Itching in penis

Itching in the penis and groin area could itself be a symptom of conditions like pubic lice, a sexually transmitted disease (STD) like genital herpes or a common gym infection like jock itch. While most cases of penile itching resolve with proper care and home remedies, see a doctor if penile itching is accompanied by any of these symptoms:

• Blisters or warts
• Inflammation
• Pain in the penis
• Painful urination
• Scaly patches
• Blood in urine or semen

The causes of penile itching include:

• Genital herpes: Genital herpes is a viral infection caused by a virus called the herpes simplex virus (HSV). This infection can result in pain and itching in the genital region and penis. The virus itself can remain inactive for a long period of time in the body. When it becomes activated, it can result in intense itching along with fluid-filled blisters. 
• Lichen nitidus: It is defined as a condition in which the skin cells become inflamed which results in tiny lesions on any area of the body including the penis. The lesions are flat, small and flesh coloured.
• Candida infection: Penile yeast infection is also known as male thrush or male yeast infection. It most commonly develops on the head of the penis. It may be associated with itching on the penis tip and underneath the foreskin (Sheath of skin that covers the head of the penis). It can result in penile burning sensation, development of rash along with a discharge (cottage cheese type in appearance) underneath the foreskin. 
• Genital warts: They are the result of a viral infection caused due to human papillomavirus (HPV). Genital warts are considered to be a sexually transmitted infection. The warts have a cauliflower-like appearance, are flesh coloured and may be itchy. You may also notice some bleeding during intercourse. 
• Lichen planus: Lichen planus is defined as an inflammatory illness that can affect numerous parts of the body such as the hair, nails and skin including the penis. It can result in intense itching and present as blisters. 
• Psoriasis: Psoriasis is a chronic skin illness that may sometimes involve the penis. In this disease, skin cells develop rapidly, resulting in the accumulation of these cells on the surface. This results in severe itching and development of reddish scaly patches on the skin.
• Scabies: Small mites form burrows underneath the skin’s surface in scabies. These mites usually form burrows in the skin folds, but can also involve the penis and the genitalia. Patients usually complain of intense itching that is worse at night. 
• Contact dermatitis: It is defined as a condition that occurs after contact with an allergen that results in a rash. These allergens can be anything from soaps to fragrances and fabrics. Contact dermatitis can result in dry skin, red rash and lesions on the penis. 
• Balanitis: Penile inflammation or balanitis is defined as a condition that involves the inflammation of the glans penis. Symptoms usually include soreness, redness, swelling and intense itching along with pain while urinating. 
• Ingrown hair: This can occur at the base of the penis and can cause a painful and itchy lesion. 
• Urethritis: Inflammation of the urethra, the tube that carries urine from the urinary bladder to outside the body, is known as urethritis. Patients may complain of itching sensation, increased frequency of urination, discomfort while urinating. Some patients may also present with blood in semen.

Itching in the pubic/groin area may be caused due to the following conditions: 

• Pubic lice: Pubic lice is also referred to as crabs. Lice are small parasites that can attach to the skin and hair on the body.
• Folliculitis: The hair follicles become inflamed in folliculitis.
• Jock itch: Jock itch is a fungal infection involving the groin
• Atopic dermatitis: Atopic dermatitis involves an allergic reaction of the skin to any common allergen
• Molluscun contagiosum: A viral skin infection.

Maintaining good hygiene and proper self-care in case of chronic conditions or allergies can go a long way to prevent penile itching. Here are some rules of thumb you should follow:

• Avoid substances that can cause allergies and inflammation, especially if you have contact dermatitis. Be careful about which soaps, fabrics and similar materials you use.
• Maintaining good hygiene can help you avoid many infections. Take a bath every day and cleanse the groin area and penis properly with soap and water.
• Remember to clean the area underneath the foreskin to remove any smegma that may have collected, and bacteria that can cause intense itching and infections.
• You should properly dry your body after taking a bath as moist skin is highly susceptible to fungal infections.
• If you remove your pubic hair, and you have a history of getting ingrown hairs, you should remove/shave the pubic hair in the direction of growth of hair and utilise good shaving creams beforehand.
• Wear loose underwear to avoid friction and rashes on the skin.

Most causes of penile itching don’t require a visit to the doctor. Conditions like contact dermatitis usually resolve after contact with the allergen is removed. Ingrown hair also resolves spontaneously after a week or ten days. 

In some situations, the itch cannot be resolved without treatment. Patients should go to the hospital if the itching is so intense that it is affecting their daily life, does not improve over time or if it is associated with symptoms that point to infectious causes like penile discharge, blisters and rashes.

The doctor can make the diagnosis clinically based on the clinical profile of the patient, history and thorough clinical examination. Sometimes certain investigations like swabs from the affected area may be needed to identify the bacteria, fungus or virus causing the symptoms.

One important fact to remember before discussing various treatment options is that scratching an itch only relieves it temporarily and intense scratching may result in complications like skin injuries and infections. Some basic home treatment options are available to help with any sort of penile itching. These may include the following:

• Cold compress: This involves the application of a wet, cold cloth on the affected area for 10 minutes. One may also use a towel with some ice wrapped in it. This cooling effect may relieve itching that occurs due to ingrown hair, allergic dermatitis or parasitic infections like scabies. It can also reduce the inflammation in conditions like balanitis and urethritis. 
• Oatmeal bath: An oatmeal bath can be prepared by mixing some oatmeal with warm water. Oatmeal is known for its anti-inflammatory qualities and thus can help reduce inflammation, redness, dryness and itching in the penile region. 
• Apple cider vinegar: Apple cider vinegar (ACV) can be mixed with water and applied on the affected area directly and rinsed off after it dries. This method could help in case psoriasis is the cause of penile itching. ACV should not be applied on broken skin, as it may result in discomfort and burning sensation. 
• Epsom salt pack: Epsom salt is also called Dead Sea salt. You will need one tablespoon of epsom salt and enough warm water to make a thick paste. Apply this to the affected area. Leave it on for about 15 minutes, before washing it off gently with room temperature water. Applying this paste could relieve penile itching caused by chronic skin conditions like psoriasis.
• Baking soda: Patients with candida infections (male thrush) on the penis can utilise baking soda. You will need one cup of baking soda and enough warm water to create a paste. Apply it on the penis. This may be washed off after a few minutes.

Drug therapy for penile itching: Some patients may require over-the-counter medications in case home-based therapy does not work. The treatment option selected depends on the cause behind the itching.

The following treatment protocols can be used: 

• Antibiotics: Your doctor may prescribe antibiotics in case of bacterial skin infections
• Steroids: Creams containing steroids can reduce the itching and inflammation
• Antifungals: These may be prescribed in cases of candidiasis—antifungals could be available as ointments or oral medication. 
• Antihistamines: These medicines would reduce skin inflammation and provide relief in case the itching is caused by a skin allergy.