• Chronic rubbing, scratching, sweating, or irritation from tight clothing, soaps, shaving, or moisture. This can make skin thicker, darker, and rough.
• Fungal rash or dermatitis (eczema/contact allergy), especially if there is itching, scaling, redness, or spread to the groin.
• The small bumps may be inflamed hair follicles, blocked skin glands, or small cysts. Do not squeeze them.

• Wash gently with plain lukewarm water and dry well.
• Wear loose cotton underwear and avoid rubbing/scratching.
• Avoid fragranced soaps, powders, bleaching creams, and steroid/antifungal creams unless advised after an examination.
• Do not pop the bumps.

• A lump that feels inside or attached to the testicle
• Sudden severe testicle pain or swelling
• Fever, spreading redness, warmth, pus, or open sores
• A hard lump that is growing

• Gently wash once daily with lukewarm water and a mild fragrance-free soap. Dry by patting, not rubbing.
• Wear loose cotton underwear and change it daily. Keep the area dry.
• Stop shaving, trimming very close, scratching, or rubbing until it heals.
• Do not squeeze, pop, or pierce the bumps. This can cause infection and scarring.
• Avoid steroid creams, strong antiseptics, powders, or “fairness” creams on the scrotum unless a clinician tells you to use them.

• If small and painless, it often needs no medicine.
• If it becomes large, painful, recurrent, or bothersome, a dermatologist/urologist can remove it under local anesthetic. Complete removal of the cyst wall helps prevent recurrence. The NHS skin-cyst advice specifically notes that cysts can occur on the scrotum and should not be squeezed.

• Avoid shaving and friction.
• A doctor may prescribe an antibiotic or antifungal treatment only after examining it. Do not start oral antibiotics yourself.

Recent guidance on scrotal skin lumps

What clinicians look for

• Common benign skin causes: epidermoid cysts, blocked glands, and inflamed hair follicles. Epidermoid cysts can be multiple on the scrotum and may feel like small, firm, skin-level nodules. See DermNet cyst guidance.
• Folliculitis: small tender or pus-tipped bumps around hairs, often triggered by shaving, sweat, friction, tight clothing, or bacteria. Diagnosis is usually by examination, though a swab may be used if persistent or severe. See DermNet folliculitis guidance.
• STIs or other genital skin diseases: genital warts, herpes, molluscum, fungal infection, eczema, and other conditions may resemble simple bumps. A sexual-health or dermatology examination may be appropriate if there are new sexual partners, sores, discharge, itching, or wart-like growths. DermNet genital-skin guidance advises a full skin/genital examination and, when indicated, swabs or biopsy.

When a skin lesion needs urgent or prompt assessment

When ultrasound is needed

Usual treatment principles

• Small painless cysts: often monitored. Do not squeeze them. If painful, infected, large, recurrent, or bothersome, removal can be considered after examination. The NHS cyst guidance notes that cysts can occur on the scrotum.
• Folliculitis: reduce sweat/friction, stop close shaving, use loose cotton underwear, and use gentle skin care. Antibiotic or antifungal treatment should be chosen only after a clinician decides the cause.
• Avoid self-treating with strong steroid creams, antibiotics, or antifungal combinations on scrotal skin without a diagnosis. The area is sensitive and the wrong cream can worsen infection or mask important signs.

Go to emergency care now if

1. Blocked hair follicles or epidermoid cysts
   • Skin cells and keratin get trapped under the skin, forming small firm bumps.
   • They can occur in multiples on the scrotum.
   • Sometimes they follow minor irritation, blocked follicles, or injury to the skin. They are usually not sexually transmitted.
2. Chronic irritation and scratching
   • Sweat, heat, friction, tight underwear, frequent washing with strong soap, shaving, or scratching can cause thick, darker, wrinkled skin.
   • Itching leads to more scratching, which further thickens the skin.
3. Folliculitis
   • Inflammation or infection around hair follicles.
   • More likely with shaving, sweating, tight clothing, friction, or bacteria.
   • Usually causes tender, itchy, or pus-tipped bumps.
4. Less commonly
   • Fungal rash, genital warts or other sexually transmitted infection, scrotal calcinosis, eczema, or another skin condition.
   • These require examination because treatment differs.

