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Hidradenitis suppurativa (HS) is an inflammatory skin disease that can affect any part of the body with apocrine (sweat) glands. Because the penis and scrotum contain apocrine glands, it’s possible for men and people assigned male at birth to develop HS symptoms in this location.
Having HS symptoms in a sensitive area of your body can feel embarrassing. It’s important to know you’re not alone. Continue reading to learn more about the symptoms and treatment of HS on the penis and scrotum.
It’s difficult to know exactly how often HS affects the penis and scrotum because it’s often underreported by people with the condition. Most reports of HS on the penis and scrotum are case reports (a detailed report based on an individual case). Case reports may be used to help identify rare forms of a disease.
HS often develops in areas where the skin rubs together. The groin, which includes the penis and the scrotum, is one of the most common parts of the body affected by HS. However, according to Mayo Clinic, fewer men have HS compared to women, so HS on the penis and scrotum may not be as commonly reported.
The symptoms of penile and scrotal HS are similar to HS in other parts of the body, including:
You may have HS nodules on other parts of your body at the same time, such as the armpits, buttocks, and the perineum (the area between the anus and scrotum).
Some people may not seek treatment for HS on their genitals because they’re embarrassed. However, it’s important to understand that if left untreated, HS on the penis and scrotum can continue to progress and cause serious complications and chronic (long-term) pain. Early recognition and treatment of HS may help reduce the likelihood of experiencing severe complications of HS.
Without treatment, HS nodules may become infected, causing more pain and tissue damage. If HS nodules or the scar tissue interfere with the drainage of lymph fluid, it can cause genital swelling due to lymph node swelling (lymphedema). Rarely, unusual tissue growth or enlargement of the affected area related to HS can make it difficult to walk.
When the nodules heal, they can leave behind scar tissue. The scar tissue may be stiffer than healthy tissue (called a contracture). Contractures can restrict movement and may contribute to sexual dysfunction, erectile dysfunction, and difficulty using the bathroom.
The pain and complications associated with HS can also affect your mental health and quality of life.
Healthcare providers typically diagnose HS based on your symptoms, how the lesions look, and your medical history. HS is typically diagnosed by a dermatologist, a healthcare provider who specializes in diagnosing and treating skin conditions. A specialist in the urinary tract, called a urologist, may also be involved in the diagnosis and treatment when HS affects the penis and scrotum.
There aren’t any laboratory tests to check for HS. Some tests may help rule out other conditions with similar symptoms, such as an infection or another skin disease. A skin biopsy, which involves examining a tissue sample from the affected area under a microscope, can help confirm that HS is the cause of a lump.
The best HS treatment for you depends on the severity of your symptoms. The Hurley staging system is the most common method to assess the severity of HS. There are three Hurley stages, from stage 1 to stage 3. Stage 1 indicates mild disease. Moderate disease is classified as stage 2, while stage 3 indicates severe disease.
You may need a combination of treatments to help reduce your symptoms.
Topical treatments are treatments applied directly on the skin. They can be used to treat HS on the penis and scrotum. However, the skin on the penis and scrotum is delicate, so treatments must take this into account. The skin on the penis and scrotum is thinner than in other parts of the body. That means that medications applied to this skin may be more likely to cause side effects.
Topical treatments can be used alone for mild symptoms or in combination with other treatments for more severe symptoms. Topical treatments may include antibacterial skin cleansers and topical antibiotics. In some cases, healthcare providers can inject an anti-inflammatory corticosteroid medication directly into an HS lesion to improve inflammation.
Systemic treatments are therapies that affect the whole body. People with Hurley stage 2 or stage 3 HS may need systemic treatments in addition to topical treatments to control their symptoms. There are many systemic treatment options, including:
Surgical treatment of HS may be needed for people with moderate to severe cases of HS. A surgical approach to HS treatment is typically considered for people who don’t respond to topical or systemic treatments. You’ll likely need to consult with a urologist or plastic surgeon before having surgery that involves the penis and scrotum.
Incision and drainage of HS lesions typically only provide temporary pain relief and can result in scarring. Recommended surgical treatments for HS may include:
Self-care measures can work along with other treatments to help improve your symptoms.
Adding healthy lifestyle habits may help you manage HS. Examples of healthy lifestyle habits for HS include eating a healthy diet, exercising, and not smoking.
It’s important to follow your healthcare provider’s instructions for how to clean and dress your wound. However, bandaging the groin can be difficult. Feminine hygiene pads are a cheap and absorbent option for bandaging the groin. One myHSteam member had a unique suggestion: “Bed/table liners, like they use in hospitals, along with paper towels — this has allowed me to stay dry as well as keeps from embarrassing leaking, which used to happen all the time.”
Follow up with your healthcare provider for specific instructions for how to best care for your wound.
It’s thought that HS develops due to tiny tears in the skin that occur from the skin rubbing together or against another material. Comfortable underwear may help.
“I love bamboo fabric!” shared one myHSteam member. “I stick with breathable cotton ‘tighty whities,’ either briefs or boxer briefs,” shared another.
People with HS may be more likely to have anxiety and depression. Having a painful and chronic condition, like HS on your penis and scrotum, can take a toll on your mental health. Your healthcare provider can help you find care if you’re struggling with your mental health.
HS in the groin can also affect your relationships and sex life. Establishing open communication with your partner can help you maintain intimacy.
If you or a loved one is living with HS, consider joining myHSteam today. Here, more than 46,000 members from around the world come together to ask questions, offer support and advice, and connect with others who understand life with hidradenitis suppurativa.
Have you experienced HS on your penis or scrotum? Share your tips in the comments below or by posting on myHSteam.
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