Itching of the scrotum in men

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

Causes of the itchy scrotum in men

In fact, the clarification “in men” can be considered superfluous, since the  scrotum  or scrotum (musculocutaneous receptacle of the testicles) is part of the external genital organs of males, including children and adolescents.

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

• bites of the scabies mite (Sarcoptes scabiei) spread by direct contact or contaminated bedding, developing  scabies ; [1]
• pubic pediculosis or  phthiriasis ; [2]
• mycoses - damage to the skin in the region of the inguinal folds by dermatophyte fungi (Epidermophyton, Microsporum, Trichophyton), which are diagnosed as  inguinal epidermophytosis ; [3]
• candidomycosis  of the external genital organs (candidiasis or thrush) - a disease caused by the yeast-like fungus Candida albicans; [4]
• various types of dermatitis, including contact - 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;
• reverse genital psoriasis or  psoriasis on the genitals ; [6]
• genital warts (also called genital warts); their appearance is the result of skin lesions with the human papillomavirus (HPV types 2 or 6), which is infected through sexual contact; [7]
• genital herpes , caused by the herpes simplex virus (HSV), transmitted by any contact route. [8]

Invasion Enterobius vermicularis - pinworms in children - provoke itching of the scrotum in a child or adolescent; in adults, this helminthiasis is also not uncommon, and at night it causes severe itching of the scrotum and anus, as well as in the perineum.

Risk factors

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

Contact of the very thin, capillary skin of the scrotum with the surrounding skin, high humidity and temperature - in the absence of air access - are ideal conditions for the development of contact dermatitis (due to the material of underwear, condom latex, etc.) and allergic skin reactions ( on the same body care products), which cause hyperemia, itching and swelling of the scrotum.

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

Pathogenesis

In general,  the pathogenesis of skin pruritus , regardless of its location, is due to irritation of free nerve endings associated with receptors in the epidermis and dermis and the release of pro-inflammatory mediators (cytokines) and / or chemical mediators, one of which is histamine, released in response to allergen exposure by dermal mastitis. Cells.

Release of cytokines can 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 along the sympathetic afferent fibers C to the dorsal horn of the spinal cord, and then - along the spinothalamic tract - to the cerebral cortex.

Symptoms of the itchy scrotum in men

Accompanying itching symptoms 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 can be the first symptom, as in the case of infection with pinworms, which cause quite intense itching of the scrotum at night.

At night, there is a strong itching of the scrotum, as well as between the scrotum and anus with scabies - with small red papular-vesicular rashes on the skin (with a careful examination of the skin, you can notice the moves made by the tick).

With fungal infections that affect the skin of the genital organs, the inner thighs and buttocks, there is redness, a papular rash in the form of rings with scaly edges, and itching of the scrotum and perineum. The rashes are contagious and can spread throughout the body.

How candidomycosis manifests itself, 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 (peeling). Eczema (atopic dermatitis) usually presents as patches of irritated, red or reddish-gray skin that may develop small, fluid-filled blisters; exudate from them oozes with the formation of areas of weeping and erosion of the skin, eventually covered with a crust.

Symptoms of genital warts (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, blistering rash and ulceration covered with a scab - these symptoms are familiar to those who have experienced 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 pruritus in the scrotum and other male genitalia are manifested by excoriation - skin scratching in the form of scratches and abrasions. Scratches can bleed and become 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.

With scabies in the skin of the scrotum and perigenital zone, tumor-like infiltrates can form - benign lymphoplasia of the skin. And in cases of genital candidomycosis, the development of  candidal balanoposthitis is possible .

Diagnostics of the itchy scrotum in men

In dermatology, diagnosis begins with a physical examination of the patient's skin and a comparison of the identified changes with complaints and anamnesis; a  study of the skin  is carried out - with the definition of the morphological type of rashes and taking into account their localization.

Tests may include: skin scrapings (for fungus or scabies), perianal swab, papillomavirus biopsy, skin tests for allergens; blood test for eosinophils, PCR analysis for HPV, for antibodies to HSV.

To exclude diagnostic errors and prescribe the correct treatment, differential diagnosis is extremely important, since there are cases when, in dermatoses, the etiology of rashes, against which the scrotum itch occurs, is difficult to determine clinically. Therefore, dermatologists may prescribe additional studies.

Also read -  Diagnosis of pruritus .

Treatment of the itchy scrotum in men

Symptomatic treatment is aimed at relieving itching. Quite quickly, but not completely, it passes after using the  Fenistil antihistamine gel ; other  ointment for itching can also be used . Oral medications are also prescribed -  antihistamines .

In accordance with the diagnosis, topical agents are used:

• Ointments for allergic dermatitis
• Ointment for genital warts
• Creams for herpes

Etiological treatment requires parasitic and fungal diseases. The parasite  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 disposed of with Permethrin and other  lice ointments .

Oral anthelmintics should be used against pinworms, such as Piperazine adipate or  Helmintox  (Pyrantel) tablets.

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

• Skin fungus pills
• 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 dermatosis .

Alternative medicine and homeopathy

In some cases, alternative treatment can help:

• Fast and effective treatment for scabies at home
• Alternative treatment for thrush in men
• Alternative remedy for human papillomavirus

With fungal infections and genital warts, it is suggested to fight with 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 of the scrotum, natural honey and sea buckthorn oil can be used.

With a fungal infection, herbal treatment includes applying juice from fresh celandine, as well as using licorice root: it is crushed into powder, mixed with water to a slurry state and boiled for 10 minutes. The agent is applied to the skin for a quarter of an hour twice a day.

Homeopathy offers antifungals such as Petroleum, Silicea, Graphites, Sepia and Thuja. And with the defeat of the fungus Candida - Borax and Helonias. If itching is associated with eczema, homeopaths recommend Sulfur, 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 provoking irritation. That is, it is better to wash the groin and genitals area with mild soap (you can use baby soap with string and chamomile), prevent overheating and accumulation of moisture, avoid tight synthetic underwear, treat diaper rash in time.

The concept of hygiene also includes protected sex.

Forecast

Scabies, fungal infections, and contact irritative dermatitis can also be cured. But regarding other diseases accompanied by itching of the scrotum - atopic dermatitis, genital psoriasis, genital warts and herpes - the prognosis is not so optimistic because of their relapses.