Red scrotum syndrome, as the name signifies is a chronic disease of the scrotum that is associated with persistent redness of the scrotum in association with sensation of burning, pain, itching, heat and increase sensitivity to touch. Although, referred to as rare or uncommon previously, today it is quite common among the males in their second half of their life.
Red Scrotum Syndrome Causes
Just like in Red Face Syndrome, Red scrotum syndrome (RSS) can also be the consequence of prolonged application of strong topical corticosteroids creams to the scrotal area. However, in majority of cases there may not be history of corticosteroid use. Other factors that are thought to contribute or co-exist with red scrotum syndrome include sexually transmitted diseases, fungal infections, bacterial infection and few other skin conditions.
Symptoms and Signs of Red Scrotum Syndrome
A person with RSS may have difficulties wearing underpants or just sitting down as it aggravates the pain. The patients may need to sit forward, allowing the scrotum to hang down past the seat edge. RSS involves the scrotum and sometimes base of penis. Scrotum may look bright red in color and associated with itching, pain and burning sensation. Although itching can be experience in almost all people, major problem is neurological pain and burning. Symptoms can sometimes be very stressful and may interrupt your sleep or even sexual activities.
Red scrotum syndrome when associated with itching may suggest the development of irritant contact dermatitis due to various creams and shops or due to secondary fungal infection.
How is it Diagnosed?
Based on the clinical symptoms your doctor can easily diagnose the case without requiring any special lab tests. When in confusion your doctor may perform few lab tests to exclude other causative factors. Patch tests may be done to see if it was due to steroids or other allergens. Other tests like fungal testing, some blood works and biopsy may be needed in few cases.
What Treatment options are available?
Several treatments both topical and oral have been tried but unfortunately there is no any definitive treatment that works on all. For general symptomatic relief you may try few of the below mentioned tips:
Things to avoid in Red scrotum syndrome
Avoid soaps (especially scented ones).
Avoid tight fitting underwears.
Avoid antiseptic washes, wipes or deodorants in the area.
Avoid all the over the counter creams and steroids preparations that may be prescribed for jock itch and other conditions.
Other Options
For temporary relief cold compress may be a good idea.
Over the counter soothing lotions containing calamine and menthol may provide soothing and relief. It has been suggested that tacrolimus and pimecrolimus cream reduce redness and burning in some men with Red scrotum syndrome.
Recently it has been suggested that oral doxycycline has good response in RSS with satisfactory improvement after 2 weeks of starting therapy and marked or sometimes complete improvement after 3-4 months of therapy. If doxycycline fails oral gabapentine or pregabalin may be the other option. Low dose Tricyclic medication like amitriptyline may also benefit in such neuropathic pain syndrome. For better outcome, oral doxycycline in combination with oral gabapentine/pregabalin or amitriptyline along with topical tacrolimus nightly may be the better option.
As some experts believe that it might also be influenced by stress, anxiety and depression, so using some relaxation techniques and may be self-hypnosis could work on some individuals.
[expand title=”Click for References:”]
1. Wollina U. Red scrotum syndrome. J Dermatol Case Rep. 2011 Sep 21;5(3):38-41. Red Scrotum Free Open Access
2. Abbas O, Kibbi AG, Chedraoui A, Ghosn S. Red scrotum syndrome: successful treatment with oral doxycycline.J Dermatolog Treat. 2008;19(6):1-2
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I have fought a losing battle for years against red scrotum syndrome. At times, it made life very uncomfortable. The symptoms are greatly improved by doing the following:
1) Avoid any contact of soap with your scrotum. In the shower take strict precaution not to let any soap touch your genitals. Wash your genitals only with water;
2) twice a day apply mineral oil to your scrotum;
3) avoid any other medication.
If you or someone you know has experienced these genital symptoms, I have found the cure!
Symmetrical redness on scrotum, tingling/itching feeling, random testicle pain, hair follicles on scrotum are raised, scrotum droopier than normal.
I dealt with these symptoms for over six months after traveling to Mexico, Honduras, and Belize. When I got back and saw a dermatologist he said it DEFNITELY was not herpes (no boils or sores) and he misdiagnosed it as contact dermatitis. He prescribed me steroid cream that did more harm than good. Finally, after scouring the internet I found a testimony very similar to mine.
After trying everything from dipping my balls in vinegar to assaulting my nuts with baby powder I finally used the dandruff shampoo Nizoral. After washing my genitals once, a day with Nizoral the symptoms finally started receding! My testicles FINALLY returned to normal skin color instead of a fiery red color. This pesky rash caused me an enormous amount of stress and I am relieved to say I finally found this treatment that works! If you have experienced these symptoms, please try Nizoral dandruff shampoo and spread the word!! (I saw two doctors who had NO IDEA what it was or what to do. Self-treatment for the win! This condition seems to be unrecognized by most doctors. Once you try this treatment and see that it works please spread the word around the internet. People deserve access to this useful information.)
How long did it take to see improvement
Hi Keith, Can you tell if that got rid of the condition? I’ve been battling with it for over a year now and every single day is uncomfortable for me… Sex not enjoyable at all.. I really need help
wow, awesome article.Really looking forward to read more. Will read on…
Hi am philip i wish to know what cause the old man balls
Yes I have found the cure, It is called Humira and it is injected every two weeks. It is precribed by Dermatoligists only, it costs about 15000 dollars per year but is covered by most insurance companys. including seniors
Fore some people it works right away, for others 3-6 months. This mediaation cures red testical and red penis problems, very few side effects. Google it and disregard the negative comments
Are you still taking Humira? How is your progress
Are you still taking humira? What is your progress?
RSS is (a) not new, (b) not a mysterious “syndrome” (c) not easily treated/cured.
RSS is most likely AZOLE RESISTANT CANDIDA. (Yeast infection) Some candida is multiple drug resistant. Candida can inhabit the gut and the area in question can be re-infected daily so treatment of just the skin may be a losing battle.
A foul odor not attributable to hygiene or bacterial infection may be caused by the same fungi/yeast which cause odor in women with yeast infections.
http://www.medscape.com/viewarticle/861041
MDs with a 12 minute average office visit would prefer not to treat a drug resistant disease. Further, if there is azole resistance, the stronger drugs which could be used have low toxicity levels. MDs would prefer not to Rx toxic drugs which require near daily monitoring.
Several strains of candida exist and Anti fungal susceptibility testing is necessary for treatment:
https://www.uptodate.com/contents/antifungal-susceptibility-testing?source=see_link