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
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.
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
- Long term use of corticosteroids
- Improper hygiene of groin area
- Keep the groins clean and dry.
- Wash the area frequently with soap and water. This should be done after any work that involves sweating.
- Wear loose cotton underwear; avoid tight-fitting clothes.
- 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.
- Remove the offending agent, if identified. This may include stopping any over-the-counter topical agent.
- Wear loose clothing to avoid moisture and friction.
- Manage stress with lifestyle modification and counseling.
- 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.
- 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.
- Frequently change the diapers, especially if he has passed urine or stools.
- 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.
- Avoid alcohol and perfumed based wipes in order to avoid skin irritation.
- Use absorbent diapers and put them on the baby loosely.
- 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.
- Avoid corn starch and talc.
- 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.