The appearance of a bump on the scrotum can cause worry and anxiety. While searching for information is natural, self-diagnosis is not a substitute for a medical evaluation. The scrotal skin is prone to many common, non-threatening skin conditions, but also susceptible to issues requiring professional care. Understanding the potential causes, from normal anatomy to contagious infections, can help guide the decision to seek a definitive diagnosis.
Benign Glandular and Structural Bumps
Many common scrotal bumps are benign and represent normal anatomical structures or harmless growths. Fordyce spots are a frequent finding, appearing as small, painless, whitish-yellow or skin-colored bumps, typically between one and three millimeters in diameter. These are visible, enlarged sebaceous glands (oil glands) that are not associated with a hair follicle. They are a normal variant of the skin and are neither infectious nor cancerous.
Another structural bump is the sebaceous cyst, often referred to as an epidermoid cyst. These common, typically painless lumps form when a sebaceous gland duct becomes blocked, leading to an accumulation of sebum, a thick, oily substance. Scrotal cysts can range in size from tiny to over a centimeter and may appear whitish, yellowish, or skin-colored. They can become painful, swollen, or red if they become infected.
Angiokeratomas of Fordyce are small, dark red, purple, or black papules that commonly appear on the scrotal skin. These lesions form when superficial capillaries become enlarged and the overlying skin thickens, sometimes giving them a rough or pebbly texture. They are non-contagious and non-cancerous, but they can occasionally bleed if scratched or rubbed.
Follicle-Related Irritations
Temporary bumps often arise from hair follicles and localized skin irritation. Folliculitis occurs when hair follicles become inflamed, often due to a bacterial infection, appearing as small red bumps or white-headed pimples. This condition is often managed with improved hygiene and topical treatments, though severe cases may require antimicrobial therapy.
Ingrown hairs are a common cause of irritation, occurring when a hair that was cut or removed curls back and grows into the skin. This results in a small, red, swollen, and sometimes painful or itchy bump. Ingrown hairs frequently occur after shaving, tweezing, or waxing and may affect people with naturally coarse or curly hair.
These irritations are typically temporary inflammatory reactions to trauma or minor infection. Unlike permanent structural bumps, these often resolve on their own once the cause of irritation is removed or the body clears the infection.
Bumps Caused by Infection or Contagion
Other scrotal bumps are transmissible and require medical intervention, often due to viral or parasitic causes. Molluscum contagiosum is a viral skin infection that manifests as small, firm, raised bumps, which may be white, pink, or skin-colored, and typically feature a small central indent or dimple. While highly contagious through skin-to-skin contact, the infection is generally self-limiting but can take several months to a year to resolve.
Genital warts are caused by certain strains of the Human Papillomavirus (HPV) and appear as small, skin-colored or whitish growths that can sometimes resemble the surface of a cauliflower. They may be flat or raised, soft or firm, and can occur anywhere in the genital area, including the scrotum. Genital herpes, caused by the herpes simplex virus (HSV), typically begins with a tingling or itching sensation followed by a cluster of small, painful, fluid-filled blisters. These blisters soon break open to form painful, shallow sores that eventually crust over and heal.
Parasitic infestations can also cause bumps, such as scabies, caused by microscopic mites burrowing into the skin. This infestation leads to intense itching, especially at night, and a rash of tiny, raised, pimple-like bumps on the scrotum and surrounding area. Pubic lice, often called “crabs,” feed on blood, causing small, irritated bites that can appear as bumps, often accompanied by severe itching.
Warning Signs and Seeking Professional Diagnosis
While most skin-surface bumps are harmless, certain signs warrant prompt evaluation by a healthcare provider. Any scrotal lump or bump that is rapidly changing in size, is persistently painful, or is accompanied by open sores or ulcers should be examined. Other concerning symptoms include fever, unexplained swelling, or bruising.
It is important to distinguish between a bump on the skin surface and a mass that feels deeper, originating within the testicle. A hard lump or mass felt inside the testicle, a change in size or shape, or a persistent dull ache or feeling of heaviness should be checked immediately. These symptoms can indicate a serious condition, such as testicular cancer, though most lumps are benign. Only a medical professional can perform a physical examination and potentially use imaging tests like an ultrasound to provide a definitive diagnosis.