Scrotal eczema, also known as scrotal dermatitis, is a form of eczema that affects the scrotum. This condition can be uncomfortable and frustrating, and you may not even want to talk to your doctor about it.
Keep in mind, however, that this is a common condition. In fact, more than 750 members of MyEczemaTeam report that eczema has affected their genitals. “I can’t sleep well since my scrotal eczema itches really badly at night,” one member said.
If you have scrotal eczema, you don’t have to deal with burning, itching, or general discomfort. Although there’s no cure for eczema, scrotal dermatitis can be treated.
Talk to your dermatology specialist if you notice any changes in the appearance of your scrotum. They’ll help rule out any other potential causes, such as fungal or bacterial infections and sexually transmitted infections (STIs). They can also help you develop a scrotal eczema treatment plan.
Scrotal eczema is one type of genital eczema. Eczema can affect the scrotum, as well as the penis, foreskin, or groin (the area where the upper thigh creases against the lower abdomen). It can also impact the skin between the buttocks and around the anus (referred to as perianal eczema).
Scientists don’t think scrotal dermatitis is a separate disease on its own. But some researchers have pointed out that more studies are needed to understand the differences between scrotal eczema and eczema that appears on other parts of the body.
Eczema that affects the scrotum often causes intense itching and burning sensations. The skin of the scrotum also becomes scaly, discolored, and lichenified (thick and toughened). Scrotal inflammation leads to itching, and scratching this itch worsens the inflammation and eczema symptoms. This is referred to as the “itch-scratch cycle,” and it’s often responsible for the discoloration and lichenification seen in scrotal eczema.
Researchers have classified scrotal eczema into four different types based on severity and symptoms.
“I have scrotum eczema, type 3,” one MyEczemaTeam member said. “I normally sweat a lot, so that made it worse. I get oily there, too.”
Some researchers have suggested that scrotal eczema may be linked to infertility, but studies are limited. An older study from 1990 published in the journal Fertility and Sterility found an association between scrotal dermatitis and infertility in males. Researchers suggested that increased blood flow and thickening of the skin on the scrotum caused the testicles to overheat. Heat stress can damage sperm.
Treating the underlying eczema improved sperm counts and sperm motility (the cells’ ability to “swim”) in most of the study participants. More studies are needed to confirm whether this link is widespread.
Scrotal eczema can be caused by many factors. Some forms of the condition are triggered by environmental factors. These may include soaps, detergents, or allergens such as pollen or animal dander. What’s more, several different types of eczema can affect the scrotum.
Stress is linked to eczema of the scrotum. When stress leads to an itching sensation, scratching the itch results in a feeling of relief. This rewarding sensation leads to further scratching, which can worsen eczema symptoms. This cycle continues to worsen symptoms until the itch-scratch cycle is broken.
Scrotal skin affected by eczema becomes inflamed. Inflamed skin is more permeable, meaning treatments are more easily absorbed. As a result, over-the-counter remedies may irritate the sensitive skin of the scrotum and worsen eczema symptoms.
Occupation-related scrotal eczema may occur if your job exposes you to irritating chemicals or products. High temperatures, sweating, and protective work uniforms all increase the skin’s absorption of irritating substances. This increases the risk of allergic contact dermatitis and irritant contact dermatitis.
Three main types of eczema can affect the scrotum: atopic dermatitis, contact dermatitis, and seborrheic dermatitis.
Atopic dermatitis is the most common form of eczema. It develops when a person’s immune system becomes overactive and sets off inflammatory processes that attack the skin. Atopic dermatitis usually affects the face, hands, feet, arms, legs, and neck. However, the condition can develop anywhere on the body, including the scrotum. It causes persistent itching, scaling, and dry skin.
Contact dermatitis occurs when bare skin comes into contact with an irritating substance. It typically causes burning and itching where the contact has occurred. Blisters may also form. Two types of contact dermatitis may affect the scrotum: irritant contact dermatitis or allergic contact dermatitis.
Irritant contact dermatitis is common on the genitals. It can result from sweat, frequent contact between areas of skin, and friction from clothes. Soaps, body washes, moist towelettes or toilet paper, and other products that come into contact with the genitals can also trigger irritant contact dermatitis.
If you’re experiencing allergic contact dermatitis, you may notice itching and inflammation when your skin comes into contact with an allergen. For instance, spermicidal creams and condoms can cause allergic contact dermatitis on the scrotum.
Seborrheic dermatitis is a type of eczema that affects areas of the skin with a lot of oil glands. It typically causes yellowy-white flakes or scales and itching, and it is known to affect the scrotum.
There are many possible causes of an itchy, irritated scrotum besides eczema. They include the following:
These other conditions can make it hard to diagnose scrotal eczema. For that reason, a doctor might perform tests, such as a patch test, to confirm what’s causing your symptoms.
Talk to your dermatologist or other healthcare provider to get medical advice about how to treat scrotal eczema. Don’t try to treat eczema yourself, as certain remedies may irritate the sensitive skin of the scrotum and worsen your symptoms.
Treating genital eczema often begins with a topical medication, such as a corticosteroid. Corticosteroids (also known as steroids) reduce inflammation, helping to ease skin irritation and other symptoms of eczema. Strong steroids aren’t used on the scrotum because they can thin out the skin.
Topical immunomodulators — such as tacrolimus and pimecrolimus — suppress the immune system in the skin but don’t thin out the skin like steroids do. These are often recommended for the genital area. Crisaborole is a newer topical agent that doesn’t contain steroids and may be safer to use near the genitals.
Moisturizers, also called emollients or lotions, can help relieve itchy, dry scrotum skin. You should apply a topical steroid cream and an emollient at least 30 minutes apart. Either one can be applied first.
If scratching itchy skin has led to open sores or wounds, your doctor may prescribe antibiotics to prevent or treat bacterial infection. Your care team may take a culture sample to see if any bacteria are growing on the skin.
Phototherapy — also known as light therapy — is an effective treatment for atopic dermatitis. Light therapy for eczema works by repeatedly exposing affected skin to ultraviolet radiation — from natural sunlight or artificial light. This slows or suppresses inflammatory activity that causes flares.
The genitals are typically covered during routine phototherapy sessions. But researchers have found that one type of phototherapy, narrow band UVB therapy, may help improve scrotal dermatitis.
Part of managing scrotal eczema involves reducing or eliminating contact with irritants.
Friction and tight clothing can aggravate genital eczema. Wearing loose, comfortable clothing made from cotton can help ease irritation. Avoid laundry detergents that have fragrances, and always rinse your clothes well after washing them.
Some people with eczema find that physical contraceptives — such as condoms and diaphragms — cause genital irritation. This is particularly true if you have a sensitivity or allergic reaction to latex. Spermicidal creams or gels, which help prevent pregnancy by killing the sperm, can also cause the genitals to become irritated.
Intense itching is one of the most common symptoms of eczema on the scrotum. Some over-the-counter anti-itch products can help relieve this uncomfortable symptom. Your doctor may also perform more testing to see if something else is causing the itching.
Keeping the genitals clean is an important part of managing scrotal eczema. But overwashing or using irritating soaps can worsen symptoms. People with genital eczema may be advised to wash the affected areas with warm water and a nondetergent cleanser.
MyEczemaTeam is the social network for people living with eczema and their loved ones. Here, more than 55,000 members from across the world come together to ask questions, offer advice and support, and meet others who understand life with eczema.
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For scrotal eczema, also consider possibility of Red Scrotal Syndrome or balanitis (if rash extends to penile skin).
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