Diagnosis | The scrotum itches – What is behind it?

Diagnosis

The dermatologist first looks at the skin of the testicles and, based on the appearance of the region, assesses which clinical pictures are possible. An experienced dermatologist can in most cases identify the cause with relative certainty at a glance. To be able to detect germs such as fungi or bacteria reliably, a smear can be taken from the skin.

Often, however, a drug is administered for treatment before the result of the smear is known, as the diagnosis at a glance is usually correct and the smear is only used to check and possibly test for resistance. A biopsy, in which a piece of skin is removed and examined under a microscope, can be done to clarify the cause, but is an absolute rarity and is only done in everyday clinical practice if an atypical cause is suspected, as all common causes could be excluded. These articles may also be of interest to you:

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Associated symptoms

Itching rarely comes alone and is usually accompanied by other symptoms. However, these can help to find the cause and better classify the clinical picture. In the text below you will find various symptoms that can occur in addition to itching in the testicular area.

If the skin is scaly and itchy, the probability of a fungus is extremely high. The term tinea inguinalis describes a fungal infection in the groin or genital area. Here the fungi usually grow in a circular pattern, which is why the scaling is more likely to be on the edge where the fungus is active.

Especially men who sweat a lot in the genital area and wear tight, tight trousers, as is common in cycling, for example, are more often affected, as fungi feel comfortable where it is damp and warm. Although fungi on the skin are part of the normal flora, they can also be transmitted during sexual intercourse or through commonly used clothing or towels. The dermatologist usually recognizes a fungus by a glance diagnosis and can prescribe an anti-fungal agent (antimycotic).

If the itching is moderately pronounced and scaling is still present, a pseudomycosis caused by an erythrasma can also be considered. It is caused by bacteria and should also be treated by a dermatologist. With dry skin, the natural skin barrier is no longer intact and thus more sensitive to external irritations.

This leads to itching. The skin also loses a lot of fluid. Oily creams can ensure that the skin’s protective barrier is restored and the fluid is stored.

However, it is also important to drink enough water to supply the body with sufficient fluid. Fruits and vegetables also often contain a lot of fluid. Alcohol and cigarettes, however, dry out the body and should be avoided.

In general, weeping skin areas occur almost exclusively in the context of eczema or rashes. The causes can be very different. Infections with fungi or bacteria are an important cause that should be clarified.

Often the wet spots are caused by blisters, but these are sometimes very short, so that they are often not noticed at all. It is also not uncommon for this secretion to become encrusted and the skin condition to change. It is important to keep the areas dry, so that no other germs are added and make the problem worse.

Powders or pastes are often used in this context, which can dry out the wet areas. A reddening is considered a classic sign of inflammation and can therefore be caused by bacteria or other pathogens. But also abrasive clothing, lack of intimate hygiene and irritation through sweat or simply a new detergent that the fine skin underneath cannot tolerate can be responsible for the symptoms.

Therefore it should be possible to narrow down possible triggers by careful consideration. Lotions or creams can be used to alleviate the irritation. To achieve a cooling effect, water-based care products such as lotions or gels are recommended.

Powders can also help to minimise friction on clothing, even if it was not the original cause of the complaints. If the scrotum hurts, a doctor should be consulted. In the worst case it can be dangerous circulatory problems, torsion of the testicles or inflammation of the testicles, which can reduce fertility.

A urologist can find the cause through a physical examination or ultrasound imaging. However, if pain and itching occur at the same time and if too tight clothing is worn, which rubs against the skin or can trigger an allergic reaction, it is also possible that it is a harmless trigger. If in doubt, it is safer to see a doctor, as some venereal diseases can also cause pain, especially when urinating.

Burning and itching in the crotch may be caused by Lichen sclerosus et atrophicus, a skin disease that initially causes burning and itching of the testicular and genital skin and later leads to nodules and whitish discoloration. If the burning sensation occurs during urination, an infection with a skin germ or by a pathogen transmitted through sexual contact is possible. A doctor should be consulted to find the correct diagnosis.

If there are itchy nodules in the genital area, scabies should be clarified in any case. This is a contagious disease in which the scabies mite can be transmitted through prolonged, direct physical contact. Sexual intercourse is therefore a very frequent source of infection. As a rule, a dermatologist prescribes the nerve poison permethrin, which only needs to be administered once. However, it is also important to follow the dermatologist’s further instructions, such as washing all kinds of textiles at at least 60°C or not to have close skin contact with others for about 24 hours after administration of the medication in order to avoid infecting yourself or other people.