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STDs  (Expert Forum)
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Rash under scrotum
Answered by
University of Washington Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Rash under scrotum

by johnstrat, Dec 06, 2007 02:43PM
Tags: irritable
Doctor,

Trying to get some information. I have had a rash on and off under my scrotum for about 3 weeks. Its red and a little irritated. I have also had itching on my anus and hemorrhoids. When I put cream on it it usually feels a bit better.

My concern is that 10 weeks ago I had unprotected oral sex. I have been tested for bacterial infections (negative) and HSV-1 and HSV-2 at 9 weeks (both negative) as well as HIV at 9 weeks (non-react). So my questions are:

1) Is a rash under the scrotum typically a concern for a STD?

2) If so, what am I missing here given my tests?

3) If no, can hemorrhoids cause a rash such as this?

4) If its just a rash, what should is best used to treat it?

Thanks for information.

by H. Hunter Handsfield, M.D., Dec 06, 2007 03:21PM
Reacting first only to the title you chose for your question, before reading anything else:  STDs rarely cause rash in that location.  Most likely something else is responsible.  Tinea cruris (jock itch) probably is a good bet.

Now I have read it.  Receiving oral sex is low risk for STDs in general, and could not plausibly result in an STD with symptoms in areas not directly contacted during oral sex.  Almost certainly the oral sex is not the cause of either the rash or your anal irritation.  Had you been my patient, it would not have entered my mind to test for herpes, unless the rash was highly typical for that STD.  As for the questions themselves:

1) Nope.  See above.

2) You aren't missing anything from an STD standpoint.

3) Hemorrhoids per se would not cause a rash. However, any number of things in addition to hemorrhoids cause anal itchiness and irritation, including anal fissures, minor infections of various types, and simple pruritus ani.  The last is the "wastebasket" term for anal irritation that isn't otherwise explained, maybe sometimes due to hygiene.  (The name just means itchy anus in Latin - sort of like saying someone has pyrexia rather than fever.)  Or maybe you have 2 problems, the anal itch and the rash behind the scrotum, for which jock itch still seems a good bet.

4) Ideally, you should see a health care provider before trying to treat it yourself.  However, you could safely try an over-the-counter cream intended for jock itch, such as Lamisil.  Look in the pharmacy along with the athletes foot products.  If that doesn't result is substantial improvement after 3-4 days, definitely see a health care provider.  In the meantime, don't worry about herpes or any other STD as the explanation.

I hope this helps. Good luck--  HHH, MD
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