Red Painful Lump on Side of Scrotum

Q: I am a 33 year old male. I have had a lump on the right side of my scrotum for about 2 weeks. It started small and painless and has grown to about the size of a pencil eraser. It is oval shape under the first layer of skin. As it has grown it has become red and painful. Yesterday, it seemed to pop like pimple but the fluid was white thin greasy and had blood mixed in it. This morning the fluid is clear and slightly greasy.

I do have MS and seem to have immune weakness because of my MS. I had a pilonidal cyst about a month ago and it seems slightly similar just on the scrotum. It does not seem to be attached to my testicle; it’s just under the skin. I have been keeping my groin area extremely clean by washing it with Hibiclens. Now the skin seems to be peeling and it doesn’t seem to be getting better. Can you assist me?
– By Shawn

Reply:

It looks like an infected sebaceous cyst of scrotal skin. These are fluid filled swellings formed just underneath the skin.

How Are Sebaceous Cysts Formed?

Certain glands called sebaceous glands are present near the hair follicles of the scrotal skin. They produce sebum, which helps lubricating the skin and hair of the area.

A sebaceous cyst is formed by plugging of the duct draining a sebaceous gland. This is a very common situation. Such a cyst is filled with sebum which is a cheesy or greasy fluid.

Your cyst has got infected as it grew bigger. This can be said as it became red and painful. Also it enlarged in size and drained later on oozing out blood- mixed fluid, which is indicative of infection.

Why the Cyst Got Infected?

Though you keep your groin area clean, the cyst looks infected. This could have happened due to any of the following reasons:

• Squeezing or scratching the cyst- This commonly leads to infection. The skin of our hands and around the scrotal area is all full of tiny microbes which get into the skin easily through any small breech or scratch.
• Since you have MS, you may be taking steroid medications, making you prone to infections.

Managing the Infected Cyst

Treatment of the cyst would include draining it completely. It is recommended not to squeeze it actively.

You may try warm compresses. Take clean warm water. Soak a soft wash cloth in it and keep it over the cyst for 5 minutes. Repeat this 3 times. Let the cyst drain by itself (passively).

You may do this three times a day.

The swelling would gradually subside within a week.

If it does not get better, you may require some antibiotic treatment.

Rarely, surgical excision of the cyst with its capsule is required. This is done in cases where the cyst appears again and again.

Take Care,

Buddy M.D.