Scrotal eczema, also known as scrotal dermatitis, is a dry, red, and itchy skin conditions that affect the scrotum—the sac of skin holding the testicles—and may also involve the penis and inner thighs, groin, and area around the anus.
If you have found that an annoying itch in your crotch is always afflicting you lately, chances are, it may be scrotal eczema. Read more on some of the causes of skin inflammation, what brings about it, its symptoms, and treatment.
Scrotal eczema is an inflammatory dermatological disorder that can persist for a long time with symptoms such as itching, skin color changes, and scrotal pain. Scrotal dermatitis is a form of eczema that occurs on the thin and sensitive skin of the scrotum, and causes the scrotal skin to thicken and become itchy. The scrotal skin is 40 to 80 times more permeable than normal skin and readily irritated by allergens and other exogenous substances.
Constant care is required, per the American Academy of Dermatology, for eczema is a condition that needs to be continually controlled. Earlier opportunities for diagnosis and personalized therapy can enhance the prognosis for the patients.
Symptoms of Scrotal Eczema
Scrotal eczema symptoms are mild, moderate or severe. They are:
Severe itching and burning, aggravated by scratching;
Dry, flaky skin with flakes of skin visible;
Red or dark bled patches;
Thickened, leathery texture caused by repeated rubbing or scratching;
Splits which may secrete;
Blisters, especially in acute contact dermatitis.
Scratching may offer temporary relief from itching, but it actually worsens the inflammation – causing a vicious itch-scratch cycle.
Researchers have classified scrotal eczema into four categories:
Type 1: Mild and dry – This type causes burning and itching on some sites, showing patchy skin irritation, discoloration, and intense itching and burning; it usually lasts from a few days up to weeks and goes away on its own.
Type 2: Severe and chronic dry – The scrotum will start to become scaly and of an irregular colour. Other symptoms may include a burning and itching sensation in the groin and penis. It may spread to the thighs and under the penis. The skin looks lighter in color than usual (this is called hypopigmented) with scales.
Type 3: Chronic wet – This type affects the whole scrotum and inner thighs. Threadlike patterns from tiny blood vessels may be visible. It’s characterized by weeping that causes skin breakdown (maceration), leading to painful sores and an unpleasant odor.[5]
Type 4: Ulcerated and swollen – The scrotum becomes swollen and then begins to break down (ulcerate). Fluid and pus ooze out, causing pain and a foul smell. In severe cases, this process may spread, causing the death of tissues from the scrotum into the lower part of the abdomen and legs.
Checklist: identify your triggers
Have you changed laundry detergent recently?
Do you wear tight or synthetic underwear?
Are you under a lot of stress?
Using new body care products?
Are you seeing more people with potential allergens?
Diagnosis and Prevention
A dermatologist can only confirm the diagnosis of scrotal dermatitis after a physical examination accompanied by discussion of medical history. If allergic contact dermatitis is suspected, patch testing may be done to determine the substances causing the allergy..
Eczema affecting the scrotum is the commonest form of genital eczema, and is more common in those with atopic dermatitis. It often runs in families, and is associated with an overactive immune system and a compromised skin barrier.
Contact Dermatitis
Develops as a result of scrotal skin contact with materials — can be irritant (due to sweat or chemicals) or allergic (due to allergens such as latex).
Seborrheic Dermatitis
Involved in the pathogenesis of seborrheic dermatitis that affects fatty areas such as the scrotum and produces yellow-white, pruritic scales associated with Malassezia yeast.
Scrotal Eczema and Male Fertility
There might be an association between scrotal dermatitis and male infertility but the evidence is limited. Scrotal dermatitis could potentially lead to infertility by raising testicular temperatures and causing sperm damage, according to a report in 1990Fertility and Sterility; many saw improvements in sperm parameters after treating eczema. Severe dermatitis may reduce sperm production and survival through inflammation: a 2020 NCBI study. Further studies are required to elucidate this relation.
Scrotal eczema causes are typically linked to genes. Allergens, irritants and exposure at work can also act as symptoms triggers or make them worse. The skin on the scrotum absorbs more, so it’s particularly sensitive to these triggers.
Other Potential Causes of Skin Symptoms on the Scrotum
While there’s no cure for scrotal eczema, several treatments can help reduce its symptoms:
Moisturizers
Applying moisturizers, emollients or lotions, can soothe itching and dryness. Use them after waiting at least 30 minutes after applying a topical steroid cream, and reapply after bathing.
