Red Scrotum Syndrome

Red scrotum syndrome is a chronic disease of unknown cause characterized by persistent redness of the scrotum in association with pain, itching and burning sensation. It usually affects males in their second half of their life. Red scrotum syndrome (RSS) can develop after prolonged application of topical corticosteroids to the scrotal area like in the red face syndrome. However, in majority of cases there may not be history of corticosteroid use.

Other factors that are thought to contribute or co-exist with red scrotum syndrome include sexually transmitted diseases, fungal infections, bacterial infection and few other skin conditions.

A person with RSS may have difficulties sitting as it aggravates the pain. The patients may need to sit forward, allowing the scrotum to hang down past the seat edge. RSS involves the scrotum and sometimes base of penis. Scrotum may look bright red in color and associated with itching, pain and burning sensation. Although itching can be experience in almost all people, major problem is neurological pain and burning.

To exclude other disease fungal testing, patch testing, some blood works and biopsy may be needed.

Several treatments both topical and oral have been tried with not much success. Recently it has been suggested that oral doxycycline has good response in RSS with satisfactory improvement after 2 weeks of starting therapy and marked or sometimes comlete improvement after 3-4 months of therapy. If doxycycline fails oral gabapentine is another option.

As some experts believe that it might also be influenced by stress, anxiety and depression, so using some relaxation techniques and may be self hypnosis could work on some individuals.

Reference:

  1. Wollina U. Red scrotum syndrome. J Dermatol Case Rep. 2011 Sep 21;5(3):38-41. Red Scrotum Free Open Access
  2. Abbas O, Kibbi AG, Chedraoui A, Ghosn S. Red scrotum syndrome: successful treatment with oral doxycycline.J Dermatolog Treat. 2008;19(6):1-2

Comments

  1. Just need to tell you how I have solved my long standing RSS problem.You name it and I have tried it.Then quite by accident,when treating a muscle ache,I discovered that my infra red lamp absolutely relieves the problem.Now after several months I just need a short treatment possibly daily,and I have my life back.Hope this message might help some other sufferer out there.It is well worth a try.Good luck!

  2. Thank you Darrel for your updates, lets hope it gets better and better…

  3. I currently an trying a last resort recommended by my dermatologist. Using capsaicin creame applied 3 times daily plus doxycycline . The idea is to depleat the substance P in the nerve ending so the burning itching sensations is gone. Very painfull hoping it works.

  4. I have had red scrotum for 2yrs i have had this and that you name it test after test ..and i did use doxycycline for 7 mths and all kinds of creams . then i noticed in the morning i did not have all the redness .so that told me something else was going on. I told doctor now im on gabapentine 300mg . 3 times a day it has done a very good jog but time to time it comes back and my back hurts .THE DOCTOR SAY ITS NERVE IN MY BACK DOING ALL OF MY RED SCROTUM.. this may help you all

  5. been trying multiple MD remedies but nothing seems to work. Trying Amitriptyline now, which has shown to reduce nerve related issues like burning mouth syndrome. So far its not working for RSS. Going to go to neurologist to see if its something related to lower back/nerve pain. So far, only thing that works is something I created on my own: pure coconut oil and aloe vera, which have made it much better.

  6. john mensch says:

    I have been a victim of RSS for 3 three yrs and have tried everything. So far the only treatment I use is cold water and mild derm soap. TDhe biggest wild card was the use of greek yogurt(plain). It, smoothed on does stopl itching on contact…but alas eventually it fails as a cure and HELL returns.

    I followed the Protopic, doxyycyclene route for 4 months (no success) and two series of prednisone(failed two and reaised blood sugar. I didn’t get to the final bout of gabapentin. Has anyone been cured of RSS using gabapentin?? And if so, How long do u take the pills? They have BAD sideffects

  7. I have been dealing with RSS for several years, but didn’t realize what it was. I had prostrate surgery, and then a male sling installed. I thought ist was irritation because of minor leakage and wearing a pad. But now that I have had a second sling installed and have zero leakage I realize that was never the cause. Doctor says it was caused by the sling surgery which damaged the nerves in the area of the scrotum. So far have tried pimecrolimus cream and doxyctcline 50mg. No better. Any ideas appreciated, as I am up every night with burning and itching, ant sleep

  8. I have had this problem now for over 4 years – tried everything even those mentioned in this article with no luck – Have been to several doctors and they are just lost………..

  9. Hey everyone.
    I had RSS for one year, recently saw much improvement to a level that I can say i dont really have any problems at all right now.. just wanted to share what I did so maybe some of you can start feeling better. It’s a list of different things i picked up from different parts of the internet and a lot of different forums over this year of searching for a cure. Perhaps not all are needed but I suggest you take 3 weeks and follow this plan closely.
    1.Stop drinking alcohol
    2.Stop eating sugar
    3. After washing your underwear in the machine, fold and stack and put them into the microwave for five minutes on high. then hang to dry. do this every time you wash your clothes until problem goes away. It kills any bacteria in your underwear.
    4. Shave your testicles with a shaving razor ( to take off the top layer of skin – immediately follow by step number five ( and just to warn you apple cider vinegar on freshly shaved balls hurts …ALOT)
    5.for 5-10 minutes every-night sit yourself pants down in front of infrared light (I used a thermal 150w light, make sure the light is about 70 cm away if you are using a thermal light cause you can burn your balls!) then when balls are warm rub apple cider vinegar all around your the affected area.
    6..In the morning take a warm shower and immediately on getting out, while your balls are still warm and your pores are still open rub apple cider vinegar again
    I suggest you start this process with the light and vinegar after at least 2 weeks of no alcohol and no sugar for best result.

    Good luck everyone!

  10. What seems to help is a warm shower and putting epsom salts directly on scrotum and let soak for a couple of minutes. After use nizoral shampoo on area, let stand for a couple of minutes then dab not wipe off.

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