Peeling skin on the scrotum: causes and methods of solving the problem

What is it, how does it manifest itself and why does it happen?

Epididymitis is an inflammation of the epididymis. Orchitis is inflammation of the testicle itself, and orchiepididymitis is simultaneous inflammation of the testicle and its epididymis. The testicle, epididymis and spermatic cord are also called the scrotal organs. In practice, epididymitis is most often observed, less often orchiepididymitis and even less often isolated orchitis. Also quite rare is isolated inflammation of the vas deferens, which is part of the spermatic cord - deferentitis . These inflammatory processes can be acute, chronic and recurrent.

Acute epididymitis, orchiepididymitis or orchitis is a sudden inflammation, accompanied by enlargement and hardening of the testicle and/or its epididymis, sharp and intense pain and a rise in body temperature. With proper treatment, these diseases disappear within 2 weeks.

Chronic inflammation of the testicle and/or epididymis is characterized by a long-term (from several months to several years) course and resistance to treatment. Tuberculous epididymitis most often has a chronic course. Recurrent inflammation of the scrotal organs is associated with inadequate treatment or repeated infection in the epididymis and testicle. Chronic and recurrent epididymitis, orchiepididymitis and orchitis are manifested by a less pronounced increase and more local compaction of the scrotal organs, the pain is less intense and paroxysmal in nature, body temperature is usually normal.

The causes of these inflammatory processes are most often infections that enter the epididymis through the vas deferens from the urethra (urethra). Moreover, in young men under 35 years of age, these are most often sexually transmitted infections. In particular, chlamydia is the cause of acute epididymitis in young men with a frequency of more than 50%. At older ages (after 50 years), the leading cause of inflammation of the scrotal organs is intestinal microorganisms that cause urinary tract infections (cystitis, pyelonephritis). These include Escherichia coli, Klebsiella, Enterococcus, Pseudomonas, Proteus, etc. Less commonly, the cause of epididymitis and orchitis, as well as deferentitis, can be a tuberculosis or viral infection. Thus, in boys under 15 years of age, orchitis can often become a complication of viral mumps (mumps) or rubella. The development of epididymitis, orchitis and orchiepididymitis is greatly facilitated by sudden hypothermia, which leads to a deterioration in the blood supply to the scrotum. Inflammation of the scrotal organs can also be caused by injuries and operations on the testicle, its epididymis and spermatic cord. In this regard, after injuries to the scrotum and operations on its organs, antibiotics and anti-inflammatory drugs are often prescribed.

Why does the scrotum itch?

Physiological reasons

In the absence of provoking diseases, the cause of the symptom is:

• Neglect of hygiene.
  The skin of the scrotum contains a large number of sebaceous and sweat glands. Irregular hygiene procedures lead to the accumulation of sebum, sweat residues, waste products of microbes and other components that provoke itching and irritation of the skin.
• Poor hygiene.
  Itching may be caused by the use of hygiene products that cause dryness and irritation of the skin. Sometimes the symptom occurs when washing with too hard water.
• Shaving.
  When removing hair using a razor, microtraumas occur, which are manifested by pain, itching and burning at the site of damage. Another cause of discomfort can be ingrown hairs caused by shaving.
• Wrong choice of underwear.
  Insufficient ventilation due to too tight or synthetic underwear causes increased sweating. The problem becomes especially relevant in the summer and when staying in southern countries.

Prickly heat

Potentiating factors are wearing tight synthetic underwear, exposure to high temperatures, heavy physical labor, and the inability or unwillingness to carry out hygiene procedures. The pathology is caused by blockage of the sweat glands. In the groin area, as a rule, prickly heat develops, which is accompanied by severe itching, the appearance of blisters with cloudy liquid and small red nodules. Similar manifestations can be observed in the armpits.

Dermatitis

Simple contact dermatitis is characterized by the absence of an allergic component, develops as a result of the direct action of an irritating substance, and can be acute or chronic. With the erythematous variant, slight itching, redness, swelling, and sometimes dryness and cracks of the skin are noted. Patients with the bullous form complain of pain, burning, heat and itching. Objectively, blisters with clear liquid are found on hyperemic skin.

Allergic contact dermatitis is provoked by components of detergents, fabric dyes, sexual lubricants, and latex. The acute form is characterized by intense itching. Skin changes are located in the area of ​​contact with the allergen and have clear boundaries. Swelling and hyperemia are replaced by the appearance of papules, which turn into vesicles and open to form erosions. In a chronic course, the itching becomes constant, the boundaries of the lesions are blurred. Dryness and flaking of the skin are detected.

Atopic dermatitis develops in childhood and is chronic. In adults, it is more often detected on the face, in skin folds and the groin area. Sometimes there is spread to the scrotum. Pale pink lesions are detected in the affected area. The skin is dry, rough, flaky. The appearance of papules and cracks, secondary infection is possible. Exacerbations are caused by contact with mold, animal hair, house dust and other allergens.

