Causes and Management of Scrotum Skin Rash

Rash in the scrotal area may occur due to many reasons. Causes such as jock itch, eczema and psoriasis should be considered under its differential diagnosis.

Jock Itch is the Commonest Cause

Scrotum rash

Jock Itch

Strictly speaking jock itch is not a scrotal lesion, at least initially. It usually starts in the groin area that may later involve scrotum. It tends to produce itch and redness in the affected area.

It’s due to a superficial fungal infection called dermatophytes, which is caused by Tinea Cruris. It is also known as ringworm, a misnomer since the causative agent is not actually a worm, but a fungus.

It is associated with heavy sweating and rubbing of inner thighs with scrotum in the groin area. That is why it’s commoner during conditions of excessive heat and moisture.

Tinea Cruris Microscopic

Fungus under microscope

The rash is raised, pinkish red, flaky, cracking, peeling and very itchy. It consists of circumscribed lesions consisting of small, multiple pinpoint-like pinkish bumps. Lesion’s central area may consist of dry scales with distinct edges.

Jock itch is associated with:

  • Excess moisture and sweating
  • Tight underwear
  • Rubbing and friction of skin
  • Fungal infection
  • Obesity
  • Diabetes
  • Long term use of corticosteroids
  • Improper hygiene of groin area

Management

Clotrimazole skin cream

clotrimazole cream

  1. Keep the groins clean and dry.
  2. Wash the area frequently with soap and water. This should be done after any work that involves sweating.
  3. Wear loose cotton underwear; avoid tight-fitting clothes.
  4. You may need a topical antifungal cream such as miconazole, clotrimazole or tolnoftate- as deemed suitable by your physician. If scrotum rash doesn’t go away in 2 weeks, then you may need to see a dermatologist.

Scrotum Eczema or Dermatitis

It is characterized by severe burning-like itching, redness, scaling and thickening of scrotal skin. The common causes of scrotum eczema or dermatitis include allergens, irritants and stress.

Contact dermatitis may be induced by variety of factors including chemicals such as topical antiseptics, clothing dyes, rubber of condom, spermicidal agents and grease etc. Other causes may include bug infestations such as pediculosis and scabies, generalized skin conditions such as psoriasis, atopic and seborrhoeic dermatitis and medical conditions like diabetes and systemic infections.

Treatment

  1. Remove the offending agent, if identified. This may include stopping any over-the-counter topical agent.
  2. Wear loose clothing to avoid moisture and friction.
  3. Manage stress with lifestyle modification and counseling.
  4. Medications such as oral antihistamines and mild topical steroids may be required for short duration.

Scrotal Psoriasis – a Generalized Skin Condition

Several areas of the body may be affected with psoriasis in addition to genital region. Psoriatic lesions are red and shiny with clear cut boundaries that are usually present on both sides symmetrically.

Treatment may include application of mild topical steroids for limited duration. Scrotum psoriasis may co-exist with fungal infection, hence topical antifungal creams may need to be applied.

Is Scrotal Skin Lesion an STD?

Many times people ask if rash on their balls an STD, that is, whether it spreads sexually.

Though jock itch fungal infection is not considered a sexually transmitted disease (STD), but direct skin-to-skin contact during sexual intercourse may cause it to transfer to the mating partner. Both the partners may need to be treated if direct skin transfer has occurred.

Scrotal eczema and psoriasis do not spread through sexual contact.

Rash in Infants and Toddlers

These rashes are noted on the skin beneath the baby’s diaper. These are seen among infants and sometimes early toddlers. Scrotal rash is bright red and scaly with pimples or blisters that may get bigger. Multiple patches may blend together to form larger lesions.

It is due to a yeast called candida which grows in warm and moist area under the diaper.

Diaper rashes may be seen in babies with:

  • Tight, ill fitting and friction-producing diapers.
  • Poor hygiene leading to unclean area with moisture.
  • Having diarrhea or more frequent bowel movements.
  • Taking antibiotics.
  • Reactions to soap or detergents used for cleaning cloth diapers.

