Scrotal Itching and Foreskin Issues: Causes and Solutions - Urology

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Scrotal issues and foreskin problems?


Hello, Director Chen.
I would like to ask about a few conditions:
1.
My scrotum is itchy, and I have scratched it to the point of breaking the skin.
I have used a cooling anti-itch cream twice, but after reading some articles, I am now afraid to use it again.
Currently, there is some discharge that forms crusts, and after scratching, I noticed that my scrotum has become swollen, with the skin feeling thicker than before.
Now, the outer skin of the scrotum feels slightly painful when irritated, but there is no pain inside the scrotum.
The itching sometimes extends to the penis, but it is not constant.
Should I take medication, apply ointment, or will it resolve on its own? What kind of symptoms could this be? Does the itching get worse with scratching? I saw online that it might be scrotal eczema, but I only noticed the itching.
The color of my scrotum seems to be closer to brown than my normal skin tone, and I am unsure if it matches the "brown" described in the articles.
At the time of writing this, the itching has become so intense that I couldn't resist scratching, so I rubbed the skin of my fingertips against the scrotum to relieve the itch without breaking the skin, and even the perineum feels slightly itchy.
2.
Two days after the scrotal itching began, I noticed that the skin at the tip of my foreskin is swollen, and the length of my penis appears slightly shorter when not erect.
After reading articles online, I confirmed that I have phimosis, but I can retract the foreskin behind the glans without discomfort.
I wash my foreskin daily with body wash, but after rinsing, I do not dry it with a towel or tissue before retracting it back over the penis.
Now, I see articles mentioning foreskin edema.
Is this truly foreskin edema? If there is no external trauma or force affecting it, will it resolve on its own? I have a history of surgery from a car accident, and I am really apprehensive about undergoing any more surgeries.
If there are non-surgical options for recovery, I would appreciate your guidance.
Thank you!

wei, 30~39 year old female. Ask Date: 2023/10/14

Dr. Chen Jiansheng reply Urology


Please seek medical attention.

Reply Date: 2023/10/14

More Info


Understanding scrotal itching and foreskin issues can be quite complex, as these symptoms can arise from various underlying conditions. Let's break down the issues you've described and explore potential causes, solutions, and recommendations.


Scrotal Itching
1. Causes of Scrotal Itching:
- Dermatitis: This could be contact dermatitis due to irritation from soaps, detergents, or even sweat. Allergic reactions to certain materials (like latex) can also cause itching.

- Fungal Infections: Conditions like tinea cruris (jock itch) are common and can cause intense itching and irritation in the groin area, including the scrotum.

- Bacterial Infections: Sometimes, bacterial infections can lead to itching and inflammation.

- Eczema or Psoriasis: These skin conditions can also manifest in the genital area, leading to itching and discomfort.

- Hygiene Issues: Inadequate hygiene can lead to the accumulation of sweat and bacteria, causing irritation.

2. Symptoms and Complications:
- The fact that you have scratched the area to the point of breaking the skin can lead to secondary infections. The thickening of the scrotal skin and the presence of discharge may indicate a more serious condition that requires medical attention.

- Itching often leads to a cycle where scratching exacerbates the irritation, leading to more itching—a phenomenon known as the "itch-scratch cycle."
3. Management and Treatment:
- Topical Treatments: Over-the-counter antifungal creams may help if a fungal infection is suspected. However, avoid using any creams that contain steroids without a doctor's guidance, as they can worsen certain conditions.

- Hygiene: Maintain good hygiene by washing the area gently with mild soap and water. Ensure the area is dry after washing, as moisture can worsen fungal infections.

- Avoid Irritants: Identify and avoid any potential irritants, such as certain soaps or fabrics.


Foreskin Issues
1. Phimosis and Swelling:
- Phimosis: This condition occurs when the foreskin cannot be retracted fully over the glans (head of the penis). It can lead to discomfort, especially if there is swelling or inflammation.

- Swelling: The swelling of the foreskin could be due to inflammation, infection, or allergic reactions. If the foreskin is swollen and you are experiencing discomfort, it is essential to consult a healthcare provider.

2. Management:
- Gentle Care: Continue to clean the area gently, but avoid forcing the foreskin back if it causes pain.
- Topical Treatments: If there is inflammation, a healthcare provider may recommend a topical corticosteroid to reduce swelling and allow for easier retraction of the foreskin.

- Consultation: Given your concerns about surgery and the potential for complications, it is crucial to discuss your symptoms with a urologist. They can provide a thorough examination and recommend the best course of action, which may include non-surgical options.


When to Seek Medical Attention
- If you notice increased redness, swelling, or discharge, or if the itching becomes unbearable, it is essential to seek medical attention promptly. A healthcare provider can perform necessary tests to determine the underlying cause and prescribe appropriate treatments.


Conclusion
Scrotal itching and foreskin issues can stem from various causes, and self-diagnosis can often lead to mismanagement. It is advisable to consult a healthcare professional who can provide a proper diagnosis and treatment plan tailored to your specific situation. Avoid self-medicating with over-the-counter products without guidance, especially if you are experiencing significant discomfort or complications.

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