What Is Scrotal Eczema?

Eczema is a condition that damages the barrier of the skin. It is known to leave the skin itchy, dry, discolored, and bumpy.

Eczema is not contagious and can affect different areas of the body. Although eczema is a known condition, scrotal eczema is a common condition that is typically overlooked by physicians and dermatologists.

Research shows it is easily mistaken for a fungal infection and considered to be a general case of eczema. Many times, it is not taken into consideration that scrotal eczema can be a separate stand-alone condition.

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Symptoms

In general, eczema is caused by a variety of factors. These include:

  • Genetics
  • The immune system
  • Stress
  • The environment

Overall, the symptoms of eczema include the following:

  • Dry skin
  • Itchy skin
  • Red rashes
  • Crusting skin
  • Swelling
  • Bumps on the skin
  • Scaly, leathery patches of skin

When an individual has scrotal eczema, it is often overlooked as a fungal infection.

The symptoms of scrotal eczema include:

  • Severe itching
  • Scaling
  • A thick and leathery texture of the scrotal skin

The factors of this condition include contact dermatitis and psychological stress.

Types of Scrotal Eczema

 Scrotal eczema is classified into four categories.

  • Type 1: Mild, acute, and dry: This is characterized by a burning and itching sensation in a specific area. At this stage of scrotal eczema, the condition will affect the individual for a few days to weeks, and it will go away on its own.
  • Type 2: Severe, chronic, and dry: In this stage, the thighs and the undersurface of the penis may also be affected. The scrotum is hypopigmented (a condition in which the skin is lighter in color than normal) and scaly. 
  • Type 3: Chronic and wet: In this stage, the whole scrotum and inner sides of the thighs are affected. Tiny blood vessels that cause threadlike patterns on the skin are known to be seen in the affected area. Another symptom is that the scrotum and inner side of the thighs are macerated (loss of skin), and oozing can occur. 
  • Type 4: Swollen with ulcers: In this stage, the scrotal skin is swollen. There is fluid and pus discharge along with a foul smell. This stage produces extreme pain from ulceration. If the case is extreme, gangrene can set in and spread from the area of the scrotum to the legs and the lower abdominal wall.

Causes and Risk Factors

One of the main factors of scrotal eczema is psychological stress. This causes the initial itching sensation on the scrotum. The cycle of itching and scratching can result in the skin having a thick and leathery texture.

Other causes include a deficiency in vitamins and minerals, such as riboflavin and zinc.

Another cause includes a reaction to dye on clothing or other materials such as:

  • Grease
  • Diesel
  • Rubber from condoms
  • Nonoxynol spermicide

In addition, other causes include:

  • Extreme heat and humidity
  • Topical antibiotics
  • Other medical and skin conditions

Diagnosis

A doctor can determine the proper diagnosis for scrotal eczema. The primary care physician may refer you to a dermatologist, who can help diagnose the condition.

To make a proper diagnosis, a skin culture may be taken and sent to a lab. Scrotal eczema is known to be misdiagnosed as other conditions such as fungal infections.

Treatment

The treatment of scrotal eczema varies depending on the severity.

A healthcare provider can determine the proper treatment.

Medications and treatments include:

  • Steroid creams (prescription or over-the-counter)
  • Steroid injections
  • Absorbent powders
  • Radiation therapy

Managing Scrotal Eczema

Since stress is the primary cause, finding ways to consistently reduce stress is helpful.

Ways to reduce stress include:

  • Seeking professional help
  • Exercising
  • Getting enough sleep
  • Meditating

Other ways to manage scrotal eczema are to wear loose clothing and stop using any potentially irritating products.

Frequently Asked Questions

How common is scrotal eczema? 

Scrotal eczema is a very common condition that is often misdiagnosed as other conditions such as a fungal infection.

What causes scrotal eczema? 

One of the main factors of scrotal eczema is psychological stress. This causes the initial itching sensation on the scrotum.

The treatment of scrotal eczema varies depending on the severity. The doctor can determine the proper treatment.

A Word From Verywell

Scrotal eczema is known to be a common condition. If you have any symptoms, it is important to contact your doctor. That way, you can get the proper treatment and plan to manage scrotal eczema effectively with the help of your doctor.

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Article Sources
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  1. Krishnan A, Kar S. Scrotal dermatitis - can we consider it as a separate entity? Oman Med J.2013;28(5):302-305. doi:10.5001/omj.2013.91

  2. Cleveland Clinic. Eczema. Updated October 28, 2021.