Overview
The scrotum is the skin found underneath and behind the male genitalia. It includes the small sacs (scrotum sacs) that protect and contain the testicles, part of the spermatic cord and blood vessels. The male genitalia consist of the scrotum and penis.
Scrotum itch may have a variety of causes, from a minor issue, such as an allergy to soaps or detergents, to more serious issues, such as a sexually transmitted disease. Determining the cause of the itch often relies on discovering the underlying condition causing the itching.
Once the cause is determined, the itching and the cause may be treated.
Causes on an Itchy Scrotum
Why Men Scratch Their Genitals
Doctors explain common causes of jock, scrotum and genital itching.
Folds in the testicular area and under the scrotal sac can allow moisture and sweaty conditions to occur, enabling fungal infections to take hold. The most common cause of male genital itch, the fungus that causes jock itch, rarely causes scrotum itch. So a claim of jock itch on scrotum is rarely correct.
Any type of itch can have multiple possible causes or reasons to occur.
Review the list below to see which best matches your symptoms and to identify the best remedies.
Fungal Infections (Common)
- Candidiasis (Yeast Infection on Scrotum): This is often takes hold in the moist skin fold of uncircumcised men, when a woman with a yeast infection has sex with a male that is not using a condom, when on antibiotics or if you have diabetes. The condition is characterized by a bright red, raw, rash. It is sometimes accompanied by a rash on the penis head (as pictured above) and in some cases, pain. Treatment is with a topical such as terfenidine, cicloprox, ketoconazole or econazole.
In men with recurrent candidiasis, causes in uncircumcised men could be due to frequent exposure to humidity and heat (due to candidal balantitis, which is a yeast infection). In all men diabetes as an underlying condition should be explored. - Tinea versicolor: Tinea versicolor is another type of fungal infection. Tereatment includes axole creams or selenuim sulfide lotion.
Source: Prescriber
Bacterial Infections (less common)
Erythrasma: genital bacterial infection caused by corynebacterium minisutum. Symptoms include red patches along skin folds. It can be differentiated from Tinea versicolor by the absence of no raised borders. The cause is usually poor hygeine such as infrequent washing. Diagnosis is with a Wood's light.
Treatment includes oral antibiotics (clindamycin or erythromycin).
Scrotal Eczema
Scrotal Exzema (dermatitis); Eczema is a chronic skin condition which causes intense itching, swelling and redness of the skin.
Itching is often related to sweat and heat. Dark skinned patients may experience changes in skin pigmentation.
Eczema can cause fluid-filled bumps and irritated red or red/gray skin patches. The cause of scrotal eczema is not well known although it is thought that skin in this area is more absorbent then other skin areas and therefore more prone to irritation. This condition is often confused with Jock Itch. Types of male genital eczema include irritant contact eczema, allergic contact eczema, seborrhoeic dermatitis and atopic eczema.(2)
Excessive rubbing and scratching could cause lichenification (making skin thick and leathery).
Treatment includes the use of topical medications. Zinc oxide paste can help to soothe the area and absorb sweat. Patients should stop excessive washing.
Other Causes
- Scabies: An infestation of the skin by tiny organisms called mites.
- Pubic Lice: Also referred to as “crabs”, pubic lice are small parasitic insects found in pubic hair and spread through sexual contact.
- Contact Dermatitis or Allergies to soap or shampoo or a partners nail varnish (this is more common then you think). Keeping the genitals too clean can also dry the area creating itch.
- Herpes: Sexually transmitted disease caused by the herpes simplex virus.
- Psoriasis: Raised areas of thickened skin, caused when new skin cells are produced faster than old skin cells are shed.
- Scrotal Cancer (rare cases): Where the itching and irritation do not respond to anti-fungal therapies. A biopsy is needed for diagnosis.
- Idiopathic: When there is no known cause for an itchy genital condition, studies show that it is often attributable to lumbosacral radiculopathy which is when symptoms of tingling, numbness or pain travel down the back into the genitals or legs. It is caused by the sciatic nerve which exits the spinal cord as multiple nerve roots.(1)
Symptoms
The most obvious sign of this problem is the itching. The skin in the affected area might also become flaky and crack. A rash could appear, or just a reddening of the skin could also be present. Swelling, inflammation or the thickening of the skin can occur as well.
Difference Between Scrotal Eczema and Jock Itch
Jock Itch Symptoms
- Rash in groin
- Treatment cures condition
- Rash has clearly defined edges
Scrotal Eczema Symptoms
- Chronic scrotum itch
- Skin can look leathery and thick
Diagnosis
Diagnosis of an itchy scrotum can be performed by a doctor by examining the groin area, and if necessary, tests can be performed for sexually transmitted diseases or other ailments.
Problems such as a yeast infection can be detected with a skin scraping and from the appearance of the condition.
Scrotal Eczema and Jock Itch are two conditions that are often confused with each other. Itching of the scrotum specifically is rarely caused by the condition called Jock Itch when occurs in the groin, which is where the legs and torso come together.
Scrotum Itching Treatment and Skin Care
The best treatment for an itchy scrotum or testicular irritation will depend on the underlying condition. Some quick relief for eczema the may come from icing the area with an ice pack for 10 to 20 min. 3x per day. Avoid scratching!
Treatment may range from washing the area with a mild soap and ensuring the area stays dry, to medications for control the condition and the itching.
We suggest seeing a Doctor instead of self medicating, since treatments are cause specific. Doctors can also prescribe anti-fungals or topical steroids.
For Jock Itch, Lotrimin AF or the homeopathic/natural product like Puriya is recommended if you believe ringworm fungus (jock itch) is the cause (which is not always the case).
For Tinea Curis, see a Doctor for a prescription cream. Recurrent cases may require an oral medication.
For yeast infection, try the natural solution Candida Clense. Medicated ointments that contain nystatin or miconazole can also help.
Pubic lice requires a product that kills these parasites such as Rid.
DO NOT use hydrocortisone cream unless under the direction of a Doctor as this will worsen any fungal infections.
Also do not scratch the area to avoid the spread of bacteria or fungal infections.
Brochures
References
(1) Journal of the American Academy of Dermatology
Wrong Diagnosis: Causes of Testicle Itch
Prescriber (March 2011)
Date Published: 2017-9-24