Red testicles can have associated symptoms of pain, itchiness, swelling, or dryness of the skin. Common causes for scrotal redness include allergic reactions to hygienic products, chemicals, or medication. In addition, skin conditions like eczema and scabies can cause a red scrotum. Read below for more information on causes and treatment options.
8 most common cause(s)
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Scrotal redness symptoms
Issues related to the genital area can be embarrassing and uncomfortable situations to discuss; however, genital health is an important topic as it can signal underlying health problems beyond those related to reproductive or sexual capabilities such as ejaculation or erection. Any issues related to the penis or parts of the genitalia should be followed-up appropriately.
The scrotum is an external sac of skin that encloses the testicles (also known as testes). The testicles are the round, egg-shaped male reproductive organs behind the penis. The main function of the testes-scrotal system is the production of sperm male reproductive cells and testosterone, a hormone important for male sexual and reproductive development.
See this image for a visual representation of the testicle and its anatomy within the scrotum here.
Common accompanying symptoms of scrotal redness
Scrotal redness may also be associated with symptoms such as:
- Pain
- Soreness or burning
- Itching
- Swelling
- Warmth to the touch
- Pain with urination (dysuria)
- Penile discharge
- Foul odor
- Dry skin or scaling
Fortunately, scrotal redness is a benign and easily treatable disease. If you notice any of the symptoms above, follow-up promptly with your physician in order to get appropriate care and treatment.
What causes scrotal redness?
Redness (also known as erythema) of the skin is the result of increased flow in the blood vessels close to the skin that occurs in the setting of injury, infection or generalized inflammation. There are many things that may cause a red scrotum, so it is important to seek medical attention for proper diagnosis.
Inflammatory
Inflammatory causes of scrotal redness can be related to the following.
- Infection: Many different infectious pathogens can infect the genital area bacteria, fungi, and viruses. These infections are often but not exclusively sexually transmitted and can also result in associated symptoms such as dysuria and penile discharge. Fungal infections can also result in white patches on the scrotum in addition to redness.
- Dermatologic: There are multiple dermatologic diseases that can affect the scrotum and cause redness and associated symptoms. For example, psoriasis is a chronic inflammatory skin disease that is characterized by erythematous papules or plaques (small, raised lesions or swellings) with irregular borders covered by scales. Psoriasis can affect both the scrotum and penis.
Hygienic
Proper hygiene is key in maintaining genital health. Regularly cleaning underneath the foreskin of the penis and around the scrotum with mild soap and water is very important in keeping harmful bacteria away. It is also important to practice good sexual hygiene. Using condoms and limiting the number of sexual partners is essential in preventing the transmission of sexually transmitted infections.
Allergens
Being exposed to allergens can easily irritate this sensitive area of the body.
- Irritants: Many substances can irritate the skin and cause rashes and redness. This is known as dermatitis. Products such as heavily scented soaps, lotions, perfumes and cleansers used around the genital area can be very irritating and cause inflammation to the scrotum due to allergic or sensitivity reactions.
- Medication: Some medications may cause reactions that result in redness, inflammation or swelling of the scrotum. For example, older males who have a history of prolonged topical corticosteroid use may develop red scrotum syndrome as a side effect of the medication. Talk to your physician about any medications you have started and possible side effects.
This list does not constitute medical advice and may not accurately represent what you have.
Testicular torsion
Testicular torsion is also called ATT or acute testicular infarction. It is a twisting of the spermatic cord, which runs from each testicle up into the abdomen and carries blood vessels, nerves, and sperm-transporting ducts.
The cause is believed to be a congenital abnormality that leaves the testicle insufficiently anchored within the scrotum.
Most susceptible are infant boys and boys just reaching puberty. Torsion may occur in older boys after an injury and/or an athletic workout.
Symptoms include sudden, severe, one-sided testicular pain and swelling, with nausea and vomiting.
