Itchy scrotum in men

Among the diseases of the skin and subcutaneous tissue, itching is separately identified in ICD-10, although it is a secondary symptom of dermatological diseases. And a very common problem - itching of the scrotum in men - is included as a diagnosis in the section "Dermatitis and eczema" with a separate code - L29.1.

Causes itchy scrotum

In fact, the clarification “in men” can be considered redundant, since the scrotum or scrotum (the skin-muscular receptacle of the testicles) is part of the external genitalia of males, including children and adolescents.

Such an annoying symptom as itching of the skin of the scrotum has different etiologies, and dermatologists note the following as the main reasons for its appearance:

• bites from the scabies mite (Sarcoptes scabiei), spread through direct contact or contaminated bedding, resulting in scabies; [ 1 ]
• lice pubis or phthiriasis; [ 2 ]
• mycoses – skin lesions in the groin area caused by dermatophyte fungi (Epidermophyton, Microsporum, Trichophyton), which are diagnosed as inguinal epidermophytosis; [ 3 ]
• candidomycosis of the external genitalia (candidiasis or thrush) is a disease caused by the yeast-like fungus Candida albicans; [ 4 ]
• various types of dermatitis, including contact dermatitis – simple irritative and allergic, as well as eczema (atopic dermatitis). [ 5 ] By the way, dermatitis can be localized only on the scrotum and groin and be a multifactorial pathology;
• inverse genital psoriasis or psoriasis on the genitals; [ 6 ]
• genital condylomas (also called genital warts); their appearance is the result of skin damage caused by the human papillomavirus (HPV types 2 or 6), which is transmitted through sexual contact; [ 7 ]
• genital herpes caused by the herpes simplex virus (HSV), transmitted by any contact routes. [ 8 ]

Enterobius vermicularis infestation – pinworms in children – causes scrotal itching in a child or teenager; in adults, this helminthiasis is also not uncommon, and it causes severe itching of the scrotum and anus at night, as well as in the perineal area.

Risk factors

There are certain risk factors for the appearance of this symptom, in particular, poor hygiene, increased sweating, excess body weight, tight clothing, the presence of intertrigo - diaper rash in the groin.

Contact of the very thin, capillary-filled skin of the scrotum with the surrounding skin, high humidity and temperature – with virtually no access to air – are ideal conditions for the development of contact dermatitis (due to the material of underwear, latex condoms, etc.) and allergic skin reactions (to the same body care products), which cause hyperemia, itching and swelling of the scrotum.

In addition, there is an increased risk of skin itching in diabetes and thyroid disease; deficiency of riboflavin (vitamin B2), iron and zinc; asthma and hay fever; weakened immunity and oncology.

Pathogenesis

In general, the pathogenesis of skin itching, regardless of its localization, is caused by irritation of receptor-associated free nerve endings of the epidermis and dermis and the release of proinflammatory mediators (cytokines) and/or chemical mediators, one of which is histamine, released in response to exposure to an allergen by dermal mast cells.

Cytokine release may be mediated by the immune system, such as in atopic dermatitis. Increased itching is caused by other biologically active compounds, neurotransmitters and neuropeptides: acetylcholine, serotonin, some prostaglandins and proteinases, lymphokines and interleukins.

The sensation of itching is transmitted via sympathetic afferent fibers C to the dorsal horn of the spinal cord, and then via the spinothalamic tract to the cerebral cortex.

Symptoms itchy scrotum

The symptoms accompanying itching vary depending on the etiology.

In some cases, the first signs in the form of any visible changes in the skin of the scrotum and anogenital area are absent, that is, itching may be the first symptom, as in the case of pinworm infection, which causes quite intense itching of the scrotum at night.

At night, severe itching of the scrotum is observed, as well as between the scrotum and anus in case of scabies - with small red papular-vesicular rashes on the skin (upon careful examination of the skin, you can see the passages made by the mite).

Fungal infections affecting the skin of the genitals, inner thighs and buttocks cause redness, a papular rash in the form of rings with scaly edges and itching of the scrotum and perineum. The rash is contagious and can spread throughout the body.

How candidomycosis manifests itself is described in detail in the article – Symptoms and signs of thrush in men.

Contact dermatitis is characterized by redness and itching of the scrotum with desquamation of the epithelium (flaking). Eczema (atopic dermatitis) usually appears as patches of irritated, red or reddish-gray skin, on which small fluid-filled blisters may appear; exudate from them oozes, forming areas of weeping and eroding skin, which eventually become covered with a crust.

