: Immunization schedules Opens in new window
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