Itchy scrotum in men

Among diseases of the skin and subcutaneous tissue, itching is separately identified in ICD-10, although it is a secondary symptom of dermatologic diseases. And 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 fact, the qualifier "in men" can be considered superfluous because scrotum or scrotum (the musculocutaneous receptacle of the testicles) is part of the external genitalia of male individuals, including children and adolescents.

Such an annoying symptom as itchy scrotum skin has different etiologies, and dermatologists note as the main causes of its appearance, such as:

• Bites of the scabies mite (Sarcoptes scabiei), spread through direct contact or infected bedding, with the development of scabies; [1]
• pubic pediculosis or phthyriasis; [2]
• mycoses - skin lesions in the area of inguinal folds 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;
• reverse genital psoriasis or genital psoriasis; [6]
• genital condylomas (also called genital warts); their appearance is the result of skin lesions caused by the human papillomavirus (HPV types 2 or 6), which is contracted through sexual contact; [7]
• genital herpes, caused by herpes simplex virus (HSV) transmitted by any contact route. [8]

Enterobius vermicularis infestation - pinworms in children - provoke itching of the scrotum in a child or adolescent; 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 this symptom, including poor hygiene, excessive sweating, excessive body weight, tight clothing, the presence of intertrigo - diaper rash in the groin.

The contact of the very thin, capillary-permeated skin of the scrotum with the surrounding skin, the 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 of condoms, etc.) and allergic skin reactions (to the same body care products), which cause hyperemia, itching and swelling of the scrotum.

There is also an increased risk of itchy skin with diabetes and thyroid disease; riboflavin (vitamin B2), iron and zinc deficiencies; asthma and hay fever; immunocompromised and cancer.

Pathogenesis

In general, the pathogenesis of pruritus, regardless of its localization, is due to 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 allergen exposure by dermal mast cells.

The release of cytokines can be mediated by the immune system, for example, as in atopic dermatitis. Other biologically active compounds, neurotransmitters and neuropeptides: acetylcholine, serotonin, some prostaglandins and proteinases, lymphokines and interleukins, can also increase itching.

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 of the itchy scrotum

The 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 may be the first symptom, as in the case of infection with pinworms, causing a fairly 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 in scabies - with small red papule-vesicular rashes on the skin (with close inspection of the skin can be seen made by the mite passages).

In fungal infections affecting the skin of the genitals, 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 may spread over the body.

How manifests candidomycosis, 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) is usually manifested by patches of irritated, red or reddish-gray skin, which may have fluid-filled small vesicles; exudate from them oozes out to form areas of mottling and erosion of the skin, eventually crusting.

Symptoms of condylomas (anogenital warts) in men are described in detail in the publication - Acute condylomas 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 flecked, scab-covered ulcers - such 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 skin itching in the scrotum and other male genital areas are manifested by excoriations - skin scrapes in the form of scratches and abrasions. The scabs can bleed and are easily infected by bacteria and viruses, which can lead to skin inflammation.

Itching can also lead to local thickening of the stratum corneum and underlying skin layers - lichenization.

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 it is possible to develop candidal balanoposthitis.

Diagnostics of the itchy scrotum

In dermatology, diagnosis begins with physical examination of the patient's skin and comparing the detected changes with complaints and anamnesis; skin examination - with determination of the morphological type of rashes and taking into account their localization.

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

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

Also read - Diagnosing skin itch.

Treatment of the itchy scrotum

Symptomatic treatment is aimed at relieving itching. Quite quickly, but not definitively, it goes away after the use of antihistamine gel Phenistil; can be used and other ointment for itching. Oral medications are also prescribed - antihistamines.

Topical agents are applied according to the diagnosis:

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

Parasitic and fungal diseases require etiologic treatment. The parasite remedy Benzyl benzoate (in the form of 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.

Oral antihelminthic drugs such as Piperazine adipinate tablets or Helminthox (Pyrantel) should be used against pinworms.

Fungal infections are best treated with topical and systemic antimycotics, which ones, in detail:

• Pills 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 conditions that cause scrotal itching in men, physiotherapy treatment may be possible - Physiotherapy for dermatitis and dermatoses.

Folk treatment and homeopathy

In some cases, folk treatments may help:

• Quick and effective treatment of scabies at home
• Folk treatment of thrush in men
• Folk remedies for human papillomavirus

With mycoses and genital condylomas offer to fight paste of fresh garlic with the addition of olive oil (applied 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 scrotum can be used natural honey and sea buckthorn oil.

With fungal infection, herbal treatment includes the application of juice from fresh celandine, as well as the use of licorice root: it is crushed into a powder, mixed with water to the state of mush and boiled for 10 minutes. The remedy 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 in case of Candida fungus, Borax and Helonias. If itching is associated with eczema, homeopaths recommend Sulphur, Hepar sulphuris, Lycopodium clavatum and Natrum Muriaticum.

Prevention

The main prevention lies in hygiene. It is necessary to keep the genitals clean and dry and avoid irritating factors. That is, the groin and genital area is better to wash with mild soap (you can use baby soap with chamomile and chamomile), do not allow overheating and moisture accumulation, avoid tight synthetic underwear, treat diaper rash in time.

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 because of their recurrences.