Dear Dr G,
I have an embarrassing problem.
I am 25 years old and sexually active. In the past three months, I have been experiencing problem with itchy balls.
On several occasions, my partner caught me scratching my scrotum in public.
She was embarrassed and had threatened to leave me.
Sometimes, in the middle of the night, the itch can be so bad that I scratch it during my sleep. I even woke up noticing bleeding on the skin.
I am so embarrassed to go and see the doctor, as I am worried I may have caught something from my past “mischief”.
I am so sorry to put Dr G on the spot - can you tell me what is the problem with my balls? Should I avoid scratching it?
Can this be a sexually transmitted condition? Can this be cured?
First of all, it is important to clarify that itchy balls technically is not due to the testicles. The blood and sensory supply to the testicle actually derive from the abdomen and the testes themselves should not be itchy.
In fact, rash and itchy problem are commonly caused by the scrotal skin, resulting in skin irritation of the groin, pubic area and the scrotum.
Itchiness affecting the scrotal skin is the result of infective and non-infective causes. The common infection is tinea curis, which is a type of dermatophyte infection, also known as jock itch.
The other type of fungal infection of the groin is candidiasis. This is a yeast infection affecting both men and women, which may result in profuse cheese-like discharge and intense itch.
Both of the fungal infections are common among men with poor hygiene, and occasionally, this may also be an early sign of diabetes.
The non-infectious itch of the scrotum can be caused by eczema.
This is a chronic skin condition presented with marked itchiness, inflammation, redness and swelling.
On the other hand, psoriasis of the groin, is another itchy skin complaint often be mistaken as eczema.
This chronic skin disorder presents as slivery scales. When psoriasis is mixed with the sweat in the groin, the condition is difficult to differentiate from eczema.
The more serious form of the itchy balls with rash can be due to extra-mammary Paget’s disease.
Technically, this is a form of skin cancer affecting the scrotum. Such rash can be itchy and red, affecting the groin and even anus, which mimics eczema.
Generally, if the itchy rash does not respond to treatment, it is advisable for men to get further examination, which may include biopsy of the skin to rule out cancer.
In reality, simple measures of good hygiene will solve the problems of itchy scrotum.
Firstly, daily baths or showering and washing the groin are crucial steps to keep the groin healthy.
Avoiding fragranced soap or bubble bath is equally important.
After cleaning, keeping the groin dry is helpful to prevent the proliferation of fungus. It is also important not to share the towel with anyone, especially in the gym.
More importantly, changing to clean underwear daily will also ensure no fungus retained in the dirty underwear can continue to multiply.
Topical creams such as antifungal or corticosteroid creams are often prescribed by clinicians for the treatment of tinea cruris and eczema.
In the more severe cases, absorbent powders or steroid injections may also be necessary. For men who cannot resist the itch, scratching may itself result in secondary skin infection, and may require antibiotics interventions.
Many men worry about their naughty past causing the itch in their pants.
In reality, the problem is merely a nuisance and is rarely serious.
Consulting a doctor and accepting treatment can relieve the anxiety and embarrassment of itchy balls.
The American songwriter and poet, Ogden Nash once said: “Happiness is having a scratch for every itch!”
When it comes to the itch in your pants, Dr G’s advice is: “Pursue your happiness of ball scratching as much as you want - as long as you restrain of reaching in your pants in front of ladies or in public!”
> The views expressed are entirely the writer's own.