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Red Scrotum Syndrome and anxiety question
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Red Scrotum Syndrome and anxiety question

About three weeks ago I noticed my scrotum was bring red. The only skin involved was the scrotum, the strip down the middle was its normal color.  It was not a rash just bright red pigmented skin, it did not itch, it had a slight burn every so often so I can live with it.   I also had a classic case of jock itch, I work out alot, sit around in sweaty compression shorts and the folds on both sides of my groin became red, itchy and scaly.   I went to my doctor who prescribed me 100 mg of Diflucan for 7 days and gave me a prescription anti fungal cream which seems to be working on the groin skin fold problem.   I applied this cream for three days to my scrotum and realized that the problem on my scrotum may not be fungal at all.    Alittle back ground on myself in May of this year I did something completely out of character and had a drunken fling with someone I did not know.  The condom broke and for almost 6 months now I have dealt with an huge amount of anxiety, guilt and paranoia over std's. I am also a severe hypochondriac and suffer from OCD.    I have been taken a 7 week IGG test negative for herpes and also a 17 week IGG test which was negative.  

This red scrotum came on at about 5 and a half months since this encounter and in researching it It seems there may be some connection to red scrotum syndrome psychological distress.  Can anyone confirm this ?

Also I have red the best treatment for this is no treatment at all is this also correct?

Has anyone had any luck working with a psychologist in relieving these symptoms ?

Thanks in advance
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Avatar m tn
I can not connect an STD to Red scrotum syndrome.This is a chronic condition and perhaps you are connecting this to an irritant dermatitis, which is possibly what you have.
However recent work has shown that doxycycline is effective in a few patients with the syndrome.
Red scrotum syndrome
Uwe Wollina http://dx.doi.org/10.3315/jdcr.2011.1072
Do consult your doc.Best wishes.

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Avatar n tn
Thank you maatson, have you ever seen any research indicating red scrotum syndrome may be the result of psychological distress or guilt? I have seen a few posts on the Internet about the connection between the two. I found it interesting that during the most guilty and stressful time of my life this condition manifested
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Avatar m tn
wow -your story mirrors my experience word for word from the sexual encounter to the symptoms. I have wondered if its a mind thing(although the pain and redness is real) all std tests and yeast tests are neg. i have found that anything i treat it with seems to irritate it more. my dermatologist said it is contact dermatitis or red scrotum syndrome-but offered no cure or relief. I feel some guilt but more worry of an undiagnosed disease. i think it has made me more of a hypochondriac.not treatin it seems to help, but its not a cure just a temp fix. pure talcum powder helps from time to time but even seems to irritate it sometime. im surprised theres not more info on this because it seems to be a common problem.do you have any additional skin problems?
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Avatar n tn
Hey.. Hoping I can help you out  abit... I used the prescription cream for a few days and it made everything feel alot worse and look alot worse when I was using the cream on my scrotum it turned it fiery red and it had an itchy crawling feeling.  I stopped using the cream in late october and everything returned pretty much returned back to normal.  I did have jock itch but i believe the scrotum was totally unrelated to the jock itch.   I believe what I had was related to prolonged stress and anxiety.  Looking back I believe what happened was I experienced some irritation from shaving which caused the redness and because i was looking for anything in my genital region i freaked out and was examining it non stop which did not help.  As my guilt and anxiety lessened almost all of the symptoms i percieved vanished.   I realized growing up that at times when I would be stressed of anxious my face would turn red and realized that its possible from focusing on one area for so long that this could happen to the scrotum.

The only thing I use now is baby powder and some gold bond every few days.  

It has been almost 3 months now that my scrotum has been normal.  I am thankful I did not continue to use the topical antifungal and steroids for a prolonged period because it seems this can create an even bigger problem and make the recovery much longer and more stressful.

