They sometimes experience difficulty pulling back the foreskin and have decreased sensation in the tip of the penis. The cause is unknown, although an overactive immune system may play a role. Some people may have a genetic tendency toward the disease, and studies suggest that abnormal hormone levels may also play a role. Some scientists believe that an infectious bacterium, called a spirochete, may cause the changes in the immune system that lead to lichen sclerosus. No, lichen sclerosus is not contagious.
Doctors can diagnose an advanced case by looking at the skin.
Because other diseases of the genitalia can look like lichen sclerosus, a biopsy is advised whenever the appearance of the skin is not typical of lichen sclerosus. Patients with lichen sclerosus of nongenital skin often do not need treatment because the symptoms are very mild and usually go away over time. However, lichen sclerosus of the genital skin should be treated, even when it is not causing itching or pain, because it can lead to scarring that may narrow openings in the genital area and interfere with either urination or sexual intercourse or both. There is also a very small chance that cancer may develop. In uncircumcised men, circumcision is the most widely used therapy for lichen sclerosus.