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Allergic dermatitis of the scrotum

Eczema

Most often, post-traumatic microbial eczema is detected in the scrotum area. The affected areas are localized around scratches and abrasions from shaving and scratching that occur against the background of other pathological conditions. In rare cases, itchy and weeping red lesions of sycosiform microbial eczema are visualized in the groin and scrotum.

In true eczema, involvement of the scrotum is also rare. The pathology is characterized by the formation of papules and vesicles, transforming into microerosions with copious serous discharge. The severity of itching varies significantly - some patients complain of minor or moderate discomfort, while in others the symptom is so painful that it causes insomnia and the development of neurotic disorders.

Other skin diseases

Inguinal epidermophytosis has a fungal etiology. Inguinal folds are typically affected, sometimes spreading to the intergluteal fold, thighs and base of the scrotum. The pathology is manifested by severe itching and discomfort when walking. Upon examination, round, flaky pink spots with a tendency to increase, vesicles and pustules along the periphery are determined.

Erythrasma is caused by corynobacteria. Large skin folds, including the inguinal folds, are affected. As in the previous case, when spreading, the changes can cover the base of the scrotum. The itching is minor, often asymptomatic. Brownish or brownish spots with rounded or scalloped edges are found on the skin, gradually merging with each other.

Scabies

A typical localization is the peri-umbilical zone; in men, the process may spread to the scrotum and penis. Patients are bothered by unbearable itching, which intensifies in the evening and at night. During examination, itch tracts are revealed on the skin of the scrotum in the form of short straight or curved lines with a small vesicle and a bloody crust at the end. When allergization occurs, nodular scabies forms with a rash in the form of brownish nodules over the scabies tracts.

Pediculosis

Persistent itching of the scrotum and perineum occurs due to pubic lice bites. The symptom intensifies at night and is accompanied by scratching and the appearance of bluish-bluish spots at the bite sites. Low-grade fever and regional lymphadenitis are possible. Itching can also be provoked by body lice, but in this case the unpleasant sensations occur not only in the groin, but also in other parts of the body; the bite sites are erythematous papules.

Other reasons

Sometimes itching of the scrotum develops against the background of systemic metabolic disorders. Unpleasant sensations are not limited to the groin, but spread throughout the body; other signs are revealed that indicate the presence of one or another pathology. Possible reasons are:

• Endocrine disorders:
  diabetes mellitus.
• Damage to the liver and biliary tract:
  cholelithiasis, chronic hepatitis, cirrhosis of the liver.
• Kidney disease:
  severe renal failure.

In some men, the symptom appears against the background of strong experiences or accompanies mental disorders of a neurotic level. It can be detected in obsessive-compulsive disorder, hysteria, and some other pathological conditions.

Consultation with a dermatologist

What are the dangers of inflammation of the scrotal organs? Do I need to see a doctor urgently?

Inflammation of the testicle and/or its epididymis is dangerous, first of all, due to the development of male infertility. If they are not treated promptly, they can lead to disruption of sperm production, their normal development and transport from the testicle to the posterior urethra, where sperm is finally formed. If there is bilateral inflammation of the scrotal organs, the risk of infertility is much higher. In such cases, problems may develop associated with insufficient production of the male sex hormone - testosterone (decreased libido, weakened erection, decreased performance, decreased muscle mass, etc.).

The second very important point that dictates the need to urgently consult a doctor is the danger of having a testicular tumor, which can begin to manifest itself in the same way as epididymitis orchioepididymitis. As it is known that testicular tumors occur in more than 90% of those under 45 years of age, we recommend that you be tested for sexually transmitted infections; at this age they can develop and become malignant and can cause the death of a young person if he does not consult a doctor in a timely manner. At the same time, if a testicular tumor is detected in time and treated correctly, it is curable in almost 100% of cases. If there is a painful enlargement, and especially hardening of the testicle, it is important to exclude its infarction, or necrosis associated with the cessation of normal blood supply to the organ. Testicular infarction is an irreversible disease that leads to organ death and requires removal of the testicle. It usually occurs as a result of torsion of the spermatic cord and compression of the testicular artery. Torsion of the spermatic cord most often develops against the background of significant hypothermia or injury, when a spasm of the muscle that lifts the testicle (musculus cremaster) occurs. Thus, if the symptoms described above appear (enlargement and hardening of the testicle and/or its epididymis, pain in the scrotum, increased body temperature), you should immediately consult a urologist and undergo proper diagnosis and treatment.

What symptoms should you see a doctor for?