Feel free to shoot me a pm if you have any questions I am no expert but have gone through and experienced the same thing you have and came out alright.
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Avatar m tn

I have had this problem I believe to be RSS for 18 months. First I thought it was hernia related then I thought it was result of a kidney stone I passed but I am now in the camp that it is a deviant herpes or a stress related neurological trigger. I have been tested twice for HSV2 and both negative, never a breakout of any kind. The combined panel gave me a +1.24. So I can assume a possible HSV1. But as I am 45 and discovered after the fact that about 2/3 of adults will show positive HSV1. At the time of my physical and blood work I did not know that there was a difference or even two types of HSV. The stress put me over the top. I freaked. I believe this to be the neurological trigger that launched my condition. Also these last two years there have been other stresses like job and finances. I just hope I haven’t caused any irrevocable damage trying every crazy remedy on these boards. Everything I have tried has been a failure. I only get temporary relief from coco butter. Nothing else. All else are irritants. Question? Does the color and pain level stay static with everyone or is it fluid. In the morning it is less painful but in the afternoon much more painful. Also my sac is like a mood lamp. The color can change from bright red to a dark purple and everything in-between. It is more often very tight than free hanging.  I have 3 veins that consistently are dilated and varicose in my sac. But the redness pattern stays the same, it never changes. I often get burning in my legs, outer thighs and top of feet. But that comes and goes. Sitting seems to make it worse. The one constant is like a buzzing tingling feeling in my nuts. That is the most predominant symptom. Does anyone out there have a similar experience? Has anyone tried Acupuncture? Even a vasectomy’s invasive procedure may cause this to sidetrack. Feedback anyone?
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Avatar m tn
I have the same redness from time to time it's also itchy. To cure the itch is easy with ebson salts or/and tea tree wash but the redness seems to persist. I have exceema so I guess you just have to let life run it's coarse sometimes.
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Avatar n tn
RSS has a different name and it does have a solution: Scrotal Neurodermatitis.


1. Started with red skin and red small dots on my inner thighs
2. It looked like a regular infection from sweat.
3. I’m a runner and usually get this on my chest and rarely on my crotch.
4. I used Canesten which has always helped.
5. The red skin on my thighs got better during the first 2 days.
6. On the 3rd day my scrotum got very red and itchy
7. I put canesten on my scrotum and showered with antibacterial soap (BIG mistake)
8. I suspended canesten and antibacterial soap after 1 week.
9. I started missing sleep, I would wake up at 2am with my scrotum in flames.
10. I started reading blogs online, the online pictures looked exactly the same, the symptoms were just like what I had.
11. During the day it would be ok, but at night it was just awful.
12. I remembered a special soap that a urologist suggested to treat/avoid human papilomavirus from developing (I have it and my girlfriend developed it) in men if we have a good higiene we should be ok.
13. I started using this soap, this is in Spanish since I’m in South America: “Saforelle Fem – Bardana Dinafitoles” is the commercial name.
14. This soap is sold in pharmacies over the counter, it’s liquid and makes foam like a regular soap.
15. The soap helped a lot, I showered my scrotum and legs twice a day with this and it just alleviated the itch and redness for about a week
16. One day I thought I was completely cured so I thought I had found the cure, however I was wrong, that night was one of the worse.
17. The itch was different, it was like electric shocks on my scrotum, I didn’t scratch even once cause I knew that would just make it worse… but I could feel the electricity… like this tingling feeling. If I could draw it, it would be like an electric feel/lightning on my balls.
18. That day I got no sleep, I took a shower at 3am with the soap I described before and that helped somehow.
19. I spent hours that day online, reading. I was ready to go buy antibiotics and get a doctor’s appointment that morning… but I had never looked up this issue in Spanish (usually there’s more info on anything in English than in Spanish) but I gave it a try.
20. There’s less info in Spanish, however there’s a different perspective of this issue. They relate the RSS to Scrotal Neurodermatitis.
21. Dermatologists who find these symptoms send their patients to psychologists/psychiatrists.
22. It immediately made sense in my head. This is not a skin infection, or anything you can treat with antibiotics… this is all in your head.
23. I had a very rough break up with my exgirlfriend that really messed up my head, I became very anxious.
24. I would say I had been experiencing something I would call sexual anxiety, like thinking too much about sex, and I knew it was all related to this past experience with my ex that was not solved.
25. So since that day, I have kept on showering with the soap above, and meditating, letting things out of my head, facing my past, looking at women with respect, letting the anxiety out… and this has been the answer for me. Sometimes I feel the tingling on my scrotum and I just relax and observe my mind and it calms down.


