Scrotal​‍​‌‍​‍‌​‍​‌‍​‍‌ Eczema: Symptoms, Treatments, and Causes

What Is Scrotal Eczema?

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.

What Are the Triggers of Scrotal Eczema?

Identifying your own triggers is important in scrotal eczema management. Examples of eczema triggers include:

• Chemical irritants: soaps and detergents, fragranced products;

• Allergens: pollen, pet dander, dust mites, some fabrics;

• Physical friction: skin-to-skin contact, clothing, sports gear;

• Heat and Moisture: heat exhaustion, high temperatures, steam rooms

• Stress: emotional or psychological stress;

• Contraceptives: latex condoms, spermicidal cream;

• Occupational exposure: chemical agents at work, protective clothing.

Checklist: identify your triggers

1. Have you changed laundry detergent recently?

2. Do you wear tight or synthetic underwear?

3. Are you under a lot of stress?

4. Using new body care products?

5. 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..​

Dos & Don’ts for Preventing Scrotal Eczema

Types and Classifications of Scrotal Eczema

Atopic Dermatitis

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 1990 Fertility 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.

Causes of Scrotal Eczema

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

Treatment Options

Moisturizers

One of the main methods in the scrotal eczema treatment is to use fragrance-free emollients. The main effect restores the skin barrier, reduces dryness, and prevents flares, particularly when used post-bathing.

Source: American Academy of Family Physicians

Topical Medications

Corticosteroids, JAK inhibitors, and calcineurin inhibitors effectively reduce inflammation and pruritus.

Source: Cochrane Library, Mayo Clinic

Antibiotics

In cases when scrotal eczema is accompanied by infection, antibiotics like flucloxacillin are necessary to resolve this problem.

Source: National Library of Medicine

Phototherapy

Narrowband UVB treatment is a safe, and effective option for moderate to severe disease, working by targeting inflammation. Phototherapy for eczema helps reduce itching, redness, and flare-ups when other treatments are not enough.

Get your UVB therapy now — consult a dermatologist to find out if it’s right for you.

Source: Directory of Open Access Journals

Avoiding Triggers

Trace the factors that cause and provoke your symptoms and you will notice that the management will be much easier. A symptom diary will help you understand the factors that provoke your symptoms and avoid those that are irritants.

Clothing Recommendations

Stay away from fabrics made of polyester or other similar materials that trap moisture and heat.

Physical Contraceptives

If you find that symptoms were triggered by the use of latex condoms or spermicidal creams, take into consideration hypoallergenic replacements or non-latex alternatives for your products.

Source: PubMed

Managing Itch

Cool compresses, cool baths, and short, clean nails can help you break the cycle of itching and scratching. Severe itching can be treated in some cases with oral antihistamines. Scrotal eczema involves anti-inflammatory and soothing measures to promote healing, unlike jock itch which is a fungal infection.

Source: Cochrane Library, PubMed

Maintaining Hygiene

Use a mild, fragrance-free soap on the groin to avoid irritation. After cleaning, the site needs to be patted dry rather than rubbed.

Summary

Scrotal eczema is a long term condition which can be well controlled with appropriate treatment and avoiding triggers. Although there is no cure, treatment can enhance quality of life. Early intervention and consultation with a dermatologist allow for individualized treatment.