Acute testicular torsion is a medical emergency. If not corrected immediately, the loss of blood flow can lead to infertility and loss of the testicle. Take the patient to the emergency room or call 9-1-1.
Diagnosis is made through physical examination and sometimes ultrasound.
Treatment involves first attempting to manually rotate the testicle back into place. If unsuccessful, surgery will be done to either correct the torsion or to remove the testicle if the damage is not reversible.
Scabies
Scabies is a rash caused by the microscopic human itch mite. It burrows into the top layer of skin to feed and causes severe itching and irritation.
The mite spreads through direct contact or through infested bedding or furniture. It can infect anyone, though most susceptible are:
- Children.
- Sexually active young adults.
- Anyone with a weakened immune system.
- Patients in nursing homes and other long-term care facilities.
Symptoms include intense itching, especially at night, and a rash of tiny red bumps. Scratching may cause the rash to form sores, scales, or crusts. The rash most often forms between the fingers, in the folds of the wrists and elbows, and any place normally covered by clothing.
It is important to get treatment because the scratching can cause an infection in the skin. In children, mites can cover nearly the entire body.
Diagnosis is made through physical examination and skin test.
Treatment involves a prescription for skin cream. Everyone who has come into contact with the affected person must be treated, even if they show no symptoms.
Rarity: Rare
Top Symptoms: vaginal itch or burning, vulvovaginal redness, feeling itchy or tingling all over, butt itch, elbow itch
Urgency: Primary care doctor
Ringworm (tinea corporis)
Tinea corporis means "ringworm that affects the body." It is caused by a fungus, not an actual worm, on the surface of the skin. It is also called dermatophytosis.
Ringworm is very contagious through direct contact and through shared clothing, bedding, shower floors, locker rooms, etc. A person showing no symptoms can still spread ringworm. It is also transferred between humans and animals, especially dogs, cats, and horses.
Most susceptible are those with weakened immune systems, though anyone can contract ringworm.
Symptoms include an itchy, circular red rash that spreads outward and grows larger. It may form a pattern of rings on the arms, legs, and/or body.
Treatment is important in order to prevent further spread of the disease, and to ease the discomfort. The rash itself can become infected from constant scratching.
Diagnosis is made through physical examination and skin culture.
Treatment involves anti-fungal medications applied to the skin, and sometimes a course of prescription anti-fungal pills.
Rarity: Common
Top Symptoms: dry skin, rash, red rash, itchy rash, curved rash
Symptoms that never occur with ringworm (tinea corporis): groin skin changes, fever, scrotal itch, groin itch, facial skin changes, hand skin changes, genital skin changes
Urgency: Self-treatment
Jock itch (tinea cruris)
Tinea cruris is a common fungal infection of the skin in the groin area. It can cause ring-shaped redness, and sometimes itching or pain.
Over-the-counter antifungal ointments should be enough to clear up the infection. Apply directly to the rash and the surrounding skin. Try to keep the area as dry as possible.
Rarity: Uncommon
Top Symptoms: groin redness, groin itch, scabbed area of the groin, rash, itchy rash
Symptoms that always occur with jock itch (tinea cruris): groin redness
Urgency: Self-treatment
Irritant contact dermatitis
Irritant contact dermatitis means a skin reaction that is caused by directly touching an irritating substance, and not by an infectious agent such as a bacteria or virus.
Common causes are soap, bleach, cleaning agents, chemicals, and even water. Almost any substance can cause it with prolonged exposure.
Contact dermatitis is not contagious.
Anyone who works with an irritating substance can contract the condition. Mechanics, beauticians, housekeepers, restaurant workers, and health care providers are all susceptible.
Symptoms include skin that feels swollen, stiff, and dry, and becomes cracked and blistered with painful open sores.
A medical provider can give the best advice on how to heal the skin and avoid further irritation. Self-treatment can make the problem worse if the wrong creams or ointments are used.
