Friction scarring/marks?

Men's health
1

Hello,

I recently visited the dermatologist regarding some white scarring present on my frenulum and the inside of my foreskin. He couldn't make a definitive diagnosis by examination, so he took a biopsy. I'm expecting results in the next couple of days.

One possibility he did mention was friction scars. I have never heard of this and can't really find anything on the internet with the same name and appearance as what I have. Does anyone know of these or does anyone have experience with these?  And if so, have you found a way of lessening the severity or getting rid of them entirely?

Thanks

2

Not heard of this, at all.  Since the Derm is taking a biopsy, hopefully the test results may show something.  Without seeing what you are talking about it could be anything from natural pigmentation changes, friction issues sound a strange explanation, but obviously could be what you have.  The other is Lichen Sclerosus - and I am wondering whether the biopsy will reveal this is what you have?

Do friction marks make sense to you?  Are you sexually active just now anyway?  Do you masturbate regularly?  If so, do you use any form of lube, skin lotion, or skin cream to hydrate the skin around the head of your penis?

3

My GP refereed me to the dermatologist suspecting it was Lichen Sclerosus. I do meet most of the symptoms, however, the dermatologist was not sure, hence the biopsy. The suggestion of friction marks was a bit of a surprise to me, as these marks have been there for a while and seem to be spreading. I am not sexual active and do moisturize. I'll include an image for some context. They marks continue around the right side of my shaft.

4

Can you pin-point when it was you first noticed these marks?  Should the symptoms worsen, try to think what was going on immediately prior in terms of particular foods - where you using quite a bit of moisturiser (more than usual).  You also need to be very careful regarding masturbatory practices as this does actually cause a great deal of friction between the different layers of foreskin, and between the foreskin and the glans / head of the penis.

This would not usually be an issue for men that have a completely healthy skin of the foreskin.  You obviously have something going on, whether a dermatological issue of some kind, or indeed, whether you actually have Lichen Sclerosus [LS] itself.  From the image and your description it does sound like LS to me.  It would do you no harm to follow the information I shall re-post below on previous guidance I have given to other men (the specific comments do not apply to you, only the hygiene routine to practice >>>>>>>>

* What I do know is the when you have ANY condition affecting the penis you need to implement squeaky clean hygiene practices to rule out the real possibility that it is simply an irritant creating the condition you have!  

  The skin on the penis is more sensitive than any other part of the body, particularly the head of the penis.  During sex or self-pleasuring there is a whole lot of friction going on for this area of skin - in YOUR CASE if you use condoms, there is often a whole load of chemicals on the inside that certainly don't help if your skin is reacting to irritation!

Try this for a while (2 / 3 weeks) - prevent as far as possible, soap, or shower gel, hair shampoo etc., or skin cream / lotion or any form of lube (oil based particularly) from getting on your penis.  Always wash with water ONLY (never hot water) after urinating (in public toilets go in a cubicle and use toilet paper to ensure the head and surrounding area is 100% dry) when showering – if possible, make sure the skin of the penis is drawn forward to cover the head to protect the area from soap / shower gel, etc. getting on it.  At the end of the shower - make sure the entire penis is 100% dry afterwards.  You can also combine this with giving your penis an 'exercise holiday' - no masturbation or sexual activity, you may need to do this for as long as 5 or 6 weeks.>>>>>  {Your penis could simply) be reacting to an irritant, usually some form of chemical - from anything from a specific soap, washing powder you use on your clothes, (and so on) or something related to your sexual practices: lube, lotions, gels, condoms etc. <<<<<<<<

*Hopefully your biopsy will conclude on what exactly you have, until then I would strongly advise putting in place a hygiene practice that works for you.  If you ARE confirmed as having Lichen Sclerosus I would suggest you start a new discussion forum on here RATHER than updating this one.  As I have been dealing with LS for 7 years+ I can guide you on what worked for me and the best practices to keep it at bay.

5

Just an update - I heard from the dermatologist today and my biopsy was negative for LS. He did mention friction scarring again but didn't advise of any treatment or further prevention apart from circumcision, which I'm not too keen about. I'm not really sure how to feel about this as on the one hand I don't have LS, at least according to this biopsy, which is good.

However, this does not really provide me with any answers as to preventing further marks or removing these or why I posses other symptoms often associated with LS. I am going back to my GP later this week , so maybe I can get some more info.

6

Of course, you need an answer - I certainly would not recommend circumcision at all, as, once it's gone, you can't get it back!!!

The alternative you have is to - as you seem to be going round in circles with the Medic's you have had contact so far, is, to go to a specialist Sexual Health Service such as a GUM Clinic.  Ask to see a Urologist and state you want this sorting as you are confused at to what you have ....

