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Know what’s worse than having an intense itch that you just can’t reach? Having an itch that you absolutely could reach — but it’s on your penis and you’re at work, and you might get fired for doing so. (Unless you happen to be a professional baseball player, in which case it’s apparently encouraged.)
Skin irritations on the penis therefore present perils that more safe-for-work skin versions don’t, which is one reason it can feel extra urgent to identify the cause and move on quickly to treatment.
Eczema is one common cause of penile skin irritation, but given the neighborhood of the body we’re talking about, there are other causes to rule out as well — particularly those related to sexually transmitted infections.
So pull out your junk (in private, of course!) and read on to decipher what it’s trying to tell you.
Eczema is often not used as a very specific term. Formally, it refers to a condition called atopic dermatitis. But in casual use it often refers to several related conditions that can cause skin irritation symptoms such as:
- roughness or scaliness
- fluid-filled bumps
- oozing fluid that can crust over
Individual conditions in the eczema family that can affect the penis include:
Atopic dermatitis: The qualifier “atopic” means this form of eczema can occur even on skin that hasn’t come into contact with an external allergen. This form of eczema is most common in young children, but can also occur into adulthood.
Contact dermatitis: As opposed to atopic dermatitis, contact dermatitis is caused by contact with an external irritant or allergen. Thus, contact dermatitis can be divided into:
- Irritant contact dermatitis. The most common of the two, irritant contact dermatitis happens from skin exposure to a harsh chemical, heat, friction, or even water. Symptoms show up quickly after contact, and they normally don’t spread far beyond the contact site.
- Allergic contact dermatitis. This form is caused by contact with an allergen such as metals containing nickel or cobalt, chromium salts in paint or leather, fragrances found in cosmetics or food, formaldehyde, and antibacterial ointments. It can take up to 4 days to appear following contact with the allergen.
Could it be an STI?
Contact dermatitis isn’t the only way your penis can react badly to a brush with a foreign object — yes, it’s time to talk about sexually transmitted infections.
Hopefully, you and everyone your penis contacts, knows and follows the basics of safe sex. But sex is never completely free of risk. STIs can happen even to the best of us, so it’s good to know how to identify symptoms of common STIs and how they differ from eczema.
While eczema and contact dermatitis merely affect the skin, skin issues caused by an STI are often accompanied by additional symptoms that go beyond the skin.
For example, while genital herpes and syphilis can produce itchiness, bumps, and discoloration on skin around the penis, they may also involve flu-like symptoms such as headache, fever, achiness, and even swollen lymph nodes in the groin.
Another key difference between STIs and eczema is that STIs are by their very nature communicable (passed from person to person), while eczema is not contagious.
The exact cause of atopic dermatitis is unknown. But it’s believed that both genetics and environmental triggers are behind most cases.
Potential genetic factors include:
- An overactive immune system. When the body detects an infectious threat, white blood cells trigger an inflammation response to protect the body’s cells. In some people, their immune system is “wired” differently and is overactive in some parts, resulting in eczema symptoms.
- Gene mutation. There’s a gene in our bodies that creates a protein called filaggrin, which creates a protective barrier on the skin’s surface that keeps moisture in and protects the skin from marauding pathogens and other harmful substances. Among those with eczema, some have a mutation to this gene that reduces filaggrin production — making skin drier and more prone to harm from environmental triggers like those listed below.
Environmental factors that can trigger irritant or allergic contact dermatitis include:
Some environmental causes of irritant contact dermatitis:
- soaps and cleaning solutions
- prolonged water exposure (yes water can be an irritant!)
Some environmental causes of allergic contact dermatitis:
- fragrances found in cosmetics
- antibiotic ointments like bacitracin and neomycin
- formaldehyde — found in household cleaners, adhesives (all good things to keep well away from your penis, anyway)
- soaps and cleaning solutions
- certain metals, especially nickel and cobalt (double-check the metal composition of that Prince Albert)
- isothiazolinones (antibiotic chemicals found in baby wipes and other disinfectants)
- cocamidopropyl betaine (found in some *ahem* lotions, as well as in hair care products)
- paraphenylene-diamine (found in leather dyes and temporary tattoos)
Again, if it’s eczema or contact dermatitis, there’s no need to worry about contracting or transmitting it. Once you’ve ruled out an STI as the cause of your penile skin symptoms, you can be assured that it’s safe to play.
However, bear in mind that eczema symptoms, especially when aggravated by excessive itching, can open up the skin and allow easier transmission of any other infection that you or your partner may have.
Here are some home remedies you can try as a first line of defense for mild eczema or contact dermatitis symptoms, on the penis and beyond.
- Bathing in warm water. That’s warm water, not hot! (Hot water can make symptoms worse.) Follow up immediately with a cream or ointment (like Vaseline) to lock moisture in — the National Eczema Association recommends doing this within 3 minutes of bathing.
- Colloidal oatmeal. Available in creams and bath mixtures, colloidal oatmeal helps maintain a moisture barrier on the skin’s surface and can be effective at reducing discomfort.
- Aloe vera gel. Not just for sunburns, aloe vera gel gives a soothing, cooling sensation to irritated skin too.
- Coconut oil. A 2010 study found that virgin coconut oil has anti-inflammatory properties, which may help soothe your eczema or contact dermatitis symptoms.