Diagnosis is made through patient history, to find out what substances the patient comes into contact with, and through physical examination of the damaged skin.
Treatment involves avoiding the irritating substance if possible. Otherwise, the person can use petroleum jelly on the hands underneath cotton and then rubber gloves.
Rarity: Common
Top Symptoms: rash with well-defined border, itchy rash, red or pink, rough patch of skin, painful rash, red rash
Symptoms that always occur with irritant contact dermatitis: rash with well-defined border
Symptoms that never occur with irritant contact dermatitis: fever, black-colored skin changes, brown-colored skin changes, blue-colored skin changes
Urgency: Self-treatment
Genital warts
Genital warts are one of the most common sexually transmitted infections. It is caused by infection by Human Papilloma Virus (HPV). While it cannot be cured, treatment may help.
Genital warts often resolve on their own within a few weeks, but you should see a physician to determine the best course of action. Some topical treatments are effective, while other warts require surgery, depending on the size and location.
Rarity: Uncommon
Top Symptoms: small groin lump, skin-colored groin bump, marble sized groin lump, painless groin lump, scaly groin bump
Symptoms that always occur with genital warts: scaly groin bump
Urgency: Primary care doctor
Epididymitis
The epididymis is a coiled tube which stores sperm inside each testicle. Epididymitis is an inflammation of one or both of these tubes.
It is caused by a bacterial infection, most often from sexually transmitted diseases (STDs) such as chlamydia and gonorrhea. Epididymitis can also be caused by a urinary tract or prostate infection, or by trauma due to injury or heavy lifting.
Males of any age can be affected, though men engaging in unprotected sex are most susceptible.
Symptoms include redness, swelling, and pain in the testicle; pain on urination or ejaculation; discharge from the penis; and blood in the semen.
Any of these symptoms should be treated by a medical provider as soon as possible in order to prevent abscess or permanent damage.
Diagnosis is made through physical examination; penile swab for STD tests; urine and blood tests; and sometimes ultrasound of the testicles.
Treatment involves antibiotics as well as rest, cold packs to the testicles, wearing an athletic supporter, and refraining from lifting and sexual intercourse until the infection is gone.
Eczema (atopic dermatitis)
Atopic dermatitis, also called eczema, dermatitis, atopic eczema, or AD, is a chronic skin condition with an itchy rash.
AD is not contagious. It is caused by a genetic condition that affects the skin's ability to protect itself from bacteria and allergens.
AD is most often seen in infants and young children. Most susceptible are those with a family history of AD, asthma, or hay fever.
Infants will have a dry, scaly, itchy rash on the scalp, forehead, and cheeks. Older children will have the rash in the creases of elbows, knees, and buttocks.
Without treatment, a child may have trouble sleeping due to the intense itching. Constant scratching may cause skin infections and the skin may turn thickened and leathery.
Diagnosis is made through physical examination, patient history, and allergen skin tests.
AD cannot be cured, but can be controlled through prescribed medications, skin care, stress management, and treatment of food allergies. Those with AD often have allergies to milk, nuts, and shellfish. Keeping the skin clean and moisturized helps prevent flareups.
Allergic contact dermatitis of the groin
Allergic contact dermatitis is a condition in which the skin becomes irritated and inflamed following physical contact with an allergen. Common products known to cause allergic dermatitis include plants, metals, soap, fragrance, and cosmetics.
Rarity: Common
Top Symptoms: groin redness, groin itch, scabbed area of the groin
Symptoms that always occur with allergic contact dermatitis of the groin: groin redness
Urgency: Self-treatment
Scrotal redness treatments and relief
Treatment for scrotal redness will depend on the cause and may include the following:
- Antibiotics: Your physician will prescribe the appropriate antibiotics if your scrotal redness is the result of a bacterial infection such as chlamydia or gonorrhea.
- Antifungal medication: Yeast such as candida are fungi that can be treated with topical or systemic medications that your healthcare provider can prescribe.
