What are these black spots on my scrotum?

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Black spots on the scrotum may be concerning, but many of the most common causes are benign. They may require no treatment or a simple fix.

A range of conditions can cause these black spots. Obtain a professional diagnosis to ensure appropriate treatment.

In this article, we explore the conditions that cause black spots to form on the scrotum. We also describe accompanying symptoms, how a doctor will determine a diagnosis, and the treatment options available.

Causes

man looking down below using a magnifying glass with possible black spots on scrotum
Black spots on the scrotum may have many different causes.

Black spots may form on the scrotum temporarily or permanently. The following are some of the most common causes.

Bruises

Physical injury can damage small blood vessels, causing blood to pool in the tissues. This results in areas of dark, tender skin, known as bruises.

Most bruises clear up within 2 weeks.

Dark or ingrown hair follicles

After removing hair, often by waxing or shaving, new hair may appear darker than before.

If a hair in an early stage of growth becomes trapped beneath the skin, or ingrown, the resulting bump may appear as a dark or discolored spot.

Ingrown hairs can also be painful or tender and swollen.

Pimples and blackheads

These minor skin conditions are caused by mild infection or clogged pores. They are extremely common and may appear as dark spots on the scrotum.

Most pimples and blackheads are harmless. They often resolve with basic at-home care, such as good hygiene and warm compresses, within a few months.

Hyperpigmentation

Hyperpigmentation occurs when some areas of skin develop more pigment. This can appear as a variety of skin lesions, such as:

  • freckles
  • moles
  • sun spots
  • stretch marks
  • age spots

A 2013 study looked at 400 males between the ages of 3 and 91 who received medical attention for genital lesions. Of these, 85.6 percent of cases involved hyperpigmentation.

Hyperpigmentation lesions are generally harmless, and many have no symptoms beyond discoloration of the skin.

Angiokeratoma

This condition causes small blood vessels to widen, resulting in non-cancerous skin lesions that may be dark red or blue.

These lesions tend to have clear edges, and most are:

  • 1 millimeter (mm) to 8 mm in size
  • raised in a dome-shape
  • abnormally thick
  • randomly distributed, when they appear on the scrotum

If these lesions cause irritation, or if a person scratches them by accident, scaling, crusting, bleeding, and blood blisters can occur.

Angiokeratoma lesions are usually harmless and have no other symptoms. However, they concern people who mistake them for symptoms of sexually transmitted infections (STIs) or cancer.

The risk of developing these lesions increases greatly with age. At age 16, a boy is estimated to have a 0.6 percent chance of developing this condition on the scrotum. The risk rises to 17 percent for men aged over 70.

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