If contact dermatitis is suspected, identification and avoidance of the allergen (like an allergy to condoms) is key.
Be mindful not to have penetrative sex with a partner after applying topical treatments, as some may be unsafe for internal use — that’s just good manners.
Eczema is a personal thing, and this goes double for the penile variety. In addition to the fact that the visible signs of eczema may look differently from person to person, not many people have a passing familiarity with what penis eczema looks like.
If you’re experiencing any of the telltale signs of atopic or contact dermatitis listed earlier in this article, it’s a good idea to get checked by a doctor.
Doctors — especially dermatologists — are trained to identify these conditions and to differentiate them from various other conditions. They can generally diagnose atopic dermatitis with visual examination and a patient’s history.
They may also perform a patch test to rule out allergic contact dermatitis. It’s good to know your family medical history before visiting the doctor, as this information may help with diagnosis.
A doctor can hook you up with a variety of clinical treatments for what ails your skin. If you have atopic dermatitis, some of the treatments a doctor may recommend include:
- Topical medicines such as:
- Skin barrier creams. These form a physical barrier on the skin to lock in moisture and repair the skin, lasting for several hours before they need to be reapplied.
- Corticosteroid creams. Corticosteroids are applied to the skin to reduce inflammation and calm irritation. Mild versions are available over the counter, but stronger versions are available by prescription only.
- Calcineurin inhibitors. These fight inflammation by a different mechanism than steroids but with a better safety profile when used in areas with thin skin, such as the penis.
- PDE4 inhibitors. Phosphodiesterase-4, or PDE4, is an enzyme also plays a role in generating inflammation as part of the immune response. Topical PDE4 inhibitors can help calm inflammation.
- Phototherapy. Skin is exposed to narrow-band ultraviolet B light, which helps to reduce inflammation.
- Immunosuppressants. This class of drugs includes azathioprine (oral), cyclosporine (oral), and methotrexate (oral). They’re not approved by the FDA to treat eczema, but they’re sometimes prescribed “off-label” for that purpose. They’re intended to reduce itchiness in order to break the urge to scratch so that skin can heal.
- Biologic. If you’ve ever watched television for more than 5 consecutive minutes, you’ve heard of these drugs — but you may not know what they are. Basically, they’re a specific protein usually delivered via an injection that target and block certain parts of the immune system in the body. It calms an overactive immune response and reduces inflammation and irritation. Dupixent is currently the only FDA approved biologic medication for atopic dermatitis ages 12 years and up.
Having dry, cracked, or bleeding skin means your skin barrier won’t be as effective at keeping the bad things out as it would otherwise be. This means there’s an increased likelihood of skin infections from bacteria and viruses.
Two of the most common comorbid infections for those with eczema are staph infections and herpes, in the form of eczema herpeticum.
Staph is the most common skin infection for those with eczema, and its symptoms include:
- Boils. Also known as “furuncles,” boils are swollen, painful, pus-filled bumps on the skin caused by infected hair follicles.
- Impetigo. Impetigo is characterized by red sores that usually appear on the face, hands, or feet.
- Cellulitis. Cellulitis is an infection that makes skin red, swollen, painful, and warm to the touch. It’s potentially very serious if left untreated, as it can spread into the bloodstream and become life-threatening.
Eczema herpeticum is an unfortunate possibility when a person has both eczema and herpes (either herpes simplex virus 1 or 2). Its symptoms can include:
- clusters of itchy, painful small erosions or pus bumps that are red, purple, or black in color (and may ooze pus)
- swollen lymph glands
Like cellulitis, eczema herpeticum is dangerous, especially if it’s all over the skin.
Exposure to herpes is therefore a particular concern for those with eczema on the penis who are sexually active, as genital herpes is quite common in the U.S. — according to the CDC, over 1 in 6 of those aged 14 to 49 carry the virus.
There’s no guarantee against herpes even if you’re wearing a condom, as herpes is spread by skin-to-skin contact, and only the skin underneath the condom is protected. The virus can be spread even if no visible herpes sores are present.
Other comorbid conditions that can affect those with eczema include:
- hay fever
- food allergies
Eczema flare-ups may usually last a few days and then gradually clear up with proper treatment and skin care, but their duration can be hard to predict.
There may be periods of remission that last for weeks or months, and it isn’t always clear what causes relapse. But there are some precautions you can take to help prevent or calm a flare-up.
Moisturize(!). Apply a gentle, eczema-formulated moisturizer to your penis as needed, and always after showering or bathing.
Wear gentle, breathable underpants. Even without eczema, there’s nothing pleasant about scratchy fabric rubbing your parts or underpants that turn the whole region into a swamp; these factors can irritate skin and aggravate eczema.
If your skin symptoms are caused by contact dermatitis, the most essential prevention is:
Trigger management. If you’re aware of particular irritants or allergens that cause a skin reaction, avoid them if at all possible. Your doctor or an allergist can help identify such environmental triggers so you can stay one step ahead of trouble.
Eczema and eczema-like rashes like contact dermatitis on the penis can feel painful and embarrassing, but rest assured that it happens and there are plenty of treatment options to loosen its grip on your life (and penis).
Once you’ve ruled out other possible conditions and obtained a diagnosis, you’ve taken a major step toward a more comfortable future. With the variety of treatment options available, relief is possible!