• Stop using Ketopic on the scrotum for now if it was self-started or if you have burning, increased itching, dryness, redness, or worsening bumps.
• Do not apply other medicated creams, especially steroid-antifungal combination creams, until examined.
• Wash gently with lukewarm water, pat dry, and wear loose cotton underwear.
• Arrange an in-person visit with a dermatologist or urologist within a few days. Take the Ketopic tube/package so they can confirm the ingredient and formulation.

• If the skin/bumpy texture appeared or clearly got worse after starting Ketopic, it is a likely contributor.
• If the bumps existed before Ketopic, it is less likely to be the original cause.

1. Libido/sexual drive drops
2. Testicles hang lower
3. Something else

• Chronic rubbing, scratching, sweating, or irritation from tight clothing, soaps, shaving, or moisture. This can make skin thicker, darker, and rough.
• Fungal rash or dermatitis (eczema/contact allergy), especially if there is itching, scaling, redness, or spread to the groin.
• The small bumps may be inflamed hair follicles, blocked skin glands, or small cysts. Do not squeeze them.

• Wash gently with plain lukewarm water and dry well.
• Wear loose cotton underwear and avoid rubbing/scratching.
• Avoid fragranced soaps, powders, bleaching creams, and steroid/antifungal creams unless advised after an examination.
• Do not pop the bumps.Yes, I understand: the bumps are on the skin covering the testicles (scrotum), not necessarily inside the testicle itself.

• A lump that feels inside or attached to the testicle
• Sudden severe testicle pain or swelling
• Fever, spreading redness, warmth, pus, or open sores
• A hard lump that is growing

• Gently wash once daily with lukewarm water and a mild fragrance-free soap. Dry by patting, not rubbing.
• Wear loose cotton underwear and change it daily. Keep the area dry.
• Stop shaving, trimming very close, scratching, or rubbing until it heals.
• Do not squeeze, pop, or pierce the bumps. This can cause infection and scarring.
• Avoid steroid creams, strong antiseptics, powders, or “fairness” creams on the scrotum unless a clinician tells you to use them.

• If small and painless, it often needs no medicine.
• If it becomes large, painful, recurrent, or bothersome, a dermatologist/urologist can remove it under local anesthetic. Complete removal of the cyst wall helps prevent recurrence. The NHS skin-cyst advice specifically notes that cysts can occur on the scrotum and should not be squeezed.

• Avoid shaving and friction.
• A doctor may prescribe an antibiotic or antifungal treatment only after examining it. Do not start oral antibiotics yourself.

What clinicians look for

• Common benign skin causes: epidermoid cysts, blocked glands, and inflamed hair follicles. Epidermoid cysts can be multiple on the scrotum and may feel like small, firm, skin-level nodules. See DermNet cyst guidance.
• Folliculitis: small tender or pus-tipped bumps around hairs, often triggered by shaving, sweat, friction, tight clothing, or bacteria. Diagnosis is usually by examination, though a swab may be used if persistent or severe. See DermNet folliculitis guidance.
• STIs or other genital skin diseases: genital warts, herpes, molluscum, fungal infection, eczema, and other conditions may resemble simple bumps. A sexual-health or dermatology examination may be appropriate if there are new sexual partners, sores, discharge, itching, or wart-like growths. DermNet genital-skin guidance advises a full skin/genital examination and, when indicated, swabs or biopsy.

When a skin lesion needs urgent or prompt assessment

When ultrasound is needed

Usual treatment principles

• Small painless cysts: often monitored. Do not squeeze them. If painful, infected, large, recurrent, or bothersome, removal can be considered after examination. The NHS cyst guidance notes that cysts can occur on the scrotum.
• Folliculitis: reduce sweat/friction, stop close shaving, use loose cotton underwear, and use gentle skin care. Antibiotic or antifungal treatment should be chosen only after a clinician decides the cause.
• Avoid self-treating with strong steroid creams, antibiotics, or antifungal combinations on scrotal skin without a diagnosis. The area is sensitive and the wrong cream can worsen infection or mask important signs.

