The appearance of black spots on the scrotum may be disturbing, but many of the most common causes are nonthreatening. They may require little or no treatment.
A range of conditions can cause these black spots. See a doctor for professional diagnosis and treatment.
Black spots on the scrotum may be temporary or permanent. Some of the most common causes include;
Dark or ingrown hair follicles
The growth of new hair may appear darker than before after removing hair by waxing or shaving. If a hair in an early stage of growth becomes trapped beneath the skin, the resulting bump may appear as a dark or discolored spot. Ingrown hairs can be tender, swollen and painful.
Pimples and blackheads
These skin conditions are caused by clogged pores or mild infection. They are very common and may appear as dark spots on the scrotum. Most are harmless. They often resolve on their own within a few months with proper hygiene.
Bruises sustained from physical injury can damage small blood vessels, causing blood to pool in the tissues. This causes some areas to be dark, tender skin, known as bruises. Luckily, most bruises clear up within 2 weeks.
This occurs when some areas of skin develop more pigment. This can appear as a variety of skin lesions, such as moles, stretch marks, freckles, sun spots, and age spots.
A research carried out in 2013 observed 400 males between the ages of 3 and 91 who received medical attention for genital lesions. Of these, 85.6 percent of cases involved hyperpigmentation.
Hyperpigmentation lesions are generally harmless, and many have no symptoms beyond discoloration of the skin.
This condition causes small blood vessels to widen, resulting in non-cancerous skin lesions that may be dark red or blue in appearance. These lesions tend to have clear edges. Most are raised in a dome-shape and are abnormally thick. When they appear on the scrotum, they are randomly distributed. If these lesions cause irritation, or if a person scratches them by accident, scaling, crusting, bleeding, and blood blisters can occur.
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Angiokeratoma lesions are usually harmless and have no other symptoms. However, they concern people who mistake them for symptoms of sexually transmitted infections (STIs) or cancer.
Genital warts can form on the genitals, inner thighs, or anywhere in the groin area. They are caused by strains of human papillomavirus (HPV). This warts can appear as white or skin-colored bumps, and some may look like cauliflower. However, others may be dark or have darkened center.
The skin of scrotum is very thin, making it easily irritated and inflamed as a result of exposure to allergens and irritants, especially on a regular basis.
Scratching, itching and chafing of inflamed skin can irritate the small blood vessels close to the skin’s surface. This can lead to bruising or the appearance of other dark spots. Common causes of external genital dermatitis include:
- chemicals in laundry detergents
- clothing dyes
- spermicides and lubricants
- topical antiseptics and antibiotics
- chafing from underwear or protective sports gear
Less common causes
Very rarely, black spots on the scrotum can indicate a severe medical conditions like skin cancer or HIV.
Some tests often used to diagnose black spots on the scrotum include:
- a complete blood count
- a biopsy, which involves taking a sample of skin to study
- tests for liver and kidney function
- an ultrasound of the lower abdomen and genital area may be performed
- screenings for STIs, such as HIV and hepatitis B and C
- an erythrocyte sedimentation rate test, which can indicate the extent of inflammation
Different procedures, medications and home remedies can reduce or get rid of black spots on the scrotum, depending on the cause.
Dark or ingrown hair follicles
There is no medical need to treat dark hair follicles, though some may choose to lighten them for cosmetic purposes. Ingrown hairs can be eliminated by exfoliating. This will remove the top layer of dead skin cells and help to stop hairs from becoming trapped.
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Pimples or blackheads
The best way to treat most pimples and blackheads is to keep the area exfoliated, clean, and dry.
Larger pimples and blackheads may respond well to a warm compress. This will gently encourage blood flow in the area, which can help the bump to burst and resolve.
The application of an ice pack or mild heat to the area may ease bruises. Some over-the-counter creams may also ease inflammation.
In most cases, there is no need to treat areas of hyperpigmentation.
A person may choose to have prominent lesions, such as large or irregular moles, surgically removed, especially if they are causing discomfort.
See a doctor if a mole has irregular borders or grows rapidly, as this can indicate cancer.
Because they are usually harmless, there is usually no need to treat angiokeratoma lesions. A person may have them surgically removed if the location or size causes discomfort, or for cosmetic reasons.
A doctor will often take a biopsy of a lesion to ensure that it is not cancerous, particularly in cases of removal.
Techniques commonly used to remove angiokeratoma lesions include laser therapy and excision or scraping, usually with a scalpel. A person may instead have their lesion frozen off or burned with an electric current.
The best way to treat scrotal dermatitis is to avoid exposure to the allergen or irritant causing the inflammation.
To reduce symptoms, wash the skin gently with mild soap and lukewarm water several times a day. Taking a long bath with Epsom salts or oatmeal may also help.
If the dermatitis is severe or lasting, a doctor may prescribe a steroid cream to reduce itching.
The treatment of genital warts usually depends on the size, extent, and location of lesions, as well as the amount of concern a person may have.
Note that over-the-counter wart treatments are not safe to use on genital warts. There is currently no cure for genital warts, though a person may choose to have them removed.
Common methods of removing genital warts include:
- burning them with a cauterizing device
- freezing them off
- cutting or scraping them away with a scalpel
- applying prescription creams and chemical preparations designed to separate warts from the skin