First of all,i have to tell you that in reality the area is a lot more red,i dont know why it looks less red in the pictures,but keep this in mind please.
So,the first time my scrotum became red and itchy was like 2 months ago. i don't know if they are related,but i had balanitis for about 3 years now. i have used many creams but it just seems like it will never go away,and i am now ok with that. but when my scrotum became itchy,my penis foreskin did too,which i find very weird( the penis foreskin stopped itching ever since though).
In the first two weeks i have tried to deal with this red scrotum myself,by applying coconut oil and wearing no underwear while i was at home,and it kinda worked for a while,my balls were looking better. i went to a dermatologist eventually and he said that the redness might be from my overuse of creams,he didnt specify if it was from overuse of creams for my penis head but i hope thats what he meant,cause i have never used any creams on my scrotum until recently. he suggested a harmless cream for extremely dry skin,which i guess it helped me(still not sure if it was really the cream or my coconut treatment) cause after some days the itching was gone and the redness was at a minimum(still not gone completely). unfortunately,after a while the redness and itchiness came back,i have used that cream for dry skin but it didnt work...... he said its not a fungal infection,but i wonder why it came back. he also said he is afraid to give me cortisone cause its just too risky. any suggestions please?
also, when my balls were not red anymore,the skin was more firm…now when they are red the balls are more saggy
Marian, my comment would be that there is no such thing as a ‘harmless cream’ as all of them have a chemical basis - when you have had conditions of the genitalia for 3 years+ the only safe thing to use on the area is water. In practical terms this means certainly not applying any creams or other treatments.
The problem issue is when you wash or shower or take a bath, you need to keep soaps and ALL forms of body wash such as shower gel away from your entire groin region.
Just as important is keeping the area dry: to start with you should only be using a clean dry towel that ONLY YOU use, when you have spent some time rinsing your groin region with warm running water at the end of a shower you need to carefully fully dry the entire groin region. Most men, eager to get on with the rest of the day probably give little regard to the process, but ensuring the entire area is fully dried is of critical importance.
On reading the symptoms you describe reminded me of an article I recently had read on an online version of a Professional Medical journal - I am going to post the full detail of that below, however, I am in no way suggesting what you actually have, my suggestion would be to find a Dermatologist that deals with Genital Skin Disorders so that the long-standing issues you have had can be properly dealt with, and hopefully cured.
The article highlights one particular condition and also provides detail of the various conditions medical professionals try to pin-point and treat:
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This is the way seborrheic dermatitis (SD) acts: It sits around for years, causing minor problems in common areas (eg, face, scalp, ears, and beard). Then the stress of life intrudes, the candle is being burnt from both ends, and SD blossoms, appearing in places such as the chest, groin, suprapubic area, axillae, and genitals.
On the genitals, SD is often bright red, with little if any scale. Why? The moisture and friction particular to the genital and intertriginous (skin on skin) areas prevent scale from accumulating.
Penile rashes generally get everyone’s attention, including that of the patient’s sexual partner(s). For the average nonclinician, the list of possible explanations is infinite—and worrisome. The situation is, in some ways, worse for the average primary care provider, who will almost always decree such a rash a “yeast infection” (though it seldom responds to anti-yeast medications—for good reason: Otherwise healthy circumcised men almost never develop yeast infections anywhere, let alone on the penis).
If you remove “yeast” from the differential, the average primary care provider will be lost. An abbreviated differential list for penile rashes and conditions includes:
• Psoriasis
• Seborrhea
• Contact vs irritant dermatitis
• Eczema/lichen simplex chronicus
• Lichen sclerosis et atrophicus (traditionally termed balanitis xerotica obliterans or BXO when it occurs on the penis)
• Lichen planus
• Reiter syndrome
• Scabies
• Erythroplasia of Queyrat (superficial squamous cell carcinoma)
• Melanoma
• Herpes simplex
• Molluscum
• Pearly penile papules
• Tyson’s glands (prominent pilosebaceous glands on the penile shaft)
• Angiokeratoma of Fordyce
• Condyloma accuminata
• Primary syphilis chancre
• Fixed-drug eruption
(Note that while yeast is not on this list, it certainly could be considered in an uncircumcised hyperglycemic patient.)
The top five items on the list would cover 90% of patients with penile rashes. Seborrheic dermatitis is utterly common but only rarely recognized when it occurs in unusual areas (as in this case).
For this patient, I prescribed topical hydrocortisone 2.5% cream (to be applied bid to all affected areas) and advised him to shampoo the areas daily with ketoconazole-containing shampoo. But the main thing I did for him, and his wife, was provide peace of mind about all the terrible conditions he didn’t have. With treatment, his penile lesions resolved within two weeks.
TAKE-HOME LEARNING POINTS
• Seborrheic dermatitis (SD) is common in the scalp, on the face, and in the ears, but it can also appear on the chest, axillae, or genitals.
• Yeast infections are quite uncommon in otherwise healthy men.
• Stress is often a triggering factor with worsening SD.
• Asking about and finding corroborative areas of involvement (face, ears, brows, scalp) can help in diagnosing atypical cases of SD.