What Causes BXO?

According to functional medicine, BXO (or Male Genital Lichen Sclerosus) is an autoimmune disease, caused by the body's immune system attacking healthy tissue. The cause of this, like all autoimmune diseases, is completely unknown. Doctors will sometimes suggest genetics play a role.

I discovered how to heal BXO before I knew what it was called. After noticing that a very small area appeared to be peeling then turning pink and reverting back to normal appearance, I contemplated why this might be. I realised that this was happening on skin that was dry, or at least, dry more often the the surrounding skin.

When I thought back to a few years before that, I remembered that was when I first began to notice dampness after urination, on occasion.  After paying closer attention over the next few days, I realised that I had developed quite a lot of post-urination dribbling.

Medical research, research into reports from online community members, and my own experimentation all agree that dryness is instrumental to the healing of BXO. People who keep the area dry find their condition recedes. Their immune system is the same in either case.

Furthermore, the only 'cure' in functional medicine is circumcision. Once again, even after undergoing a circumcision, the patient's immune system is the same. Yet they stop showing symptoms. Again, the cause of the improvement is dryness.

Therefore, you would have to argue that:

The trigger for the development of BXO on the genitals is exposure to urine.

Urine trapped under the foreskin provides an ideal environment for BXO to develop. Some have suggested it may be fungal, while medical studies have suggested the skin in some men becomes intolerant or irritated by urine.


There are still questions, however.

BXO affects roughly 1 in 100,000 men. If we take these figures on face value, that's an awful lot of men whose foreskins are not susceptible to irritation by their own urine. Why do some men develop it while most don't?

I would be most interested to know whether the skin is abnormal, or the urine is.

There is some speculation that BXO occurs on skin that has been damaged. As a male with a restored foreskin (I was circumcised, then I have restored it by tissue expansion) I find this unlikely, as there would otherwise be a disproportionately high number of instances of BXO among restored men.

Some have suggested (not medical professionals) that BXO may be a fungal disease, but no fungal treatment I have used made any difference. Also, if it were, medicine would have an answer. Fungal infections of the skin are widely understood and diagnosis and treatment are usually very simple.

BXO is most likely caused by constant exposure of the penis and foreskin to urine. However, it's not yet understood why the skin reacts the way it does, and why some men are affected while others are not.

BXO tends to affect men of middle age and older. Research has suggested this is because such men generally have weaker pelvic floor muscles, and experience post-micturation dribble.



In summary, BXO generally develops within a small fraction of men when the penile skin is in contact with urine.

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