Rash with peeling dead skin on scrotum

[Joe]

I've a rash on my scrotum that I "acquired" about 8 years ago.  Basically, the skin becomes red and itchy and eventually, after much scratching of course, the top layer of skin becomes dry, cracks and peels off, leaving reddened moist leasions that then burn and itch.  I've had this off and on for about 10 years now.  About 2-3 weeks after acquiring this rash, I went to see a General Practioner, and was told it wasn't VD or an STD, but a rash, for which was prescribed Hydrocortizone (over the counter strength 2.5% I think).  My main concern was that it was some sort of VD/STD or something, but I was told that it wasn't a transmittable disease/rash, some internal virial or bacterial infection, I can't remember which.  True to form, I've had numerous long term relationships and a marriage, and none of my partners have ever contracted the rash, but it's still here.  How do I get rid of it, not just treat the 'outbreaks'?  It's been a problem long enough that now the skin on the left side of my scrotum is like elephant hide when the syptoms (symptoms) of the rash aren't present.  It's never spread, always been localized to the left side of my scrotum.  Any solutions or recommendations, or diagnosis?

[Alan Rockoff, MD]

Joe:

You're giving a very nice description of eczema.  This itches so much that scratching makes it look like shoe leather (or "elephant hide.")  It isn't STD or VD.  All you can do is control outbreaks, but at least you can do that with prescription-strength but mild cortisone creams.

Good luck.

Dr. Rockoff

[scarwobbler]

I'm afraid I find the solutions provided by the dermatologist to such problems rather disturbing, and I hope he or she finds the time to deal with by doubts.  It seems to me that steroids (ie hydrocortisone) are the stock solution to every problem.  I have had problems with a rash on my scrotum, and have been to a dermatologist on several occasions.  The answer is always steroids, or a combination of steroids, antibiotics and fungicides.  Certainly in my case the steroids made the problem much worse.  Indeed any form of steroid applied to my scrotum causes INTENSE itching and redness.  Having said that, I have eczema, and steroids work on other parts of my body, including the face.  One should also bear in mind that steroids are powerful drugs, and one should therefore be careful applying them so close to the testicles.  In the end the dermatologist gave up - he had no answer beyond steroid creams, with I found very disappointing.  My broad conclusions were that one should firstly not worry about the fact that there's a scrotal itch, and one shouldn't apply ointments, firstly because they're a sign of the worry, secondly because they're probably exacerbating the problem.  Of course one should also avoid everyday irritants, such as soap and sweaty underwear.  But overall, a simple case of an itchy scrotum demonstrates how primitive today's medical science is.  In a few centuries time doctors will look back in horror at the late Twentieth Century's love affair with steroids (steroids are used for treating a host of conditions, such as eczema, asthma, ulcertative colitis, rheumatism, arthritis and athletic underperformance).  Oh, how we look back in horror at the way doctors used to prescribe Mercury tablets for syphilis (that's why Oscar Wilde's teeth went black).  Happy New Year!

[Luc]

Joe, I have the same problem except that the patches do move. It seems very dependent on scatching. If I don't scatch or irratate it for 2-3 days, it goes away. Unfortunately, the itch gets intense at nights while I'm sleeping and unconsciously scatch it. At night when a pillow is tucked between my legs and being under a warm blanket, the itch intensify. Application of any creams seem to be temporary and doesn't make it go away. I know the solution is stop scatching and keep it cool, so I'll keep on working at that. Been trying for years and I must say it's hard when the intense itch kicks in. Good luck.

[Marvin Legator]

I have the same chronic problem sometimes called "red Scrotum" or "Red Bag" syndrome.  I also find that the corticosteroids do not help, and even worsen the condition.  I find it difficult to sit in one position for a long period time and have intense itching at night time.  I have yet to find a topical drug that is of any use.  Vaseline seems to help and sooth as much as any thing.  I do get relief taking 20mg/day of Viodin (hyrocodon and tylenol).  If your case is bad enough I would suggest taking a drug to deaden your nerve endings such as Vicodin.

I am frustrated by the dermatologists who seem to have nothng to offer for this condition (cause of their frustration). I hhope wwe can share ideas, and come up with some worthwhile approaches to this miserable chronic condition.  I would be interested in the manner the itch is handled at night. I also use a pillow between the knees, but I wonder if their is a better way. Some individuals I know take ATARAX at night to curb the itching. Let us share information on this not especially rare condiion.

[ed]

Hey man, I'm going on 22 years of this. My whole family has seen me scratching at one time or another. Sometimes my drawers or linen have little spots. And the flaking skin. I should have started collecting it when I was eighteen and sold it to Squibb or someone.

Anyway, after seeing a ton of Docs on this... who have diagnosed it as Lichens Planus, Excema, Dermititis, "maybe it scabies"-that MD was lame- always wanting to diagnose me with MONO- what a doof. The one Dermatologist that I think nailed it, wanted me to see a shrink, as he felt it might be a mental thing I needed to break.

