what causes scrotal eczema

Eczema is a non-contagious, itchy, and dry skin condition that affects individuals differently. There are many forms of eczema that have different underlying causes. Scrotal eczema is a form of eczema that affects the scrotum, the bag of skin containing the testicles.

Skin affected by eczema may produce less fat and oil than healthy skin. If this occurs, the skin will hold less water in, causing gaps to open up between the skin cells. These gaps allow bacteria and irritants to penetrate more easily and cause problems.

There is some debate about whether the condition is separate from eczema that occurs in other parts of the body. One 2013 article, for example, argues that it should be classified separately.

Scrotal eczema shares some of the same symptoms as eczema found elsewhere on the body. In this article, we look at these symptoms, along with steps to help treat and manage the condition.

Symptoms and complications

Man in jeans with scrotal eczema covering his crotch with his hands.

Scrotal eczema may have similarities to other conditions, making an accurate diagnosis important.

Scrotal eczema can sometimes be mistaken for other skin conditions, including fungal (yeast) infections.

For this reason, it is essential that anyone experiencing symptoms should see a skin specialist to ensure an accurate diagnosis.

In mild cases of eczema, the affected skin will be red, itchy, dry, and scaly.

More severe cases can include bleeding, crusting, and weeping of sores. Scratching of the itchy skin can also open up sores, which are at risk of infection.

A skin specialist will be able to judge the seriousness of the condition, identify the potential contributing triggers, and diagnose the underlying type of eczema.

The 2013 review lists four potentially useful classification categories for scrotal eczema:

Type 1 — mild, acute, dry

The skin appears reddened and irritated, with a clear visual difference between the healthy and affected skin. The affected skin will itch severely and sting.

Mild, acute, dry eczema may last a few days or weeks, and the symptoms may clear up on their own.

Type 2  severe, chronic, dry

The scrotum appears scaly, and either bright red or unusually pale with a scaly appearance. The thighs and skin under the penis may also be affected.

The burning and itching sensation is more severe in this type of scrotal eczema than in the mild, acute, dry type.

Type 3 — chronic, wet

The whole scrotum and inner sides of the thighs appear soft and moist, with fluid oozing from the area.

Blood vessels can seem to stick out in a “spider vein” pattern, and a bad smell and painful sores are common.

Type 4 — swollen, ulcers

The skin of the scrotum is swollen, with fluid and pus oozing from open wounds and ulcers that smell bad. This stage is extremely painful.

In extreme cases, gangrene sets in and spreads to the legs and lower abdomen.