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David Hoskings Pharmacy (compounding chemist)

Treating ultra sensitive red skin on the scrotum (Scrotodynia) - "old man balls"


QUESTION - Treating ultra sensitive hard red skin on the scrotum (Scrotodynia) - "old man balls"

Hello David, I am in middle twenties and over the past few months I have been having some issues with my groin/genital area (pubic region). Earlier in the year I had unprotected sex, but all STD testing has come back negative.

A week or so after that I trimmed my pubic region with an electric trimmer, so I could clearly see what was happening to the skin in the area. Within a few days I started having burning sensations between my legs and I immediately thought it was nothing more than razor burn and/or dry skin. It has never really itched like a bug bite or anything.

These burning sensations were significantly worse while working, standing up/walking around wearing jeans, and would go away the moment I sat down and spread my legs. About a month later, I started putting lotion on my scrotum and between my legs to help with the burn. I did this for 2-3 days and the burning finally stopped. Towards the end of the month I noticed that my scrotum began to turn blood red and get very thick and hard.

My scrotum wouldn't sag at all, even in a hot shower, and was a solid red color. Only my scrotum was this color and there were very distinct lines/ boundaries as to where the red color stopped and started. I saw a Dr. who told me to use Cetaphil after a shower, hydrocortisone an hour later and then Lotrimin AF at night - just to cover all the bases.

While this provided some relief from the burning while working, my scrotum still remained red and hard. I saw a dermatologist the next week and explained to him the burning sensation between the legs, the redness and how I had unprotected sex and trimmed. He took one look at my scrotum and described it as "old man balls" and said something had caused my nerves to be over-stimulated.

The skin around my scrotum is so thin that if it becomes overly irritated the body retracts the skin and makes it hard to protect itself. Why did my body do this? I thought that maybe since I cut myself several times while shaving I either had a bacterial or fungal issue or my scrotum was just reacting to being cut several times. My derm said he didn't know, but he prescribed me a steroid cream, Triamcinolone 0.1%, told me to stop using the other creams and he wanted me to keep that area hydrated. He tried to explain that the burning between my legs was from friction and once my nerves were calm, things would settle down.

Well, after the first application of the steroid cream I noticed my scrotum was flesh-colored again. I was very excited! I followed his regimen for 2 weeks before stopping the steroid cream. Yes, my nerves calmed down and my scrotum would sag like normal, but my scrotum was still red. It looked more like an irritated/dry skin red more than anything.

Since being off the steroid cream I've been using Cetaphil gentle cleansing bar in the shower and applying Aquaphor at night. My derm told me it can take months for the scrotal skin to go back to normal and I need to keep it hydrated. Well, it's the summer time now and I've been having issues with burning and sweating in my groin area. The red color of my scrotum comes and goes during the day and at night. It burns off and on throughout the day and I'm tired of it.

I'm afraid I'll be stuck with this issue for the rest of my life and I don't want to go through the traditional trial and error attempt with creams and pills to resolve this issue. I don't know if what I have is Red Scrotal Syndrome and I'm honestly scared because I don't know what's going on with my scrotum.

Both my derm and my doctor refuse to take a culture of or do a biopsy on my scrotum and inform me that "redness on the scrotum is normal, and there are no signs of bacterial or fungal infection. I appreciate you taking the time to read, and hopefully respond to this, and any advice you may have for me is greatly appreciated.

ANSWER - Treating ultra sensitive hard red skin on the scrotum (Scrotodynia) - "old man balls"

This is a fairly common problem and what you have been told about the nerves becoming hypersensitive is true.

It doesn't help solve the problem though. Occasionally people do get results with cortisone creams but more often than NOT the results are not lasting.

I make a Psorexederm cream which I have found to be quite successful at curing the problem. One of the first things it does is remove the discomfort and I guess that is part of the reason it works well as it gives the nerves time to desensitize.

The drawbacks to the treatment is it probably takes about 10 minutes (5 in the morning and 5 at night) to apply and it is a thick whitish cream so a bit messy.

I will tell you how to simply deal with all that but it does require a commitment of AT LEAST 1 month to get reasonable results and occasionally you may find you need to use it for 2 months. ( if you forget to use it for the odd day that isn't a problem either)

As a guide, 1 person in 5 finds it doesn't work. I give a money back guarantee so at least it's worth a try. Of the 4 successes out of 5, 1 person who plays a lot of sport, or swims or surfs and generally gets a lot of moisture in the area will need a second jar to completely fix the problem.

The treatment is very soothing. you apply the cream fairly thickly morning and night. To avoid getting cream on your clothes buy some women's pantyliners in the supermarket. Any sort will do and the ones that say they have "wings" are wider and the best to use. They are a thin absorbent pad with a peel off strip that has an adhesive back so you just stick them in the front of your underwear to prevent soiling the clothes.

This sounds complicated but is actually really simple. You can't see them through your clothes and they are not uncomfortable.

Providing you have the time to apply the cream thickly with the liners twice a day you should be getting good results within 2 weeks. Expect less redness and relief of any soreness or itch.

You should have at least 50% improvement after 3 weeks. Some people find a 250g jar is enough to clear the problem. Occasionally some people need 2 jars. Of course, if there is no improvement with the first jar I am happy to refund your money.

You will need a 250g jar to do the treatment properly. When washing the area use a mild skin wash such as Cetaphil. It is not necessary to wash all the cream off. Just wash and dry the area and reapply the Psorexederm cream.

It is interesting to know that the painful/ burning of the condition is sometimes called Scrotodynia. As an embryo forms the scrotum in men and the vulva/vaginal area in women are formed from the same tissue. Hormones just make the final form different. Women get a similar thing called Vulvodynia, which we also have a treatment for.

I have had good success treating both problems in the same way.

The Psorexederm cream is very soothing and should not sting unless on raw areas and even then only the first application. I hope this helps,
Please feel free to contact me if you need more info.
Kind Regards,
David Hosking. August 2011


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