It is not Viral, bacterial, or contagious. You have dry skin!
Hat baths/showers are a no no. Creams et al, will only exacerbate the problem- and it you do find any that work, they can only be applied after you have gone 3-4 days without attacking the "zone".

Try this... in all my years this works the best.

Trim your nails short.
when you have to scratch use the ball of your fingers rather than the nail. Don't dig at 'em. Rather, you want to give them the briefest of attention give them a soothing "yes, I know" hard tickle and then turn your mind to some other task. Don't sit there and scratch (or try not to). Get up and take the garbage out. Walk the dog. Kiss your wife. Just get up to take your mind off of the "itch". This is KEY Clip them often and file the edges smooth. If you bite them, and don't use a file, you will leave the edges really ragged. You won't notice it so much; but they will tear into your tender skin!

Don't use soap! Even the best for dry skin- Plain Dove, is too much for your already arrid scrotum. If you have to, and only if you have to use soap when you take a just warm shower, use it sparingly. Avoid your joints, behind knees and elbows. And never in your crotch. Just "wash" them with running water and rinse them well.

When you towel off, don't rub. Dab-off.

Use a low detergent laundry soap. Tide kills me with an terrible itch- clothes bright- nuts bright red. Avoid. Instead I have used Dreft baby clothes soap, and Arm and Hammer with color safe bleach. Top rated and does not leave soap in your underwear that will affect you.

Boxers are better than briefs as they keep you from getting hot, sweaty and itchy. At least go to larger briefs- Let your package dangle.

Most important. Drink lots of water. Glasses and glasses a day. Add Vitamin A (25,000 IU daily for 90 days- then reduce to 15,000 IU daily), E(400 IU daily), Evening Primrose oil (2 a day), Zinc(100mg), and B complex(as directed on label), Kelp(5 a day). I know this sounds like some voodoo "herbal" ****; but it works!. You will notice that your skin clears up in about 5 days. Even your face and other "problem" areas will seem healthier.

Lastly, the only medication I can recommend is Allegra 180's. Your doctor may not yet have heard about taking them in this large a dose; but I could probably dig up the recent study on it. These will keep the itch in check. You can take them daily am/pm; but I find that I like them best when I am expecting a stressful day. I take them the night before, that morning and evening. Metally I feel "in control" Physically, I don't feel the urge to get away and scratch. Your doctor has to write for them; but if you ask to give this a trial, you'll probably get an Ok.

Recap: Water, FILE your clipped nails, NO Hot baths, Cool shorts, mild detergents, Vitamins- get them. It is less money than you've been spending on stuff that hasn't worked anyway.

Lastly break the habit of sitting or laying there and scratching. I used to get in bed and scratch like hell just to get comfortable. The rapid change in body temp from wearing hot shorts to removing them and sliding in between the very cool sheets always made me itch. I believe the rapid cooling shrinks the scrotum so fast it creates hundresds of minor itch sites simultaneously, triggering a habitual scratch session. Get up and do something else. If you are watching TV and feel the urge, go make yourself a cold drink, and a bowl of popcorn. You gotta break the cycle.

Try this. Before bed, shower, dry and put on loose clothing, a robe or just a towel. Don't bundle up and then jump into a cold bed. Cool down, hang loose just before bed so there won't be cold sheets shock.

So now that you have not attached your sack in 5 days, and they are starting to look better, feel soft again. Don't be weak. Instead, reward yourself for making yourself well. Buy a new fishing rod, or wheels for your truck, or a dashmat. Something that you will see/use oten to remind you that you are getting better. Go buy more vitamins, a little pill calendar box will help you remember to take them, keep drinking the water. Buy new underwear. Think about how much better you are feeling. Tell yourself that you are on your way back to good scrotum health. Make an appointment to see your doctor and get a physical- you've probably been putting it off due to the condition of your scrotum. This is a good time to go, reafirming your commitment to your new level of wellness.

You need to work at it everyday now. Good luck

[canovalik]

I'm only 16 and I've been getting this the past 3 summers of my life.  I thought I was going to escape it this time cause its late August, but I was wrong...  I never knew what this was, always just thought that maybe it could be a minor thing like poison ivy.  Well I am currently in a breakout of this (FFFin sucks!) and it was just too intense for me to believe it was poison ivy.  I'm pretty sure we are all talking aboiut the same thing, the scrotum turns red and gets very dry and after it's takin its course, the peeling begins.  I stumbled across this forum because it is 7 a.m. and i haven't slept a minute all night, too much scratching and itching!  I know the best solution is to stop scratching, because no matter how intense my itch is, if I can avoid scratching it it will settle and get off my mind.  I just want to ask everyone if they started having this problem at such a young age as well and what he hell you guys think I should do!!!!

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