Scrotal Eczema: Treatments, Symptoms, and Causes
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.
What Is Scrotal Eczema?
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.
Symptoms of Scrotal Eczema
The signs and symptoms of scrotal eczema may include:
- Intense itching
- Dry, sensitive skin [2]
- Inflammation
- Burning sensation
- Redness
- Skin discoloration
- Rough, thickened, or scaly skin
- Fluid-filled blisters or oozing skin
- Swelling in certain areas
- Open sores or crusted skin
- Broken hairs
What Are the Triggers of Scrotal Eczema?
For males with scrotal eczema, potential triggers include:
- Soaps or shower gels
- Tight clothing
- Sweating [3]
- Fabric softener
- Certain laundry detergents
- Moist toilet wipes
- Aftershave or deodorant
- Allergic reactions, like latex in condoms
- Antiseptics
Classifications of Scrotal Eczema
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. [4]
- 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.
Types of Eczema Affecting the Scrotum
Eczema can manifest in three primary forms on the scrotum:
Atopic Dermatitis
This stems from an overactive immune system, resulting in persistent itching and a dry, scaly presentation of the skin. Chronic cases, over time, may show peeling, oozing, and discoloration, while acute episodes result in thickened and toughened skin.
Contact Dermatitis
Caused by contact with irritants, it results in burning, itching, and sometimes blisters. [6] Irritant contact dermatitis is common on the genitals due to sweat, friction, and certain products. Substances like personal lubricants and latex condoms can trigger allergic contact dermatitis.
Seborrheic Dermatitis
This chronic form affects oily areas and involves factors such as hormones and natural skin microorganisms. It causes red, swollen, greasy skin on the scrotum and yellowy-white flakes or scales in the groin area.
Scrotal Eczema and Male Infertility
Scrotal eczema can affect male fertility by disrupting the optimal temperature regulation of the testicles and causing inflammation. If this persists, it can result in damage to the sperm production.
However, in 1990, a study reported that there is a stronger link between scrotal eczema and an increased risk of male infertility. [7] It showed that scrotal dermatitis can increase the blood flow and thickening of the scrotal skin, resulting in overheating of the testes and damaging sperm.
Causes of Scrotal Eczema
Scrotal eczema can stem from various factors, depending on the type of eczema involved.
- Hereditary Factors: Eczema often runs in families, so if a family member has it, you’re more likely to develop scrotal eczema. [8]
- Stress: Stress is an important factor that precipitates the development of scrotal eczema. It triggers itching, and scratching provides temporary relief, thus reinforcing the same till a vicious cycle sets in.
- Irritants: Scrotal skin is particularly absorbent, making it susceptible to toxins and irritants that can trigger eczema. Other factors of scrotal eczema could be the occupational exposure of scrotal skin to any chemicals or products, especially in hot working conditions with a great deal of sweat or prolonged sitting positions, where protective uniforms increase the risk of contact dermatitis. [9]
Other Potential Causes of Skin Symptoms on the Scrotum
Several factors could lead to itching and irritation in your scrotum:
- Fungal Infections: Warm, moist skin folds are prone to fungal or yeast infections, which are common in genital areas.
- Sexually Transmitted Infections (STIs): STIs like genital herpes and syphilis may cause sores resembling eczema lesions in the genital area.
- Lichen Planus: This inflammatory skin condition can cause swollen, itchy bumps on the skin, affecting the genitals in some cases.
- Psoriasis: Although less frequent, psoriasis, an autoimmune disease, can result in dry, scaly patches on the scrotum.
Treating Scrotal Eczema
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]
Antibiotics
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. [12]
Scrotal Dermatitis Photos: Scrotal Eczema
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Summary
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.