So in a few words:

1. I got a regular skin infection from sweating.
2. I used Canesten and antibacterial soap, I got an awful rash on my scrotum which weakened my scrotum skin and created the right environment for Scrotal Neurodermatitis.
3. I stopped the scratching and started using “Saforelle Fem” soap helped cure the skin and infection, which alleviated the itching.
4. I would say RSS is actually Scrotal Neurodermatitis which means it will cure when the issues in your head are solved.
5. Look inside your mind and you will find the answer.

I have not seen a doctor or psychologist but I do believe in the power of the mind… it’s very powerful to do amazing and beautiful things, but it can also work against you. Read more about Scrotal Neurodermatitis, the answer is there.

I really hope this helps you all out there. Good luck, you are not alone.


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Avatar n tn
Just an update.  It has been a year since I had this problem.   I have been clear for a year.  I believe I have found out what brings this on.   When this occurred I had been under extreme stress and anxiety over a dumb decision I had made.   I had shaved my scrotum and ended up getting a heat/rash/friction rash in my groin area.   I believe initially it was a mixture of the prolonged stress and guilt manifesting itself physically and the rash.  I ended up putting topical steroids on which turned it from a pink hue to bright red and made it itchy.  

I have been under a similar period of stress since about April of this year. I had began competing for a promotion at my job and my presentation was coming up this week.  It was the similar feeling I had a year ago.  constant stress.  Well I shaved on Saturday and ended up getting another heat rash where my scrotum touches my leg.   My left side of the scotum had the same pinkish hue as last year.  This time I began treating it with gold bond, and cold showers.... NOTHING ELSE  I also made sure I relaxed and did not freak out this time.    This morning the heat rash is still there but the pink is starting to fade.   When I get stressed out it begins to get darker.    

I think its important for anyone who ever looks down and sees a pink or red scrotum to not freak out... DO NOT USE TOPICAL STEROIDS on it and let it resolve itself.    I think once you start using the steroids it leads to damage that takes a verylong time to heal.
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Avatar m tn
Same symptoms. Great ball of fire. Severe burning. Treated with every cream you can think of. Tried doxycycline. No help. Found a good dermatologist. He has seen it before. Gave me a very strong steroid cream for several months, some improvement. Also putting a cool towel on the area twice a day. Then reduced the strength of the cream. Problem became tolerable but did not clear up. Ok days and bad days.

All during this time, I have been under a lot of stress and just feeling off, kind of in a fog, frustrated with a lot of things. I am in my mid fifties. For the first time in my life I went to see a mental health therapist. Kind of sorted out what has been bothering me. I  won't go into details, but I will say that the red scrotum issue has significantly resolved. Still a bit red but almost no burning.

Stress related. I sure think this is a factor.
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Avatar m tn
I had the same symptoms as mentioned in these post.
1. Noticed red spots on my right inner thigh.
2. A day or so later I had red testicles with a very defined border where the testicles sack ends. The skin began to feel thick and leathery.
3. Infectioned then moved to the penis. Spots on the foreskin and tip of penis also in and above the hair line of my genital area.
4. Last noticed spot on my left inner thigh. Very distinct oval, looked like ring worm.

