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Author: Dr Anthony Hall, Dermatologist, Baycity Dermatology, Melbourne, Australia, 2013.
Male genital dysaesthesia is a form of cutaneous dysaesthesia and describes a sensation of burning, heat, irritation, discomfort or increased sensitivity to touch of the penis, foreskin or scrotum. Some men with genital dysaesthesia also find wearing underpants or sitting down difficult. Symptoms may be very stressful and interrupt sexual function and/or sleep. The affected areas may appear redder than normal.
Genital dysaesthesia does not usually result in itch (the desire to scratch). If itch co-exists with genital dysaesthesia, it may be explained by the development of irritant contact dermatitis due to various applications to the affected area including soap and creams.
Other names for male genital dysaesthesia include:
Both men and women with genital dysaesthesia may experience similar symptoms of burning, irritability or discomfort of their genital region. In women these symptoms are often called vulvodynia, which describes vulval pain in the absence of primary rash.
Most men with genital dysaesthesia are over 60 years of age, fair-skinned and of Caucasian descent (“European”). However, genital dysaesthesia sometimes affects younger or darker-skinned men. They are usually otherwise healthy.
Genital dysaesthesia associated with redness and vascular hyper-reactivity of the scrotum may be associated with rosacea, a common disorder in which facial flushing leads to persistent facial redness.
In many men with genital dysaesthesia, the affected areas appear entirely normal on careful examination. However, findings sometimes include:
The cause or causes of genital dysaesthesia are often difficult to pinpoint.
Chronic genital dysaesthesia is not caused by cancer. But to make sure this is the case, the affected skin, the prostate and the spine should be carefully examined.
Genital dysaesthesia is not due to infection. However, blood tests and skin swabs may be arranged to exclude sexually transmissible diseases (STD), eg genital herpes, which might cause rather similar symptoms.
Factors contributing to genital dysaesthesia may include:
When symptoms and signs are typical, an experienced doctor may make the diagnosis of genital dysaesthesia without requiring special tests. However sometimes the following investigations are arranged.
Many men are relieved to have their symptoms explained when given the diagnosis of male genital dysaesthesia.
Many treatments may have already been tried before the correct diagnosis is made. Unfortunately, no treatment works all the time, every time.
General measures for an oversensitive genital area may include:
Specific prescription treatments reported to be of benefit include:
Male genital dysaesthesia is a frustrating disease to live with, and can be very persistent. It can result in great distress, embarrassment and fear. Many treatments have often been recommended and tried with limited or no success. Yet sometimes, it settles down and completely resolves in time.
Medical science continues to look for better treatments.
Merhi, Ribal et al. Carvedilol for the treatment of red scrotum syndrome. JAAD Case Reports 2017; 3: 464–466. Journal.
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