Is this your child's symptom?
- Symptoms of the male genitals (penis or scrotum)
- Not caused by an injury
- Penis symptoms include rash, pain, itching, and swelling. Discharge from the end of the penis is also included.
- Scrotum symptoms include rash, itching, pain and swelling.
- Any genital pain that is not due to an injury is covered.
Causes of Rashes on Penis or Scrotum
- Most rashes on the penis or scrotum are caused by skin irritants.
- Hand-to-penis contact is normal when passing urine. Therefore, the rash is most likely from an irritant that was on the hands.
- Examples are plants (such as weeds) or chemicals (such as bug spray). Fiberglass, pet saliva or even food can also be irritants.
- Rashes are more common in the summer. Reason: Children are outdoors and have more contact with plants and pollens.
Types of Foreskin Retraction Problems
- Paraphimosis. Forceful retraction can cause the foreskin to get stuck behind the glans. The glans is the head of the penis. This can cause severe pain and swelling. It's a medical emergency.
- Bleeding. If retraction is forceful, it can cause a small cut. This cut may cause a small amount of bleeding and pain.
- Foreskin Infection. This means an infection under the foreskin. The infection can start in a cut caused by forceful retraction. The main symptom is a red and tender foreskin. Pus may also ooze out to the foreskin opening. Passing urine is painful.
- Urine Retention (Serious). Can't pass urine or just dribbles urine, despite wanting to go.
Causes of Swollen Scrotum
- Torsion of the Testis (Serious). The testicle twists and cuts off its blood supply. It is always painful. Needs to be repaired within 6 to 12 hours to save the testicle. This is why seeing all males with a swollen scrotum is an emergency.
- Hydrocele. Present at birth and both sides usually involved. A hydrocele is a painless sac of fluid sitting on top of the testicle. Present at birth and harmless. It goes away by a year of age.
- Inguinal Hernia. A hernia is a loop of intestine that slides into the scrotum. Any new bulge that comes and goes is a hernia. All hernias need surgery to fix. Most of the time, the repair can be scheduled. If the hernia can't slide back into the abdomen, emergency surgery is needed.
- Varicocele. A clump of swollen veins above the testis, often on the left side. It becomes much smaller after lying down and draining. It is painless. It is also harmless and occurs in 10% of teens.
- Orchitis. This is an infection of the testicle. It is always painful. It's mainly caused by viruses, such as mumps.
- Hematoma (Blood Clot) of Scrotum. Blunt trauma can cause a large blood clot to form inside the scrotum. Sometimes, it needs to be drained. This can happen from being hit by a ball during sports.
When to Call for Penis-Scrotum Symptoms
Call Doctor or Seek Care Now
- Scrotum is painful or swollen
- Scrotum changes to a blue or red color
- Severe pain
- Swollen foreskin (child not circumcised)
- Pain or burning when passing urine and fever
- Red rash or red foreskin with fever
- Could have been caused from sexual abuse
- Erection is painful or lasts more than 1 hour
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Pus or bloody discharge from end of penis
- Pus from end of foreskin (child not circumcised)
- Pain or burning when passing urine, but no fever
- Rash is painful
- Rash has tiny water blisters
- Looks infected (such as draining sore, spreading redness) without fever
- You are worried about a sexually transmitted infection (STI)
- You think your child needs to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Itching lasts more than 3 days
- Small lump or warts
- All other penis or scrotum symptoms. Exception: mild rash for less than 3 days.
- You have other questions or concerns
Self Care at Home
- Mild rash or itching of penis or scrotum present less than 3 days
- Purple head of the penis and healthy child. Reason: this is a normal color.
- Questions about smegma (whitish material) under the foreskin
- Questions about erections in young children
Treatment for Mild Rash or Itching of Penis or Scrotum
- What You Should Know About Mild Penis or Scrotal Symptoms:
- Rashes can be caused by skin irritants. Hand-to-penis contact is normal when passing urine. Therefore, the rash is most likely from an irritant that was on the hands.
- Examples are a plant (such as an evergreen) or chemicals (such as bug repellents). Fiberglass, pet saliva or even food can also be irritants.
- Most small rashes can be treated at home.
- Here is some care advice that should help.
- Clean the Area:
- Wash the area once with soap to remove any irritants.
- Steroid Cream for Itching:
- For itchy rashes, use 1% hydrocortisone cream (such as Cortaid). No prescription is needed.
- Do this 2 times per day for a few days.
- Antibiotic Ointment for Infection:
- For any cuts, sores or scabs that look infected, put on an antibiotic ointment. An example is Polysporin. No prescription is needed.
- Use 2 times per day until seen.
- What to Expect:
- Small rashes from irritants should go away in 1 to 2 days with treatment.
- Prevention of Recurrent Symptoms:
- Teach your son to wash his hands if they are dirty.
- Have him clean his hands before touching his penis.
- Call Your Doctor If:
- Rash spreads or gets worse
- Rash lasts more than 3 days
- Fever occurs
- You think your child needs to be seen
- Your child becomes worse
- Smegma - General Information:
- Smegma is the small pieces of whitish material found under the foreskin. It can build up under the foreskin. This happens if the foreskin is not pulled back and cleaned regularly. See Foreskin Care Questions care guide.
- Smegma also can occur before the foreskin becomes retractable. It lies under the foreskin that is still stuck to the head of the penis. It can't be removed.
- Smegma is made up of dead skin cells. These cells are shed from the lining of the foreskin and the penis. It becomes trapped under the foreskin.
- Smegma is normal and harmless. It is not a sign of an infection. It is produced in small amounts throughout life.
- Smegma Before Age 1 Year:
- Sometimes, smegma can be seen through the foreskin. It looks like small whitish lumps.
- If it lies beyond the level of foreskin retraction, it should be left alone.
- Wait until normal separation exposes it.
- During the first year of life, do not make any attempts at foreskin retraction.
- Normal Erections
- Erections in boys can occur at any age. They start in the newborn period.
- They tell us the nerves to the penis are working.
- In young boys, some are caused by a full bladder. Most occur without a clear reason.
- In teens, frequent erections start in puberty.
- Normal erections should not cause any pain.
- Call Your Doctor If:
- Erection lasts over 1 hour
- Erection becomes painful
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Last Reviewed: 04/06/2020
Last Revised: 03/21/2020
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC.