Moles and Pigmentation on the Scrotum: When to Worry?

There are many moles on the scrotum, along with a patch of hyperpigmentation?

Hello Doctor,
1.
I am 25 years old, and since puberty, I have developed many moles on my scrotum and penis.
Although they have not increased much recently, I have had over twenty moles of various sizes over the past ten years.
The moles are quite normal, flat, and their sizes have remained stable without any changes in color.
I understand that the skin in the genital area is prone to developing moles due to melanin deposition, but is it normal for me to have this many?
2.
There is a patch of hyperpigmentation in the middle of my scrotum that extends to the glans, which has been present since puberty.
When I stretch the skin of the scrotum, I notice that the dark brown area can be pulled apart and appears to crack like "age spots" or "tinea," revealing normal skin color underneath.
However, once I release the tension, the dark brown area reverts to a continuous patch.
I have also tried stretching the dark brown skin on the top of my penis, but it does not crack like the scrotum does.
Is the condition of my scrotal skin normal, or could it indicate some abnormal changes? (Additional note: The area becomes particularly itchy when moist, and I have experienced burning sensations there during my military service.) Thank you!

Han, 20~29 year old female. Ask Date: 2012/09/21

Dr. Wu Yuxin reply Dermatology

Your issue is a bit complex, and it's difficult to visualize it just through description.
I recommend that you seek a consultation for a clearer examination.

Reply Date: 2012/09/21

More Info

When it comes to moles and pigmentation on the scrotum, there are several important factors to consider, especially given your age and the history of skin changes you’ve described.
1. Normal Moles vs. Abnormal Changes: It is not uncommon for individuals, especially during puberty and young adulthood, to develop moles (nevi) on various parts of their body, including the genital area. The presence of multiple flat moles that have remained stable in size and color over the years is generally considered normal. However, it is crucial to monitor any changes in these moles. Characteristics that may warrant concern include changes in size, shape, color, or texture, as well as the development of new moles after the age of 30.
2. Pigmentation and Skin Changes: The dark pigmentation you describe in the middle of your scrotum that extends to the glans (head of the penis) could be a result of several factors, including friction, hormonal changes, or simply a normal variant of skin pigmentation. The fact that this pigmentation changes when you stretch the skin suggests that it may be superficial and not indicative of a deeper pathology. However, persistent or changing pigmentation, especially if accompanied by symptoms like itching, should be evaluated by a healthcare professional.

3. Itching and Moisture: The increased itchiness you experience, particularly when the area is moist, could indicate a condition such as intertrigo, which is a rash that occurs in skin folds due to friction and moisture. This can lead to irritation and sometimes secondary infections. If you have a history of skin irritation or burning sensations in that area, it’s advisable to maintain good hygiene, keep the area dry, and consider using a barrier cream to protect the skin.

4. When to Seek Medical Attention: If you notice any of the following, it is essential to consult a dermatologist or healthcare provider:
- Any mole that changes in appearance (size, shape, color).

- New moles that appear after the age of 30.

- Persistent itching, burning, or discomfort in the area.

- Any signs of infection, such as redness, swelling, or discharge.

5. Potential for Skin Conditions: Conditions such as seborrheic keratosis, dermatofibromas, or even benign melanocytic nevi can present similarly to what you describe. However, more serious conditions, including melanoma, can also occur in the genital region, although they are less common. A thorough examination by a healthcare professional is the best way to rule out any serious conditions.

In summary, while the presence of multiple stable moles and pigmentation on the scrotum can be normal, it is crucial to remain vigilant for any changes or symptoms that could indicate a problem. Regular self-examinations and consultations with a healthcare provider can help ensure that any potential issues are addressed promptly. If you have concerns about the appearance of your skin or any associated symptoms, do not hesitate to seek medical advice.

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