What Is Genital Eczema?

Eczema describes a range of skin conditions that cause itchy inflammation. When it affects the genitals, it is referred to as genital eczema. It can occur in both males and females, and lead to red, sore skin and irritation in the genital area.

The exact prevalence of eczema of the genital area is unknown, but it’s thought that many people with eczema will experience symptoms in their genital area.

Types of Genital Eczema

There are four types of eczema that could develop in the genital area:

• Atopic dermatitis: This type of eczema presents as an itchy and scaly rash. It is due to a reaction in the skin, which leads to ongoing itching, swelling, and redness. People with atopic dermatitis may be more sensitive because their skin lacks specific proteins in the skin barrier, the top layer of the skin that protects it from pathogens.
• Seborrheic dermatitis: It causes itchy red patches and greasy scales on your skin, along with white or yellow crusty or powdery flakes on your scalp. Although this type of eczema is more common on the scalp, it can also affect other parts of the body that have a lot of oil glands, including the groin.  
• Allergic contact dermatitis: When the genital area is exposed to an allergen, it can lead to the development of eczema in the area. It typically occurs 48 to 72 hours after exposure to the allergen.
• Irritant contact dermatitis: Irritant contact dermatitis occurs when chemicals or physical agents damage the surface of the skin faster than the skin can repair the damage. Irritants remove oils and moisture from the skin's outer layer, allowing chemical irritants to penetrate more deeply and cause further damage.

There are different types of genital eczema depending on which part it affects:

• Scrotal eczema
• Perianal eczema
• Vulvar eczema

Genital Eczema Symptoms

The symptoms of genital eczema are similar in males and females. Some common symptoms of eczema include:

• Dry skin
• Itchy skin
• Red rashes
• Scaly or leathery patches of skin
• Crusty skin
• Swelling or irritation

The condition can affect the scrotum, penis, and vulva. Females may experience chronic pain in the area affected by genital eczema and pain during intercourse.

Causes

Factors that can contribute to the development of eczema can include an overactive immune system, genetics, and high levels of stress. Causes of genital eczema can include:

• Contact allergens: The genital area is sensitive, and contact with some types of soaps, bubble baths, shower gels, hygiene wipes or solutions, perfumes, and antiseptics can cause irritation that leads to genital eczema.
• Friction and irritation: General irritation and friction in the area can cause genital eczema. This irritation could be caused by excessive sweating or wearing tight clothing around the genital area.
• Incontinence: Incontinence refers to the inability to control urinary or bowel movements. In some cases, incontinence can lead to the development of genital eczema because urine and feces irritate the skin.

Diagnosis

Genital eczema is usually diagnosed by a dermatologist. Your doctor will examine the area, ask about your symptoms and health history, and run tests to determine what is causing your symptoms.  

Since other types of infections are more serious than eczema, they will have to be ruled out prior to treatment to make sure the condition is being cared for properly. The tests your dermatologist may order include:

• An allergy skin test to determine whether something triggered your symptoms
• Blood tests to determine whether a different condition is causing the rash
• A skin biopsy to diagnose the specific type of eczema affecting the area

Treatment

Several factors need to be taken into consideration, including the type of eczema, the cause, and how severe it is. If the eczema was caused by an allergen or irritant, such as a type of clothing or soap, discontinuing their use will usually clear up the condition.

If that doesn't work or the cause isn't an irritant, your doctor will likely prescribe topical steroids and a moisturizer to be used on the area. The most common steroid used for groin eczema is hydrocortisone.

Topical steroids should be used once or twice per day and only in small amounts. The topical steroids used should also be applied at least 30 minutes before using a moisturizer so the medication does not become diluted by the moisturizer and doesn't spread to areas unaffected by genital eczema.

You can also manage your genital eczema at home with the following tips:

• Use a humidifier.
• Address stress or mental health issues that could be causing flare-ups if you have eczema on other areas of your body.
• Avoid using harsh soaps like those that are scented or contain alcohol.

You can also manage your condition by improving the function of the skin barrier. The skin barrier is the uppermost layers of your skin, and it's designed to protect the body from moisture loss and prevent certain things such as allergens from getting into the body via the skin. For people with eczema, the skin barrier doesn't work as it should. You can improve your skin barrier function using products that contain ceramide.

Since treatment is the only route to get relief from genital eczema, it’s important that you talk to your doctor at the first sign of symptoms.

Coping

Genital eczema is common, and treatment is usually effective for relieving symptoms and reducing flare-ups. Establish a medication and moisturizing routine so you are less likely to forget.

Since stress can trigger a flare-up, you can also prevent flare-ups by reducing stress. Yoga and meditation have been shown to be effective for managing stress levels, and both practices may help improve the quality of life for people with chronic skin conditions like eczema.

If your condition is causing you to feel depressed or anxious, you could explore a relatively new type of psychotherapy known as psychodermatology. Medical professionals in this field explore the connection between the mind and eczema development, and may be able to help you cope with the emotional impact of your eczema.

The National Eczema Association offers access to online support groups for people with various types of eczema. Connecting with people who share your condition will remind you that you are not alone and make your eczema easier to cope with.

Summary

Genital eczema causes itchy and red skin in the groin. It can affect the scrotum, perineum (the area between the genitals and anus), and vulva. The cause of the condition is not entirely clear, but could include irritants, allergens, and yeast. Genital eczema can be treated effectively by avoiding triggers and using topical steroids. It may be difficult to cope with, but you can seek help from others through support groups and psychotherapy.

A Word From Verywell

Having eczema anywhere on your body can be hard to deal with because of the intense itching and unsightly rash, but it can be especially concerning if it occurs in the genital area. The good news is that it is not a serious threat to your health and there are ways to treat it.

If you suspect you have genital eczema, the best thing you can do is book an appointment with your primary care physician. They will help you get a proper diagnosis and develop an effective treatment plan to help you manage the condition.

Frequently Asked Questions

How do you shave or wax if you have genital eczema?

Shaving or waxing the genital area can irritate it further if you have genital eczema. Using a moisturizer recommended by your doctor can help soothe your skin if you want to shave your hair. However, the best way to avoid making your genital eczema worse is by waiting until the condition has improved to remove hair in the area.

How can you ease the pain from genital eczema?

To help relieve discomfort in the area, you can use a cold compress. Over-the-counter pain relievers such as ibuprofen or acetaminophen may also be effective for reducing burning, pain, and inflammation in the genital area. In some cases, antihistamines can reduce inflammation. Some specific OTC antihistamines that you can try include Benadryl, Zyrtec, Claritin, and Allegra.

How can you tell if you have genital eczema or psoriasis?

Although the symptoms of eczema and psoriasis are similar and they can both affect the genital area, psoriasis causes silvery-white scales while eczema presents with red, inflamed, peeling, and cracked skin. Eczema may also cause a bumpy rash in the area.

Is cortisone or hydroxyzine better for eczema in the groin area?

Although cortisone and hydroxyzine can help clear up genital eczema, research has shown that hydroxyzine can sometimes cause further irritation and worsen the condition. Therefore, cortisone is better for treating genital eczema.