Symptoms of condylomas (anogenital warts) in men are described in detail in the publication – Genital warts in men.

Burning and itching of the scrotum and penis, swelling of the subcutaneous tissue, hyperemia and soreness of the affected area, vesicular rash and blisters, scabby ulcers - these symptoms are familiar to those who have encountered genital herpes.

More useful information in the material - Itching, burning and redness in the intimate area in men.

Complications and consequences

The main consequences and complications of itchy skin in the scrotum and other male genitalia are excoriation – scratching of the skin in the form of scratches and abrasions. The scratches can bleed and are easily infected with bacteria and viruses, which can cause skin inflammation.

Also, scratching can lead to local thickening of the horny and underlying layers of the skin – lichenification.

In scabies, tumor-like infiltrates may form in the skin of the scrotum and perigenital area - benign lymphoplasia of the skin. And in cases of genital candidomycosis, candidal balanoposthitis may develop.

Diagnostics itchy scrotum

In dermatology, diagnostics begin with a physical examination of the patient's skin and comparison of the detected changes with complaints and anamnesis; a skin examination is carried out - with the determination of the morphological type of rashes and taking into account their localization.

Tests may include: skin scrapings (for fungus or scabies), a smear from the perianal area, a biopsy for the papilloma virus, skin tests for allergens; a blood test for eosinophils, a PCR test for HPV, and for antibodies to HSV.

Differential diagnostics is extremely important to avoid diagnostic errors and prescribe the correct treatment, since there are cases when, in dermatoses, the etiology of the rash, against which scrotal itching occurs, is difficult to determine clinically. Therefore, dermatologists may prescribe additional studies.

Also read – Diagnosis of skin itching.

Treatment itchy scrotum

Symptomatic treatment is aimed at relieving itching. It goes away fairly quickly, but not completely, after using the antihistamine gel Fenistil; another ointment for itching can also be used. Oral medications are also prescribed - antihistamines.

Depending on the diagnosis, topical agents are used:

• Ointments for allergic dermatitis
• Ointment for condylomas
• Herpes Creams

Parasitic and fungal diseases require etiologic treatment. The antiparasitic agent Benzyl benzoate (in the form of an ointment or cream) is used in the treatment of scabies; there is also an aerosol for scabies. Pubic lice are treated with Permethrin and other lice ointments.

To combat pinworms, you should use oral anthelmintics, such as Piperazine adipate or Gelmintox (Pirantel) tablets.

Fungal infections respond best to local and systemic antifungals, which ones, in detail:

• Tablets for skin fungus
• Effective ointments for fungus
• Clotrimazole for thrush

Also read:

• Treatment of thrush in men
• Treatment of itching in the intimate area in men

It is recommended to additionally take antioxidant vitamins (A, C and E) and B2.

For some diseases that cause itching of the scrotum in men, physiotherapy treatment is possible - Physiotherapy for dermatitis and dermatoses.

Traditional medicine and homeopathy

In some cases, folk remedies can help:

• Fast and effective treatment for scabies at home
• Traditional treatment of thrush in men
• Folk remedy for human papillomavirus

To combat mycosis and genital warts, it is suggested to use a paste of fresh garlic with the addition of olive oil (apply to the affected area for a couple of hours twice a day); natural apple cider vinegar, cranberry juice, aloe juice and tea tree essential oil.

In case of skin irritation from scrotum, you can use natural honey and sea buckthorn oil.

For fungal infections, herbal treatment includes applying fresh celandine juice, as well as using licorice root: it is ground into powder, mixed with water to a pulp and boiled for 10 minutes. The product is applied to the skin for a quarter of an hour twice a day.

Homeopathy offers antifungal remedies such as Petroleum, Silicea, Graphites, Sepia and Thuja. And for Candida fungus, Borax and Helonias. If the itching is associated with eczema, homeopaths recommend Sulphur, Hepar sulphuris, Lycopodium clavatum and Natrum Muriaticum.

Prevention

The main prevention is hygiene. It is necessary to monitor the cleanliness and dryness of the genitals and avoid factors that provoke irritation. That is, it is better to wash the groin area and genitals with mild soap (you can use baby soap with succession and chamomile), do not allow overheating and moisture accumulation, avoid tight underwear made of synthetics, and treat diaper rash in a timely manner.

The concept of hygiene also includes protected sexual intercourse.

Forecast

Scabies, mycoses, and contact irritative dermatitis can be cured. But with regard to other diseases accompanied by scrotal itching – atopic dermatitis, genital psoriasis, condylomas, and herpes – the prognosis is not so optimistic due to their relapses.