Finding a bump on the testicles or surrounding skin can cause immediate concern. While it is understandable to worry, most bumps found in this area are not serious and are rarely a sign of major illness. True acne vulgaris, the kind typically found on the face or back, is uncommon in this specific location. However, a wide variety of other non-threatening skin lesions and growths frequently occur on the scrotum and are often mistaken for pimples.
The Scrotum and True Acne
The scrotum, the protective sac of skin that houses the testicles, possesses the necessary anatomical structures for a true pimple to form. Like skin elsewhere, the scrotal skin contains hair follicles and associated sebaceous glands. These glands produce sebum, an oily substance that lubricates the skin and hair.
A true pimple forms when dead skin cells and sebum clog a hair follicle, allowing bacteria to multiply. This leads to inflammation and the characteristic red, pus-filled bump. Since all components of the pilosebaceous unit are present, a localized blockage or infection of a hair follicle can technically cause a lesion resembling a whitehead or blackhead. However, the environment and skin texture of the scrotum often favor the development of other specific skin issues more frequently than classic acne vulgaris.
Benign Causes of Scrotal Bumps
The majority of pimple-like bumps on the scrotal skin are benign conditions or minor, localized issues. One of the most common findings is Fordyce spots, which are not pimples but enlarged, visible sebaceous glands without an associated hair follicle. These are tiny, pale yellow or whitish spots, typically measuring between one and five millimeters in diameter. Fordyce spots are completely harmless, present from birth, and become more noticeable after puberty when hormonal changes stimulate the glands.
Another frequent cause of red, inflamed bumps is folliculitis, a mild infection or irritation of the hair follicles. This condition is common because the scrotal area is often subject to warmth, moisture, friction from clothing, or irritation from shaving or grooming. An ingrown hair, where a hair curls back and grows into the skin, can also create a localized, red, and sometimes painful bump that closely mimics an inflamed pimple.
Lumps that feel firm and are located just beneath the skin surface are often epidermoid cysts, sometimes incorrectly called sebaceous cysts. These cysts form when a sebaceous gland becomes blocked, accumulating sebum and keratin. This results in a small, painless lump that may appear whitish or yellowish. Epidermoid cysts are benign and do not require medical intervention unless they become irritated, inflamed, or infected, which causes redness, swelling, and pain.
When to Consult a Healthcare Provider
While most scrotal bumps are harmless, certain symptoms necessitate prompt evaluation by a healthcare provider to rule out serious conditions. Any lump or mass felt within the testicle itself, rather than just on the outer skin of the scrotum, requires immediate investigation. This is important if the lump is firm and painless, as this can be one of the earliest signs of testicular cancer.
Other concerning signs warranting a medical visit include a bump accompanied by sudden, severe pain or tenderness, which may indicate an acute infection or testicular torsion. Professional care is also needed if a bump rapidly changes size or shape, or if it is associated with fever, chills, or a persistent heavy sensation in the scrotum. Open sores, ulcers, blisters, or a discharge from the bump or surrounding skin should also be evaluated, as these may indicate a bacterial infection or a sexually transmitted infection (STI), such as herpes or syphilis.