What is scrotal eczema? Eczema is a non-contagious condition characterized by itching, redness, scaling and thickening of the skin. Scrotal dermatitis is a form of eczema affecting the scrotum, which is the pouch of skin that contains the testicles. Dermatitis of the scrotum can also affect the penis, groin, inguinal folds, and the area around the anus. Scrotal dermatitis can result from atopic dermatitis, seborrheic dermatitis, contact dermatitis, or a combination of more than one type of eczema. Scrotal eczema shares some of the symptoms of eczema that occurs elsewhere on the body. What are the symptoms and complications of scrotal eczema? Eczema symptoms can vary depending on the severity of the condition. People with eczema often experience periods in which symptoms get worse and periods in which they improve. When eczema gets worse, it means an attack has occurred. Symptoms of scrotal eczema may include: Severe itching; Dry, sensitive skin; Inflamed, scaly skin; Discolored skin; Rough, thickened and scaly skin; Areas of swelling; Tearing, crusting sores In people with darker skin, flare-ups of scrotal eczema may present with dark brown, purple, or ash-gray patches. In lighter skin, it can appear with red spots. More severe cases of scrotal eczema may include bleeding, crusting, and tearing sores. Scratching itchy skin can also create sores that are at risk of bacterial, fungal, or viral infection. Prolonged scratching or rubbing of itchy skin can also lead to lichenification – a thickening and roughening (hypertrophy) of the surface layer of the skin. This can cause the man to scratch more, causing an itch-scratch cycle. Men who have severe eczema may experience flare-ups that last for many days or weeks. What other conditions resemble or are related to scrotal eczema? Scrotal eczema shares symptoms with a number of other conditions that cause itching and irritation around the groin, including: Tinea cruris; Fungal infection; Lumbosacral neurodermatitis; Psoriasis; Scabies; Lichen sclerosus; Lichen planus Some sexually transmitted diseases can also cause dry and itchy skin around the genitals. These include: Genital herpes; Chlamydia; Gonorrhea; Trichomoniasis; Genital warts Men with atopic dermatitis, which is a type of eczema, often experience other conditions, such as: Asthma; Hay fever; Other skin diseases; Loss of sleep In addition, when a person experiences chronic itching and discomfort that is difficult to control, they may experience depression or anxiety. Because of the common symptoms of these conditions, it is important that affected men see a specialist for an accurate diagnosis. What are the causes and risk factors for scrotal eczema? Some risk factors for eczema are genetic, while others are environmental.Risk factors can also vary depending on the type of eczema a man has. Often, scrotal dermatitis occurs as a reaction to an environmental factor, which usually causes contact dermatitis, in other cases it can be atopic dermatitis. Risk factors for atopic dermatitis that cannot be changed include: Family history. The risk of developing atopic dermatitis is higher if the patient has a family history (family history) of atopic dermatitis, hay fever or asthma; Ethnic origin. Research shows that atopic dermatitis is more common in people with darker skin at a young age; Genetics. Some people with atopic dermatitis have a mutation in a gene responsible for making filaggrin, a protein that helps protect the integrity of the skin and keep the skin hydrated. Additionally, a 2017 study found a link between the genes that cause asthma, hay fever, and atopic dermatitis Common causes of atopic, seborrheic, or contact dermatitis include: Yeast – the presence of a certain type of yeast on the skin; Environmental factors – changes in the weather or living in a particularly cold, dry or humid environment can cause eczema to flare up; Allergens – These include chemicals and fragrances found in soaps, detergents and clothing. They also include latex in condoms, pollen or mold, or exposure to materials such as metals in jewelry; Psychological stress – anxiety and stress are common causes of atopic dermatitis What is the treatment for scrotal eczema? There is no cure for scrotal eczema, but there are treatments to reduce symptoms. The main treatments for eczema include: Emollients (moisturizers). They help prevent the skin from drying out; Corticosteroids. These are topical creams and ointments that are used to reduce inflammation during flare-ups and may include clobetasol, hydrocortisone, and others. In addition, a person with a severe flare may take oral prednisone or methylprednisolone; Topical corticosteroids with low or moderate activity. They are used to treat eczema in the genital areas; Lifestyle changes. This means identifying and avoiding the triggers that cause eczema. In some cases, the specialist may prescribe drugs known as topical calcineurin inhibitors. These medications can be used on sensitive areas such as the groin without weakening the skin. A doctor may also prescribe them as part of a combination therapy with corticosteroids. If an infection occurs in an area with dermatitis, the doctor may prescribe additional medications such as antibiotics or antifungal medications. References: 1. Purvis, D. (2014). Guidelines for the diagnosis and assessment of eczema 2. American Academy of Dermatology. Eczema types: Atopic dermatitis symptoms 3. National Center for Biotechnology Information. Eczema: Steroids and other topical medications 4.National Health Service. Atopic eczema