What is the cause of itchy, cracked and peeling testicles in men?

Itching, cracking, and peeling of the male testicles may be related to scrotal eczema, fungal infection, contact dermatitis, riboflavin deficiency, or psoriasis. Such symptoms are mostly caused by damage to the skin barrier or invasion by pathogens, and require targeted treatment based on the specific cause.

1. Scrotal eczema

Scrotal eczema is an allergic skin inflammation that may be induced by a humid and hot environment and friction and irritation from underwear. It manifests as local erythema, papules, exudation and desquamation. In the chronic phase, skin thickening and cracking can be seen. Treatment requires keeping the perineum dry and clean, and avoiding scratching. You can use hydrocortisone butyrate cream, tacrolimus ointment or compound dexamethasone acetate cream as directed by your doctor. In severe cases, oral loratadine tablets are required.

2. Fungal infection

Infections with Candida or Epidermophyton floccosum are common in patients with diabetes or those with low immunity and are characterized by annular erythema with scaly edges that may cause painful fissures. The diagnosis requires microscopic examination to detect hyphae, and antifungal drugs such as miconazole nitrate cream and bifonazole cream are used for treatment. Mupirocin ointment can be added when there is a bacterial infection.

3. Contact dermatitis

Chemical irritants such as detergents and condom lubricants may cause allergic reactions, manifested as redness, swelling, and blisters with clear borders, and erosion after rupture. It is necessary to stop using allergenic products immediately, apply cold wet compresses with normal saline, and use topical calamine lotion or pimecrolimus cream to relieve symptoms.

4. Riboflavin deficiency

Long-term insufficient intake of vitamin B2 can cause symmetrical erythema, scales and fissures in the scrotum, which may be accompanied by glossitis and angular stomatitis. The diagnosis can be confirmed through serum riboflavin testing, which can be improved by supplementing vitamin B2 tablets and adjusting the diet structure. Eat more animal liver, eggs and green leafy vegetables.

5. Psoriasis

When psoriasis involves the scrotum, it appears as well-defined red plaques covered with silvery white scales that bleed in spots after curettage. It is related to immune abnormalities, and vitamin D3 derivatives such as calcipotriol ointment and tacalcitol ointment are used for treatment. In severe cases, biological agent intervention is required.

You need to choose pure cotton breathable underwear for daily use, avoid prolonged sitting and high temperature environment, do not use alkaline soap when cleaning, and keep the water temperature below 37°C. If symptoms persist for more than two weeks or symptoms such as purulent discharge and fever appear, you should immediately seek medical attention from a dermatologist to rule out malignant lesions. Note that all external medicines need to avoid ulcerated wounds, and those with underlying diseases such as diabetes need to give priority to controlling the primary disease.