7

Yea, I will ask for a referral to a urologist. The diagnosis of friction marks seems wrong to me. These marks have been there for quite some time and appear to be spreading. Additionally, I do not consider the way my foreskin moves, although not the smoothest motion at times, to be bad enough to cause such marks.

8

If you can get to a GUM clinic most of the time / at larger ones, there will be a urologist there all the time - saves the bother of going back to a GP / Dr - unless you need the referral for work absence, of course!

I also see what you mean by the movement of foreskin and these marks ... is there any possibility you have had these from birth, as you were growing up you may not have noticed then until you were in your mid to late teenage years?!

9

I couldn't tell you whether I've had them since birth. I don't recall the first time I noticed them, but it was definitely a few years ago now. I only retracted my foreskin for the first time when I was 17, as I was never told about it.

10

Okay, so I'm back again and with some depressing news.

I went to my GP last week and informed them that these white marks had spread a little. A biopsy was taken, a larger sample and in a different location than the biopsy done by the dermatologist. I recieved the results today and the biopsy showed lichen sclerosus and lichen simplex chronicus. So I've been prescribed steroid cream and informed of a regimen to follow.

I'm quite surprised by this as the dermatologist was quite adamant that this was not LS. Though I'm glad I have an answer now.

11

Hi, at least you have an answer now as to what conditions you are dealing with.  It is really surprising that the Dermatologist missed this in the biopsy they took.  If you have lichen simplex chronicus then my guess would be this has been present for some considerable time.

I am not sure whether you have ever stated your age.  Are you still a young adult, or a few years down the line from that now?

What steroid have you been given?  Is it a cream or an ointment?  What is the regimen you have been specified to follow?

In addition, once you have used the steroid for a few months it would be helpful to hear how you are getting on if you can update, or, start a new post something like 'Steroid use to treat Lichen Conditions'.

Good Luck ......

 

12

Sorry, guess I should mention that. I'm 22. I've been prescribed an ointment to begin with as the cream contains alcohol and my the area where I had my biopsy done is still healing, so alcohol would burn.

The ointment is Diprosone. The regiment recommend to me was apply twice daily for 1 week, then once daily for one week and if symptoms have improved go back to applying 2-3 times weekly. My main concern is skin thinning, but I guess only time will tell where that is concerned.

My GP believes the dermatologist missed it as they didn't biopsy deep enough. A letter has been written to them informing them of the situation, so I guess I'll wait and see how they respond.

13

Thanks for the further information.  The bad news is that the Lichens conditions are currently incurable.  However, you have a great deal of time to find the best way of keeping your penile skin as healthy as possible.

Applied correctly, Steroids do NOT overly-this infected skin, but do thin non-infected skin.  You need to have it clear where you are applying the steroid to, and where you are keeping it away from.  Follow the penile hygiene regime I posted earlier for you - sex and masturbation is no problem, as long as you keep the steroid away from your main penile shaft skin.

For Women with LS the now recognised treatment is Clobetasol - the one you currently have has the same steroid strength as this, but from personal experience, I would suggest you stay with using ointment rather than cream versions.

One little thing to think of is, I have only ever applied my clobetasol with the same finger, I only once had a concern that the skin-tip was thinning.  I very briefly switched to using another finger, and quickly returned to using the original finger with no issues

14

Do you find that new areas appear when only applying the steroid ointment to affected areas? My case is mild at the moment with only a small area affected when compared to more severe cases. I was told to apply 2 small pea sized amounts. Currently I'm using my index finger to apply, do you recommend a different finger? 

15

Also, I was told some people use the cream until the symptoms subside and only restart treatment when they reappear. Is this something you have tried?

16

Hi Cargs, sorry somehow I missed this post.  In my case, applying to the initially affected areas has not led to new areas appearing. 

The amount you are using sounds correct - index finger is fine - if you were applying 2 times a day everyday, I would have suggested alternating fingers of application, so this should not be an issue for you.

My advice would be that you should not wait (Q from your next post) until symptoms re-appear AS the infected skin will always remain infected.  What you need to find is an application regime that prevents the symptoms from being at their worst.  I an not sure how often you are applying the steroid at the moment - but many with LS can manage their symptoms using 2 applications per-week, or perhaps every 4th or 5th day.

It is only by trial and error that you would find what is right for you.  And no, while I did try stretching out the numbers of days I did not apply my Clob, the symptoms quickly returned to their worst, so the most I can knowingly leave application is to have 2 non-application days in-between.

I find I have to constantly stretch my foreskin to the limit of its stretch and this is probably why I have to use the Clob so frequently ....