- Dermatological creams: If your symptoms are caused by a dermatologic skin condition, your physician may prescribe steroid creams or ointments that can help alleviate your symptoms. However, it is important to remember that sometimes prolonged use of such creams can result in red scrotum syndrome as a side effect.
- Anticonvulsant: Several anticonvulsant medications are used to combat nerve pain or burning. Some studies have shown improvement in conditions such as red scrotum syndrome with treatment with gabapentin.
Prevention
There are some preventative measures you can take in order to stop scrotal redness and its associated symptoms:
- Proper hygiene: As stated above, poor hygiene can be a cause of scrotal redness. Properly and regularly cleaning the penis and scrotum are steps you can take at home to prevent symptoms.
- Sexually responsible habits: Preventing sexually transmitted infections not only involves using condoms but also limiting sexual partners and getting tested regularly.
FAQs about scrotal redness
Can I continue to have sex while being treated for redness of my scrotum?
If you are being treated for scrotal redness that is NOT caused by infection or a contagious condition, you can continue to have sex as tolerated. It is not advisable to continue sexual relations during treatment for infections as there is a high risk of transmission, even with proper condom use.
Is redness of my scrotum life-threatening?
Most causes of redness of the scrotum are benign and not life-threatening; however, that does not mean you should not follow-up your symptoms with a healthcare professional. Untreated sexually transmitted infections can result in such as permanent damage and infertility.
Are there at home treatments I can use to treat my scrotal redness?
It is important to get the appropriate diagnosis before self-treating for scrotal redness. There are multiple over-the-counter remedies you can use for specific causes of scrotal redness; for example, in the case of fungal candidiasis, there are many options such as nystatin or Monistat.
Why does my red scrotum burn?
The burning pain sensation you may feel in your scrotum may be due to the underlying disease process inflammation, infection, etc. or it may be due to neuropathic pain. Neuropathic pain results from damage or injury to the nerves and sensory system responsible for perceiving touch, pressure, pain, position, temperature, movement and vibration. In relation to pain, when there is damage to this system, signals to the brain are not properly transmitted and pain can be experienced in the absence of obvious injury.
What is the purpose of the scrotum?
The purpose of the scrotum is to help maintain the temperature necessary for the testes to properly make sperm (spermatogenesis). The testes are located outside the body and not internally because they need a lower temperature in order to make sperm. The normal human body temperature is 98.6 degrees Fahrenheit whereas the temperature in the scrotum is 93 degrees Fahrenheit.
Questions your doctor may ask about scrotal redness
- Do you have a rash?
- Do you notice anything going on with your testicles or scrotum?
- Have you experienced any nausea?
- Are you sexually active?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
- Red scrotum syndrome. J Dermatol Case Rep. 2011;5(3):38-41. NCBI Link
- Merhi R, Ayoub N, Mrad M. Carvedilol for the treatment of red scrotum syndrome. JAAD Case Rep. 2017;3(5):464-466. Published 2017 Sep 9. doi:10.1016/j.jdcr.2017.06.021. NCBI Link
- Krishnan A, Kar S. Scrotal Dermatitis - Can we Consider it as a Separate Entity?. Oman Med J. 2013;28(5):302-5. NCBI Link
- Contact Dermatitis. National Eczema Association. National Eczema Org Link
- Liu J, Chen W, Zhou J, Liu J, Zhang J. Psoriasis with extramammary Paget disease in a male: a case report. Int J Clin Exp Pathol. 2015;8(7):8642-4. Published 2015 Jul 1. NCBI Link
- Colloca L, Ludman T, Bouhassira D, et al. Neuropathic pain. Nat Rev Dis Primers. 2017;3:17002. Published 2017 Feb 16. doi:10.1038/nrdp.2017.2 NCBI Link
- Jones RE, Lopez KH. The Male Reproductive System: Chapter 4. doi.org/10.1016/B978-0-12-382184-3.00004-0. Science Direct Link