Like many on this and other forums, i was freaking out for fear of being infected with an STD. If you have these symptoms, you are fine, stop worrying. You have Tinea Cruris, a form of jock itch. I struggled with this for over a week and finally went to the doctor. He prescribed Terbinafine HCL 250MG daily tablets and Nystop 100,000 units/gram powder. The tablets were the cure, the powder to keep area dry and comfortable.

Within 48 hrs. the area began to look and feel normal. 4 days later I am almost completely back to normal. Skin returned to normal color and texture, with spots almost completely gone. Skin still a little tender but mild considering where I was a few days ago.

If you are afraid or can't afford a doctor I would suggest Clotrimazole USP1%
Anti fungal cream. Same thing you would use for jock itch or athletes foot. You can get this over the counter at any drug store for about $5. My doctor said this is also effective, but not as fast and much more uncomfortable. You're going to feel a burning sensation the first couple of times you apply.

Back story is that I recently began shaving my genital area. I work out at home each night after work. I fell into the habit of working out and then resting, eating, and watching a little tv before finally showering right before bed. I also recently purchased a new down comforter and was sweating more than usual at night. The skin touching skin of shaving my genitals and sweat was apparently a perfect breeding ground for bacteria.

I wanted to come back on here and give some comfort to others with these symptoms. This was an emotional and uncomfortable experience due to fear of contracting something much worse. If you can muster up the courage to go to the doctor you will feel 100% better in 48 hrs. Stop worrying, you DO NOT have an STD!
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Avatar f tn
I have had this same issue for a few years off and on. I too had it happen the first time after sex with a questionable person. No stds just red itchy burning ball sack. The more stuff I threw at it the worse it got! I believe this experience shocked me from the stress and guilt so much that my body just continues to react this way. Kind of like your body is allergic to your sack! What I have found works for me is, as soon as it starts to flair up I take a Claritin and put Benadryl cream on my sack. After the cream is rubbed in good I put baby powder all over my twig and berries. It goes in about a couple of days. But it does always rear it's ugly head again though. It's a good idea between flair ups to moisturize the boys too, potentially keeping the red sack back! I hope this works for all of you. Can't promise though!
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Avatar m tn
I know someone who had a very similar experience. HJ from SW and then severe anxiety and burning red scrotum. Yet no STD even when tested at 3 months. Based on what he was telling me I am convinced that the red scrotum issue was real, but that it was created to a large degree by anxiety. When the negative results came back the irrigation seemed to fade.
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Avatar m tn
Good day buddies,  I'm sylvester grassland from Nigeria west Africa, I'm 24.  I'm having this same similar issue and from all I noticed I just discovered the truth of this whole thing originating from our own head.  I will just try and lay most of them out to see if I will get out of the awful experience.........  Thanks peeps
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Avatar m tn
I HAVE THE CURE!!!!!!

For 5 years I went through a very similar experience as most have described here and on other boards.  I spent a fortune on Harley Street doctors, doctors in the US, Singapore and Australia.  Nothing.  Had a million and one swabs, skin scraping and different diagnoses -  none of them correct.  I've been prescribed every topical and oral anti fungal, steroid and antibiotic going.  A couple of the many combinations had some improvement but never got rid of it, particularly in summer time or if I was in a tropical country.  Wont bore you with all the details but it was basically ruining my life.

Then I decided to visit my local NHS dermatologist. Within 5 seconds he told me immediately what was wrong.  Your body is allergic to a fungus that naturally grows on the body in that area. He told me to wash a the area and as much of the surrounding body as I can with Nizoral shampoo every other day, then once every 4 days.  

I didn't believe for a second he was right or it was going to work.  I had got advice from the best professionals in the world and had been medicated with everything you could possibly think of.  But I went through the motions and tried it.  At first I thought load of rubbish, then, as if by magic, for the first time in years, it completely cleared up.  As in nothing, at all.

One year on and as long as I use Nizoral down there once every 4-5 days, its completely clear.