You should contact a urologist if you have any alarming symptoms or unusual formations in the scrotum. It could be:

• feeling of a lump, protrusion, compaction or, on the contrary, falling through (even if they are painless);
• pain: sudden, dull, aching, concentrated in one place or spreading throughout the groin, abdomen or lower back;
• feeling of heaviness;
• swelling or swelling;
• skin redness;
• frequent urination;
• pus or blood in the urine;
• change in tactile sensations (hardened or swollen testicle).

If the cause of the scrotal disorder is an infection, symptoms may also include:

• high temperature;
• nausea and vomiting.

How is inflammatory diseases of the scrotum organs diagnosed?

The basis for diagnosing diseases of the testicle, its epididymis and spermatic cord is a physical examination (primarily palpation or palpation). The leading auxiliary methods are diaphanoscopy and ultrasound examination of the scrotum. All of these methods are completely painless, and their correct use and proper interpretation allow an accurate diagnosis to be made in the vast majority of cases. In recent years, ultrasound of the scrotum, as a much more informative and accurate method, has practically replaced diaphanoscopy.

To establish the causes of epididymitis, orchitis and orchiepididymitis, a general analysis and culture of urine for microflora are required, and sometimes sperm (ejaculate) is analyzed for the presence of various infections. Tests are performed for the presence of sexually transmitted diseases. If there is suspicion, an examination is carried out for the presence of Mycobacterium tuberculosis in the urine and/or ejaculate. If a testicular tumor is suspected, blood tests are performed for the appropriate tumor markers. Only a correctly constructed set of diagnostic measures makes it possible to establish an accurate diagnosis and carry out the most effective treatment. Be sure to contact a urologist!

What is the treatment for inflammatory diseases of the scrotum?

Treatment of epididymitis, orchitis, orchiepididymitis and deferentitis is carried out primarily with antibiotics, since their main cause is various infections. The choice of antibiotic for an acute inflammatory process is carried out empirically, taking into account the known age-related characteristics of the causative infections. Upon receipt of the results of microbiological studies and analysis of the sensitivity of the isolated microflora to antibiotics, it is possible to adjust antibiotic therapy, change its duration, dosages of drugs, and sometimes the drugs themselves and their combinations.

Along with antibiotics, non-steroidal anti-inflammatory drugs (indomethacin, diclofenac, Celebrex, etc.) are prescribed in order to reduce inflammatory swelling, pain and quickly reverse the development of inflammatory changes. For severe pain, a blockade of the spermatic cord with a local anesthetic (lidocaine, prilocaine, marcaine) is used, which significantly reduces pain. All patients are recommended to wear tight panties (swimming trunks) that tighten the scrotum during treatment. This promotes better blood and lymph flow in the scrotum and accelerates the reverse development of inflammation.

In the presence of ulcers or abscesses of the testicle and its epididymis, as well as in chronic recurrent epididymitis, which is difficult to treat, in the case of testicular tuberculosis, surgical treatment is used. It may involve opening and draining abscesses, partial or complete removal of the testicle and/or its epididymis. The use of various methods of physiotherapy for inflammatory diseases of the scrotal organs has not proven its effectiveness in correctly conducted scientific studies and is not included in the international standards for the treatment of epididymitis, orchitis and orchiepididymitis. In this regard, we do not use physiotherapeutic methods for treating these diseases in our practice.

What is the prevention of inflammatory diseases of the scrotal organs and their complications?

To prevent the diseases described above and their complications, you should, first of all, avoid contracting sexually transmitted infections and treat them in a timely manner, not be exposed to sudden hypothermia, and protect the scrotum from injury. You should give preference to tight-fitting panties and dress warmly in winter. If you have the above-described signs of epididymitis, orchitis and orchiepididymitis, you should urgently consult a urologist!

Main reasons

If the epidermis in the groin area turns red, begins to peel, becomes covered with a rash or small wounds, the reasons for this may be:

• reaction of delicate skin to underwear fabric, lubricant, shower gel - for men with sensitive skin, it is better to choose hypoallergenic intimate cosmetics and underwear made from natural fabrics;
• violation of the rules of hygiene of the genital organs - both neglect and too frequent washing with aggressive detergents can cause harm;
• allergic reaction to food, toxic substances, components of household chemicals - in this case, the condition of the skin not only on the scrotum worsens;
• deficiency of vitamins and minerals - can lead to peeling, cracking, and redness of the epidermis in different parts of the body.

Common causes of peeling skin on the scrotum are also viral, fungal, and bacterial infections. In this case, active exfoliation of the upper layer of the epidermis may be accompanied by:

• changes in its color - red, yellow or white spots may appear on the scrotum,
• the appearance of rashes, plaque,
• swelling,
• discharge from the urethra - clear or purulent,
• problems with urination, discomfort during urination,
• pain in the lower abdomen.

With some infections, non-healing ulcers and wounds also form on the genitals.