Scrotum eczema, also called scrotal dermatitis, is an inflammatory condition of the skin on the scrotum. It can be uncomfortable, painful, and distressing.
Because some over-the-counter remedies can make the condition worse, it is important to be aware that self-diagnosis and treatment can lead to complications or mismanagement of the condition.
If you think you may have scrotum eczema, it is best to have the diagnosis made by a healthcare professional. They can also identify and treat any possible underlying conditions.
Symptoms
Eczema is a skin condition that makes the skin itchy, dry, and sometimes discolored and scaly. It can cause blisters and lead to infections. When symptoms become worse, healthcare professionals call it a flare-up.
Itchiness is usually the first thing people notice, and it is one of the most common parts of having eczema.
Symptoms that you may experience include:
Discoloration: The affected area may appear red or darker than your usual skin tone if you have light skin. The eczema may appear purple, brown, or ashen if you’re Black or have a darker skin tone.
Itching: Intense itching can lead to scratching and further irritation. It is very important to resist the urge to scratch affected areas. This can lead to infection and cause weeping eczema.
Swelling: The scrotal area may become swollen and inflamed.
Flaking: Dry, flaky skin may develop on the scrotum.
Discomfort: A general feeling of discomfort or soreness in the affected area.
Weeping or infected sores: In severe cases, the skin of the scrotum can develop open wounds that can lead to complications.
Scrotum eczema can also make it difficult to engage socially because of pain, discomfort, and embarrassment.
People with atopic dermatitis have expressed feeling embarrassment and disgust due to their condition. These feelings might be stronger if the condition affects a sensitive area, such as your genitals. You might avoid sexual activity because of this or avoid seeking help.
It can cause people to experience depression and anxiety, especially if flare-ups are severe or prolonged.
Causes
It is not always possible to discover the specific cause of scrotum eczema. Some of the more common causes include:
Contact allergy: This includes reactions to substances like soaps, antiseptics, laundry products, medications, latex (in condoms, for example), perfumes, and personal deodorants.
Irritation from sweat and friction: Tight clothing, sweating, and friction between skin surfaces can cause irritation.
Incontinence: Urine and feces can irritate the skin, worsening the condition.
Use of irritating products: Soaps, bubble baths, shower gels, talcum powder, moist toilet tissue or wipes, aftershave, and similar products can trigger eczema.
Eczema elsewhere: If you have other forms of eczema — such as atopic eczema, seborrheic dermatitis, allergic contact dermatitis, and irritant contact dermatitis — elsewhere on your body, you can develop scrotum eczema as well.
Genetic factors: A family history of eczema or other allergic conditions might increase the risk of developing scrotum eczema.
If you have the symptoms of scrotal eczema, a doctor can advise you on which tests you need, what could be causing the condition, and which treatment options might be most effective for you.
Management
Management of scrotum eczema requires practicing good hygiene and self-care, avoiding irritants, and wearing comfortable clothing.
Hygiene
Hand hygiene: Good hand hygiene is essential when applying treatments, including emollients and topical steroids.
Scrotal area care: Keep the scrotal area clean without overwashing. Use warm water and an emollient soap substitute. Avoid soaps, fragrances, and other irritants that might cause irritation.
Clothing
Clothing choices: Choose comfortable, loose-fitting clothing made from natural fibers. Avoid tight trousers and thongs.
Piercing and tattoos: Be mindful that body piercings and tattoos can also cause irritation.
Laundry considerations: Avoid laundry detergents and fabric conditioners that might cause irritation.
Sex
Activities: Try to avoid activities that are likely to cause skin irritation and disturb your skin’s healing process, especially during flare-ups. Semen can make irritant eczema worse.
Topical steroids and contraceptives: Allow plenty of time for emollients and topical steroids to be properly absorbed before having sex. Barrier contraceptives like condoms and diaphragms may be affected by emollients and topical steroids.
Lubricants and aftercare: Personal lubricants can help reduce friction and discomfort. Washing after sex and reapplying the emollient are important steps in maintaining skin health.
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Treatment primarily involves emollients and topical steroids. Emollients can usually be applied as often as required and used as a soap substitute.
Topical steroids should be used carefully in the scrotal area. The National Eczema Association recommends avoiding overuse or prolonged use of combination preparations.
The skin of the scrotum is very sensitive and absorbs medications more readily than other areas of skin. This makes it more important to seek professional advice when choosing a treatment.
Depending on the underlying cause of the scrotum eczema, here are some medications that a doctor may recommend:
These antifungal medications are used to treat fungal infections in scrotum eczema.
Cetaphil, Eucerin
topical emollient
These are moisturizers that soothe and hydrate the skin, forming a protective barrier to lock in moisture. They are often used to manage dry, itchy skin conditions like eczema.
If you need help covering the cost of medications, Optum Perks’ free Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.
Summary
You can manage scrotum eczema with the right treatment, though it is often a long-term condition and might not completely go away.
Proper diagnosis, treatment, and ongoing care are essential for managing the condition effectively.
Open communication with healthcare professionals, following prescribed treatments, and being aware of triggers and irritants are key to living comfortably with scrotum eczema.
Ferreira MA, et al. (2017). Shared genetic origin of asthma, hay fever, and eczema elucidates allergic disease biology. https://www.nature.com/articles/ng.3985
Ishizuki S, et al. (2021). Extramammary Paget’s disease: Diagnosis, pathogenesis, and treatment with focus on recent developments. https://www.mdpi.com/1718-7729/28/4/260
Zane LT, et al. (2016). Tolerability of crisaborole ointment for application on sensitive skin areas: A randomized, double-blind, vehicle-controlled study in healthy volunteers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045489/