Shingles, also known as herpes zoster, can affect the scrotum and surrounding genital areas. Though uncommon, the varicella-zoster virus (VZV) can reactivate in nerve tissues anywhere in the body. Recognizing signs in this sensitive region is important for prompt medical attention.
What Shingles Is
Shingles is a viral infection caused by the reactivation of the varicella-zoster virus (VZV), the same virus that causes chickenpox. After a chickenpox infection, VZV remains dormant in nerve tissue near the brain and spinal cord. The virus can reactivate years or even decades later, leading to shingles, often when the immune system is weakened due to factors like aging, illness, or certain medications. The risk of developing shingles increases significantly with age, especially after 50.
How Shingles Appears on the Scrotum
When shingles affects the scrotum or genital area, initial symptoms include pain, itching, tingling, or burning. These sensations can appear days before any visible rash. A characteristic rash then emerges, typically starting as red patches. These red areas then progress into fluid-filled blisters, also known as vesicles.
The blisters usually form in a localized band or strip, following the path of the affected nerve (a dermatomal pattern). Like other shingles rashes, it typically appears on one side of the body. The rash on the scrotum can be intensely painful and sensitive, making clothing contact or movement uncomfortable. These blisters will eventually dry out and scab over within 7 to 10 days, with the rash usually clearing within two to four weeks.
Diagnosis and Treatment
Diagnosing shingles, particularly in sensitive areas like the scrotum, relies on a clinical examination of the characteristic rash and reported symptoms. Healthcare providers look for a painful, blistering rash that follows a dermatome and typically appears on one side of the body. In some cases, a tissue sample or fluid swab from the blisters may be sent for laboratory confirmation.
Prompt medical attention is important if shingles is suspected, especially within 72 hours of rash onset. Early treatment can significantly reduce the outbreak’s severity and duration, and lower complication risks. Treatment involves prescription antiviral medications like acyclovir, valacyclovir, or famciclovir. These medications curtail VZV replication, helping the rash heal faster and reducing pain. Pain management strategies may also be employed, including over-the-counter pain relievers, topical creams, or prescribed medications for severe discomfort.
Shingles Prevention
Vaccination is the most effective way to prevent shingles and its potential complications. The recombinant zoster vaccine, Shingrix, is highly effective in preventing shingles and postherpetic neuralgia, a long-term nerve pain that can follow a shingles outbreak. Clinical trials show Shingrix provides high protection, with efficacy rates of 97% in immunocompetent individuals aged 50 and older, and 91% in those aged 70 and older.
The Centers for Disease Control and Prevention (CDC) recommends the Shingrix vaccine for adults 50 and older. It is administered as a two-dose series, given two to six months apart. The vaccine is also recommended for adults 18 and older with weakened immune systems. Shingrix maintains strong effectiveness for at least 10 years after vaccination.