Treatment

  1. Keep the affected area clean and dry. Try to provide diaper-free intervals to the baby by laying him on a soft cotton cloth or towel.
  2. Frequently change the diapers, especially if he has passed urine or stools.
  3. Clean the area with soft cloth and plain water gently, that is without rubbing, while changing diaper. Then allow it to dry for some time.
  4. Avoid alcohol and perfumed based wipes in order to avoid skin irritation.
  5. Use absorbent diapers and put them on the baby loosely.
  6. If you use cotton diapers, then avoid fabric softeners. Avoid putting rubber or plastic pants over the diaper as they do not allow adequate air flow.
  7. Avoid corn starch and talc.
  8. You may discuss about diaper rash creams with the baby’s medical care provider. Sometimes topical antifungals such as miconazole and clotrimazole may also be required.

Medical Advice (Q&As) on “How to Deal With Scrotum Skin Rash?

    1. Buddy M.D. Post author

      May be some infection, likely to be fungal.

      Read above in detail about the problem and its management.

      Reply
      1. Kay Lanza

        My testicales itch and no rash just lil bumps I think it’s become I’m shave wrong but i don’t know what it is

        Reply
        1. Buddy M.D. Post author

          Likely to be razor bumps. Just keep the area clean. Apply some emollient over the affected area.

          Reply
  1. Anonymous

    Scrotal itching. Rash comes and goes around genitals. Started one year ago. Been through all the ozole creams / 2 months Lamisil oral / vytone cream / even clobesasol steroid. Still persists. Help me.

    Reply
  2. Manuel Estrellon

    What are the alternative medicines for scrotom skin rash?There was one time that I used guava leaves to relieve itchiness co’z they said that, it is anti-bacterial.
    Please help me with this.

    Reply
    1. Buddy M.D. Post author

      Depends upon what is causing you that rash. It may be a fungal, an irritative condition of the skin or some allergy. Bacterial infections are uncommon over the skin.

      Is the affected area red or swollen? Since when do you have it? How big is the patch?

      Reply
  3. ahmed

    I work in a chemical factory for 3 years last month i felt itching, redness and scales on my scrotum i was scared and shaved that area and thought it will ease the pain but it gets worse i went to my GP she said i don’t what it is and refer me to someone at hospital but i didn’t go there and find out the next the my colleague had the same problem but his was gone within 2 days but mine lasted for 10 days ( maybe cuz i shaved and got 2 cut in the area ) i used some over the counter steroid cream. Now after a month i have the same condition.
    I am pretty sure the last one was because of some allergic reaction to a chemical at our factory but don’t know about this time as i was cautious about touching that chemical again.
    If it is allergic reaction what will help me heal fast because 10 days are tooooo long

    Reply
    1. Buddy M.D. Post author

      Very likely to be an allergic reaction. It’s now important to avoid further exposure of the chemical.

      Repeated washing with water would help. If it’s not itching, do nothing. Give it time to heal by itself. If it itches, you may occasionally use the steroid cream. Avoid too much use of the cream over the area.

      Reply
  4. Frank

    I have very tiny rashes in my balls. It itches me a lot. And I mean alot! It is reddish, tiny and plenty. Help!!

    Reply
    1. Buddy M.D. Post author

      Needs to be examined by a dermatologist for diagnosis.

      This could be an allergic rash, due to some new soap or garment used. Or else, it could be a skin condition like psoriasis.

      Can you send a picture?

      Reply
  5. Vishal Raj

    My scrotum ball is itching too much at night but their is not any type of rashes..
    And it is leaving dead skin cells also
    If that part is itched too much then it got scratched
    Please help me out from it

    Reply
    1. Buddy M.D. Post author

      It may be moisture collected in the area that’s giving you the itch.

      Wash the area thoroughly with ample water. No soaps or gels to be used. Wear loose cotton underwears to let the region breathe throughout the day.

      You may start using an antifungal powder over the scrotal skin. Zeasorb-AF powder or Miconazole powder may be used twice daily.

      Reply
  6. One poor boy

    I have some kind of red pimple like structures on my scrotum sack.(around 7 to 10). It just started with one 2,3 months back. i didn’t give much importance at first now it has become worse and the same pimple like thing has spread on to my thighs and the tip of my penis.And there are red rashes on my lower abdomen too. And there are small pimple like growths smaller than the one i mentioned above almost all over my body i.e in between my fingers, region near my armpit, thighs. when these all starts itching i use to see the 7 heavens! Please help me out.

    Reply
    1. Buddy M.D. Post author

      Likely to be a severe allergic reaction to some trigger. It may be a new food tried, laundry detergent or some other allergen around you.

      Start taking anti histaminic pills at the earliest. If the reaction doesn’t lessen in a day or two, you must see a doctor.

      Reply