Topical Medications
Initially, doctors often prescribe corticosteroids for genital eczema to reduce inflammation and alleviate skin irritation. However, strong steroids aren’t used on the scrotum to avoid thinning the skin. In some cases, topical calcineurin inhibitors (TCIs) may be prescribed as they treat sensitive areas without skin thinning.[10]
If scratching leads to open sores or wounds, antibiotics may be prescribed to prevent or treat bacterial infections.
Phototherapy
Phototherapy, or light therapy, effectively treats atopic dermatitis, offering relief for about 70% of eczema sufferers. It involves exposing affected skin to ultraviolet radiation to reduce inflammation. Recent studies suggest that ultraviolet (UV) ray therapy may be beneficial for moderate to severe eczema cases.
Genitals are typically shielded during phototherapy sessions. Yet, narrow-band UVB therapy has shown promise in improving scrotal eczema specifically.[11]
Avoiding Triggers
Avoid triggers like harsh soaps, tight clothing, and sweating to prevent scrotal dermatitis. Use gentle cleansers and wear loose, breathable cotton clothing. Keep the area clean, and avoid scratching.
Clothing
Choose loose-fitting, breathable fabrics like cotton to prevent eczema flare-ups caused by clothing. Avoid wearing rough or irritating materials such as wool.
Physical Contraceptives
Some men find condoms and diaphragms irritating, especially if they have latex allergies. Spermicidal creams or gels might also cause genital irritation.
Managing Itch
Intense itching is a common symptom of scrotal eczema. Over-the-counter anti-itch products can provide relief. If itching disrupts sleep, sedating antihistamines may be recommended.
Maintaining Hygiene
Keeping the genitals clean is essential, but excessive washing or harsh soaps can worsen symptoms. Warm water and a mild, non-detergent cleanser are advisable for individuals with genital eczema.
Scrotal eczema, similar to eczema elsewhere on the body, can result from contact with irritants and may escalate quickly without treatment. While there’s no cure, home remedies and avoiding triggers can help manage symptoms, but severe cases may require medical intervention such as steroids, antihistamines, or phototherapy.
If you’re struggling with scrotal eczema despite home remedies, fill out our form at UVB Treat. Our experts can help identify triggers, offer personalized advice, and tailor treatments to your needs.
Krishnan, Ajay, and Sumit Kar. “Scrotal Dermatitis – Can We Consider It as a Separate Entity?” Oman Medical Journal, vol. 28, no. 5, 10 Sept. 2013, pp. 302–305, https://doi.org/10.5001/omj.2013.91. Accessed 13 May 2023.
F. Hendry, William . “Wash Leather Scrotum” (Scrotal Dermatitis): A Treatable Cause of Male Infertility. www.sciencedirect.com/science/article/pii/S0015028216533044.
Krishnan, Ajay, and Sumit Kar. “Scrotal Dermatitis – Can We Consider It as a Separate Entity?” Oman Medical Journal, vol. 28, no. 5, 10 Sept. 2013, pp. 302–305, https://doi.org/10.5001/omj.2013.91. Accessed 13 May 2023.
Choi, J. Y., et al. “Narrowband Ultraviolet B Phototherapy Is Associated with a Reduction in Topical Corticosteroid and Clinical Improvement in Atopic Dermatitis: A Historical Inception Cohort Study.” Clinical and Experimental Dermatology, vol. 46, no. 6, 21 May 2021, pp. 1067–1074, https://doi.org/10.1111/ced.14676.
Scrotal eczema is a type of genital eczema and belongs to the atopic dermatitis category, which concerns the scrotum, penis, foreskin, groin, and skin surrounding the anus. The most common problem from which many men suffer is scrotal eczema – an estimated 31 million Americans have some form of eczema. [1] Scrotal eczema can be especially uncomfortable and distressing, since the skin in the genital area is very sensitive.
Managing scrotal dermatitis involves using a combination of prescribed and over-the-counter medications, as well as avoiding triggers like allergens and irritants.
Around 1 in 10 Americans may experience eczema during their lifetime. While it often affects areas like the hands and scalp, it can appear anywhere on the body. Factors like sweat, tight clothing, or skin friction near the scrotum can trigger flare-ups.
A healthcare professional, usually a dermatologist, can diagnose scrotal eczema. This may involve taking a skin culture and sending it to a lab for analysis. Scrotal eczema can sometimes be confused with other conditions like fungal infections
Home remedies such as regular moisturizing can help alleviate eczema symptoms. Wearing cotton underwear and avoiding harsh soaps may also relieve scrotal eczema.
