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With all of these protocols in place, we can expect the great majority of cases to be completely cured, although it may take up to a month to see any change, and several more months to finish the treatment, according to the severity of each case. Lichen planus (LP) manifests with purplish or brownish bumps, covered in fine whitish scales. The treatment of distal penile strictures as a result of lichen sclerosus or following previous hypospadias surgery often needs to be individualised. Creams and ointments with a corticosteroid base are often prescribed to patients of Lichen sclerosus. Operative cure for the anal or genital region is not usually recommended for women affected with this disorder.
The lichenified plaques that seemed so rooted in the skin start to dissipate over several months, and will be gone without a trace once the treatment is complete.


In severe lichen sclerosus (LS), the meatus and fossa navicularis are almost completely obliterated (Fig. The lichen may remain localized to a single spot, or spread to a few other areas that are easily reached and scratched. Lastly, lichen simplex lesions tend to develop on one side, according to whether the patient is right or left-handed. A regional centre will do more of the same but will proportionately deal with more distal penile urethral strictures as a consequence of previous hypospadias surgery or because of lichen sclerosus [15].
Trauma, typically by instrumentation, or lichen sclerosus (balantis xerotica obliterans [BXO]) are other causes. The external wash, or sitz bath, can bring about a faster improvement, and the patient is encouraged to continue and to not give up prematurely, as lichen sclerosus is stubborn, but well worth treating.


Unless a patient has a single, previously untreated, short, membrane-like stricture of the bulbar urethra, in which case there is a 50% chance of a cure with dilatation or urethrotomy, the only predictable cure for a urethral stricture at present is a urethroplasty.
Heroic measures may not always be justified in extensive urethral stricture due to lichen sclerosus (balanitis xerotica obliterans). Liver congestion is the main cause of lichen sclerosus, which is in turn caused by persistent emotional stress such as anxiety, conflict, depression, or overwork.



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