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.
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.
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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