What causes itchy scrotum with white flakes, and what should be done about it?

Generally, itching of the scrotum accompanied by white flakes may result from inadequate hygiene, environmental irritation, scrotal eczema, scrotal dermatitis, or tinea cruris (jock itch). Appropriate improvements can be made through general care or medical treatments depending on the specific cause. Detailed analysis is as follows:

1. Poor Hygiene

Accumulation of sweat, sebum, and residual urine can promote bacterial growth and irritate the skin, leading to keratin layer shedding, flaking, and itching. Wash the scrotal area daily with warm water, wear loose and breathable underwear, and change it promptly to keep the area dry.

2. Environmental Irritation

Prolonged exposure to damp and hot environments, or contact with synthetic fiber underwear and irritating shower gels, can damage the skin barrier of the scrotum, causing itching and flaking. Avoid humid conditions, wear cotton underwear, and switch to mild, non-irritating cleansing products.

3. Scrotal Eczema

An abnormal immune response or allergic reaction triggers inflammation of the scrotal skin, resulting in congestion, swelling, and peeling of the epidermis, which leads to flaking and significant itching. Under medical guidance, topical corticosteroid creams such as hydrocortisone butyrate cream or desonide cream may be applied, along with oral antihistamines like ebastine tablets. Avoid scratching the affected area.

4. Scrotal Dermatitis (Bacterial Infection)

Bacterial infection causes inflammation of the scrotal skin, disrupting normal skin metabolism and resulting in symptoms such as itching, redness, and white flakes. As prescribed by a doctor, topical antibiotics such as mupirocin ointment or fusidic acid cream may be used, along with oral cephalosporins like cefuroxime axetil tablets. Maintain cleanliness and dryness of the scrotal area.

5. Tinea Cruris (Jock Itch)

Fungal infection affecting the scrotum and surrounding skin; fungal hyphae invade the stratum corneum, causing inflammatory reactions characterized by ring-shaped red patches, itching, and scaling. Under medical supervision, topical antifungals such as terbinafine hydrochloride cream or bifonazole cream can be applied, together with oral antifungal agents like itraconazole capsules. Avoid sharing personal items with others.

Maintaining good scrotal hygiene, wearing comfortable and breathable clothing, and avoiding known irritants are essential in daily life. If symptoms persist or worsen, seek timely medical evaluation for accurate diagnosis and follow prescribed treatment regimens. Do not self-medicate, as this may delay proper management of the condition.