You've Heard of Cellulitis—But in Your Scrotum?

Skin ailments have an abundance of causes, presentations and levels of severity, from scratches to rashes to infections to necrosis. Cellulitis is perhaps one of the most common skin infections, with an ingrown hair being a frequent cause, leading to redness, swelling, tenderness and pain in the affected area.

Scrotal cellulitis—yes, it's real—presents similar symptoms, as well as skin discoloration and a raised temperature in the area. Additionally, the cellulitic inflammation can expand to the testicles.

Scrotal cellulitis is a particularly sensitive form of the condition. The scrotum is made up of several skin layers, and as you might know, the area is sensitive compared to other parts of the body; scrotal cellulitis is very treatable.

"Rarely does it get better on its own, but a simple antibiotic should treat it in about a week," said Justin Houman, M.D., a urologist and men's health specialist at Tower Urology in Los Angeles.

Direct and indirect scrotal cellulitis

According to Houman, the scrotal version of cellulitis happens in one of two ways.

The first is a direct impact on the scrotum: think shaving too closely, some sort of trauma or exposure to common strains of bacteria that live on our skin. (Relax, we have good and bad bacteria all over us.) Even a simple razor-blade nick can allow bacteria to enter another scrotal layer and begin to cause some of the cellulitic symptoms.

The second is through sexually transmitted infections (STIs) and diseases (STDs), the more indirect route. Houman added that any type of bacterial STI or STD, including gonorrhea and chlamydia, can cause cellulitis.

Untreated cellulitis can lead to serious problems

It's important to seek medical attention at the first signs of cellulitis, according to both Houman and Ariel Moradzadeh, M.D., a men's health and male reproductive urologist at Cedars-Sinai health care in the Los Angeles area.

"You want to make sure that's not growing in size, and cellulitis can progress into a more formative skin infection," Moradzadeh said.

While rare, a skin infection that originates in the scrotum can advance to the lower abdomen and quickly become a condition called Fournier's gangrene. The infection is a progression of the initial cellulitis into a serious, debilitating condition that can present with gas buildup in the abdomen, progressive tissue death and other symptoms. Fournier's can turn life-threatening as it spreads, essentially breaking down portions of the abdominal tissue and causing large areas to lose blood supply. Fournier's has a high mortality rate and requires immediate medical attention.

People with diabetes are most at risk

Some of the circulatory problems caused by diabetes can lead to blood flow issues, which put people with diabetes at a higher risk of developing cellulitis, according to Moradzadeh. He explained that cellulitis not only develops faster due to a decreased immune response and poor wound healing, but can progress quickly to something more serious, such as Fournier's gangrene.

"We need to make sure they're on the most appropriate treatment as quickly as possible," he said.

Common sense to prevent cellulitis

Fortunately, preventing scrotal cellulitis is as simple as using a good dose of carefulness.

Both urologists urged caution for men who engage in regular manscaping, or grooming of the genital area. This doesn't mean you need to stop shaving, but using a light and gentle touch with the razor is a good idea.

"Avoid any large and deep cuts," Houman said.

Also, don't sit in your own sweat for too long after a workout. Sweaty clothes are a ready harbor for bacteria, so get out of your clothes and into the shower as soon as you can.

"Cellulitis is a straightforward issue that arises with some men, and [remember] to keep the scrotal area dry, cool, and don't close-shave," Moradzadeh said.