An itchy scrotum is typically the result of sweat build-up in the area or prolonged friction of the genital skin on clothing fabric. Experiencing itchiness is usually not associated with a serious health condition, and this symptom tends to resolve on its own with adequate hygiene and underwear changes.
An itchy scrotum that presents with other symptoms, like a rash, bumps, or redness, however, can be a sign of a health condition, such as an infection, a skin disease or an STI.
If the itching does not resolve with normal hygiene, or if you experience other additional symptoms, you should see your doctor for assessment. Avoid trying any home remedies or pharmacy creams without speaking to your doctor first, as the doctor can identify the underlying problem and prescribe the appropriate treatment.
The main causes for an itchy scrotum include:
1. Excessive sweat
Excessive sweat in the genital area is one of the main causes of an itchy scrotum. It is associated with increased itching at the end of the day or after intense exercise.
Inadequate hygiene can lead to sweat build-up, which can contribute to itchiness. Without good, frequent hygiene, the development of fungal infections are also more probable, as fungi thrives in warm and damp areas.
What to do: Ensure thorough cleansing of your genitals and a shower once a day, especially after heavy physical exercise. Itchiness associated with sweat usually resolves after washing.
2. Constant friction
Constant friction is also one of the main causes of an itchy scrotum. This problem is more common in cyclists and runners, as they spend many hours doing repeated leg movements, which ends up causing friction in the area.
What to do: Prevent friction by avoiding prolonged repeated leg movements. If this is unavoidable, you can use a groin guard or jock strap and opt for cotton underwear. Adequate hygiene following exercise is also recommended.
3. Pubic hair removal
Men who remove their pubic hair regularly may feel itchy in the testicular area, especially two to three days after removing the hair. When hair start re-growing and pokes through the epidermis, this can cause a slight discomfort, similar to itchiness.
Overall itchiness usually starts to improve after a few sessions of hair removal, but some men can have persisting itchiness with hair removal (depending on their skin sensitivity).
What to do: To promote even pubic hair growth and decrease itchiness, ensure you use a blade and remove hair in the direction of the hair growth. Moisturizing the genital skin after hair removal can also help decrease post-removal itching.
4. Jock itch
Jock itch, otherwise known as a fungal infection in the groin area, is characterized by the presence of the Tinea cruris fungus. This fungus tends to develop in areas that are warm and damp for prolonged periods of time. This infection occurs frequently in men who do not shower following exercise or who wear underwear made of synthetic fabrics (which do not allow the skin to breathe).
In addition to itching, red blotches or a rash may appear in the genital area. Learn more about the symptoms of jock itch and what can cause it.
What to do: In most cases, adequate genital hygiene will spontaneously resolve the infection and relieve associated symptoms. Cotton-based underwear or other natural fabrics are recommended, as these are more breathable and will prevent the area from getting to warm or moist. In more severe cases of jock itch that do not resolve on their own, you may need to see your doctor. He or she may prescribe a topical antifungal like clotrimazole.
5. Allergic reaction
Just like skin on any part of the body, scrotal skin is also at risk for becoming irritated and swollen from an allergy. The most common cause of a genital allergy is use of underwear made of synthetic materials, such as polyester or elastane. Allergic reaction can also emerge from use of soaps or creams with strong scents or chemicals.
What to do: To avoid allergies in the groin area, you should opt for 100% cotton underwear. If itching does not improve with fabric changes, try using a different body wash or soap in the shower, preferably one without chemicals or other potential skin irritants. In more severe cases that do not resolve on their own, you should consult your doctor. He or she may prescribe a topical corticosteroid to help with symptoms, such as hydrocortisone.
Crabs, also known as pubic lice, are tiny insects that develop in regions of course hair. They can cause intense scrotal itching and red skin. Crabs are often not detectable at the beginning of the infestation, but as time goes on and they begin to multiply, it is usually possible to see little black dots moving within the pubic hairs.
The transmission of public lice is usually through sexual intercourse, and therefore this condition is often considered to be a sexually transmitted infection.
What to do: Remove each insect using fine-tooth comb after having a shower and use an antiparasitic lotion or spray (which can be purchased over-the-counter or prescribed by your doctor).
7. Genital psoriasis
Genital psoriasis is a skin condition that can affect many men who also experience regular psoriasis. Although both conditions can cause itching, genital psoriasis differs, however, as affected skin is often shiny and tight.
The causes of genital psoriasis are not fully known, but it appears to be related to risk factors like a positive family history, obesity, stress and other lifestyle factors (e.g. smoking and drinking alcohol).
What to do: If you notice genital itching with tight, shiny patches of skin along the scrotum, shaft or glans, you should see your family doctor or a dermatologist for assessment. If confirmed, the doctor may prescribe medications to relieve symptoms and speed-up healing, such topical corticosteroids or vitamin D ointments. Patients with moderate to severe symptoms may benefit from more targeted therapies, like biologic medication (e.g. ixekizumab) or systemic medication (e.g. methotrexate).
8. Sexually-transmitted infections
Although this is not as common, itchy testicles can also be a sign of a sexually-transmitted infection (STI). Itchiness is particularly present with herpes or HPV infection. These infections are common after unprotected sexual intercourse, therefore if itchiness persists after sex, you should see a doctor.
What to do: If you suspect you have a sexually-transmitted infection, you should see your doctor for assessment. If a diagnosis is confirmed, treatment will be started promptly to avoid any serious complications. To prevent your risk of getting an STI, ensure you use a condom, especially when having sex with a new partner.