NIZORAL EVERYONE - GIVE IT A GO!!!
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Avatar n tn
I have been experiencing the exact same thing as the original post. From the encounter, shattering pangs of anxiety and guilt, depression etc. The scrotum is red but the stripe down the middle is a normal colour.  It seems at its worst after every shower (bright red but not itchy or burning).   I have been dealing with it for several months now, have tried a variety of creams including hydocrotisone which made it infinitely worse. (changed an average yeast infection type rash into a tight, burning, bright red one.) Now from my experience since abandoning  any prescribed medication, how it feels is more important than how it looks. The scrotum is naturally pigmented. The more I jostle with my balls and check them compulsively, the worse I feel and the redder they become. Its a psychological battle you must face in your mind. This condition has been turning me steadily into a hypochondriac and now I feel like the first step to take is dealing with those urges (the urge to constantly go to the doctor who thus far as offered very little help other than screening for chlamydia and gonnereha,  and the urge to constantly check my parts).

If anyone else has experienced any improvement in the rash with stress and anxiety relief your input is greatly appreciated.
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Avatar n tn
I have been back to normal for a while.

I had a 'happy ending' massage in which she used her mouth. I woke that night to a burning red scrotum. No STD would appear that quickly, but I didn't know that at the time.

It is very emotionally difficult. Lots of guilt and shame. And unlike other rashes, you can't tell anyone about it. I became depressed and even suicidal (i had never experienced anything close to this, generally happy). I would turn to this thread and Dr. Rockoff's posts (search medhelp: 'rockoff red scrotum).

Eventually I had an emotional breakdown in front of a friend. Then I saw a good doctor, who didn't know anything about red scrotum but I found telling people and getting rid of the shame helped.

It got progressively better over months. However it is maddening because it seems to come and go with no control. But, each time a little easier to cope with mentally.

I found a skype phsycodermatologist who deals with warts, hives and red scrotum. Seemed to help a lot.

My take aways:

- Don't put anything crazy on it. I used vitamin E oil after showers.
- Read this thread and Rockoff
- Don't kill yourself
- Exercise
- Some doctors don't consider it real.
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Avatar n tn
It is now 5 years later.  I completely forgot about my issue.  I honestly believe that this is caused by several things.  1 severe anxiety and stress,  2) minor trauma or infection of groin, 3) use of topical steroids.    

I stopped shaving with a razer and have not had any more issues.  I started getting cold showers and the redness started to slowly fade over months..... I also stopped all topical stetoids.... I dealt with my anxiety and slowly my scrotum healed.    It has never returned back to red.    I will also never put myself in a situation that creates that much conflict in my mind!  
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Avatar n tn
Agree with Drum.... Exersise and killing your guilt helps !!  I never imagined my mind could create this... But think of how flushed your ears get when embarrassed !!!  I think the same applies for the scrotum esp when the issue is shame and guilt over the use of your scrotum !   I have been gone for years and want to help all of you out and give back so feel free to pm me any questions .... It is cureable and it will get better!!!
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Avatar m tn
So, I am in the same boat.  Same questionable decision.  Tested negative for HSV2 at 9 weeks.  Daily burning/pinching pain in various spots in scrotum.  Is this similar to what you are having? After showering, its gone.  When I wake in the am, nothing until I get up and move around.  Strange.  I can't fathom that its all mental since the feeling is so real.  Guess I'll try to stop focusing on it and retest for HSV2  at 6 months.  
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Avatar f tn
I tried Ted's suggestion of using Nizoral and it's looking like it works! I have gone from a bright red to a deep pink colour in 24 hours.
I think mine was due to steroid creams for another skin condition, so I have stopped using that as well.
I will let you know how it goes from here but a brilliant start
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Avatar f tn
One week later and I'm completely clear. Nizoral did work.
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Avatar f tn
When did it start working... The nizoral shampoo
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Avatar f tn
Im having the exact same problem and nizoral hasnt worked for me. Idk what to do
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Avatar m tn
Derma cool 1%. No cure but what relief.
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