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What You Should Know About Scrotal Eczema

Overview

Many conditions can cause itching in the crotch area. It’s a warm, moist place that invites fungal infections, bacterial infections, and rashes. Jock itch is a fungal infection also known as tinea cruris. It’s a common culprit when the urge to scratch is overwhelming. Scrotal eczema is also a possible cause of itching for many men.

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Eczema

Eczema

What causes the itch?
There are two different nerve pathways associated with itching. Histamine, the substance your body produces when you’re allergic to things, triggers one pathway. The other cause is not related to histamine. Instead, nerve pathways transmit the sensation of itching to your brain. Conditions like scrotal eczema or psoriasis activate these nerve pathways.

Eczema, or dermatitis, is a term that encompasses a few skin conditions. Areas of skin that are either dry and scaly, or moist and inflamed characterize the condition. Eczema is common in children, but people of all ages can develop it. As many as 15 million Americans have some type of eczema.

Sometimes called “the itch that rashes,” eczema may begin itching even before the rash becomes full-blown. Scratching the itch contributes to development of the rash. Eczema is not contagious.

Eczema often appears as patches of irritated, red, or reddish-gray skin. Over time, small, fluid-filled bumps that ooze and crust over may develop. Most people experience periods of time when their skin dries out and may even seem to clear up, only to have it flare up again.

Although it can appear anywhere on the body, eczema is often seen on the:

  • hands
  • feet
  • scalp
  • face
  • back of the knees
  • inner sides of elbows

Scrotal eczema can spread to the skin around the anus, between the buttocks, and on the penis.

Symptoms

Symptoms

Symptoms of scrotal eczema are similar to general symptoms of eczema and may include:

  • itching that can be intense
  • burning
  • redness
  • dry, scaly, or leathery skin
  • swelling
  • redness or discoloration
  • skin that oozes fluid and develops blisters filled with clear fluid
  • broken hairs
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Causes

Causes

The cause of eczema isn’t fully understood. It varies depending on the type of eczema you have. The skin of your scrotum is more absorbent than much of your skin. This makes it vulnerable to toxins and irritants that can cause eczema.

Eczema tends to run in families, so you’re more likely to have scrotal eczema if a family member also has it. Other skin conditions, like psoriasis or other types of eczema, may also lead to scrotal eczema.

Additional risk factors include:

  • history of allergies or asthma
  • stress and anxiety, which may trigger scrotal eczema
  • lice or scabies
  • skin infections

Diagnosis

Diagnosis

Your primary care doctor can usually diagnose eczema by looking at the rash. If you have severe or prolonged episodes of scrotal eczema, you should see a dermatologist. A dermatologist is a doctor that specializes in the treatment of skin diseases.

Your doctor will examine your eczema and may scrape off a small sample of your skin. A technician in a laboratory will study the skin sample to identify the source of the rash.

Scrotal eczema is often mistaken for jock itch. Here are some differences between the two conditions:

Symptoms Jock itch Scrotal eczema
rash starts in the groin, where your torso and legs meet
curable with treatment
chronic skin condition
rash appears in patches with clearly defined edges
skin may appear thick and leathery
 
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Treatment

Treatment

Treatment for eczema focuses primarily on stopping the itching. Your doctor may recommend one or more of the following.

  • corticosteroid creams available over the counter or stronger prescribed preparations
  • corticosteroid injections for severe eczema that’s not controlled by creams
  • steroid-free anti-inflammatory medications like pimecrolimus (Elidel) cream and tacrolimus (Protopic) ointment to suppress your immune system response
  • anti-anxiety medications
  • absorbent powders, such as pramoxine topical (Gold Bond)
  • ultraviolet B (UVB) radiation therapy
  • medications prescribed if you have a secondary infection, including fungal and staph infections
  • over-the-counter (OTC) antihistamines
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Outlook

Outlook

People who have eczema tend to swing between periods of remission and flare-ups. There’s no cure for scrotal eczema, but you can reduce the frequency and severity of eczema flares by following your doctor’s directions and taking preventive measures.

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Prevention

Tips for prevention

There are some steps you can take to reduce your risk for eczema flare-ups:

  • Avoid scratching. Use cool compresses or a take cool bath to reduce the urge to itch.
  • Keep your fingernails short with no jagged edges.
  • Wear loose clothing made from natural materials like cotton. When choosing underwear, opt for boxers over briefs since boxers are loose and will help prevent the area from becoming moist and warm.
  • Avoid temperature extremes. Sweating or the dry skin of winter can make scrotal eczema worse.
  • Use moisturizers.
  • Don’t use harsh soaps, detergents, or products with fragrances.
  • Watch for things that may make your eczema worse, such as latex condoms, spermicides, or a favorite pair of pants that are too snug in the crotch.
  • When using a corticosteroid cream, make sure it has been absorbed by your skin before having sex.
  • Avoid things you’re allergic to.
  • Reduce stress and learn stress-reduction techniques.

Learn more: 7 treatments for winter eczema flare-ups »

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