Go to emergency care now if

1. Blocked hair follicles or epidermoid cysts
   • Skin cells and keratin get trapped under the skin, forming small firm bumps.
   • They can occur in multiples on the scrotum.
   • Sometimes they follow minor irritation, blocked follicles, or injury to the skin. They are usually not sexually transmitted.
2. Chronic irritation and scratching
   • Sweat, heat, friction, tight underwear, frequent washing with strong soap, shaving, or scratching can cause thick, darker, wrinkled skin.
   • Itching leads to more scratching, which further thickens the skin.
3. Folliculitis
   • Inflammation or infection around hair follicles.
   • More likely with shaving, sweating, tight clothing, friction, or bacteria.
   • Usually causes tender, itchy, or pus-tipped bumps.
4. Less commonly
   • Fungal rash, genital warts or other sexually transmitted infection, scrotal calcinosis, eczema, or another skin condition.
   • These require examination because treatment differs.

• Stop using Ketopic on the scrotum for now if it was self-started or if you have burning, increased itching, dryness, redness, or worsening bumps.
• Do not apply other medicated creams, especially steroid-antifungal combination creams, until examined.
• Wash gently with lukewarm water, pat dry, and wear loose cotton underwear.
• Arrange an in-person visit with a dermatologist or urologist within a few days. Take the Ketopic tube/package so they can confirm the ingredient and formulation.

• If the skin/bumpy texture appeared or clearly got worse after starting Ketopic, it is a likely contributor.
• If the bumps existed before Ketopic, it is less likely to be the original cause.

1. Libido/sexual drive drops
2. Testicles hang lower
3. Something elseI misunderstood. What exactly “drops” after you use Ketopic?

• Stop Ketopic for now, unless a doctor specifically tells you to continue.
• Do not apply other medicated creams or mixed steroid creams.
• Use only lukewarm water, gently pat dry, and wear loose cotton underwear.
• Arrange an examination with a dermatologist or doctor within a few days, since it has persisted and the skin needs a correct diagnosis.

• Small epidermoid/blocked-gland cysts
• Skin tags or benign skin growths from friction
• Less commonly, genital warts or another genital skin condition

• Stop Ketopic if the skin became irritated after starting it, unless it was prescribed and your prescriber advises otherwise.
• Avoid shaving and friction.
• Use plain water or a gentle non-soap wash and loose cotton underwear.
• Consider STI screening if you have had new or unprotected sexual contact, because genital warts are one possibility among several. DermNet's genital-skin guidance notes that genital warts and other infections can cause genital papules.

• Use only lukewarm water and gently pat dry.
• Avoid Ketopic, neem oil, antiseptics, wart-remover liquids, or steroid-mix creams until examined.
• Wear loose cotton underwear and avoid shaving or squeezing the bumps.
• Arrange a dermatology or sexual-health clinic examination within 1-2 weeks.

• No Ketopic, luliconazole, neem oil, or wart-remover products.
• Gentle lukewarm water only, pat dry, loose cotton underwear.
• Get an in-person exam with dermatology, sexual-health clinic, or urology within 1-2 weeks.

• Do not use Ketopic, luliconazole, neem oil, steroid-mix creams, or over-the-counter wart-remover acids.
• Do not squeeze, scratch, shave over, or try to cut the bumps. This can spread them and cause infection.
• Avoid sexual skin-to-skin contact until examined, or use condoms knowing they reduce but do not fully eliminate skin-contact spread.
• Do not share towels, underwear, or razors. Wash hands after touching the area.
• Arrange a sexual-health clinic or dermatologist appointment soon, ideally this week. Genital molluscum is usually treated by a clinician, for example with carefully selected physical removal or freezing, after confirming the diagnosis. STI testing may be offered based on your history.

• Do not scratch, squeeze, pop, or shave the bumps.
• Keep fingernails short and wash hands after touching the area.
• Wear loose cotton underwear.
• Do not share towels, underwear, razors, or washcloths.
• Avoid sex or close genital skin contact until you are examined. Genital molluscum may be sexually transmitted, and treatment is usually recommended for genital lesions.
• Do not use Ketopic, luliconazole, neem oil, or over-the-counter wart-remover liquids on them.