White bumps on the scrotum are actually quite common. In many cases, they are completely benign and there is no known cause. However, in other cases, the cause is treatable and needs to be evaluated by a doctor. Any male who experiences this issue should make an appointment with his doctor because some causes do require treatment.
Eighty to 95 percent of adults experience fordyce spots. They are sebaceous glands that do not have hair follicles. They are completely harmless and a relatively common cause of white bumps on the scrotum. While harmless, they should still be evaluated to make sure they are not mistaken for something more serious like a sexually transmitted disease. No medical treatment is necessary for these spots. Patients should not squeeze or pick at them. If they do become a cosmetic concern, vaporizing laser treatment or electrodessication have been successful in removing them. These two procedures are generally done on fordyce spots on the lips, however.
Sebaceous cysts can vary greatly in size and amount. Some men may only have one where others have several, or clusters. These cysts tend to be clear and present on the scrotum wall. An epidermal cyst tend to be deeper than a sebaceous cyst and may become infected or uncomfortable. A simple surgical procedure can be done to remove an epidermal cyst. It is typically outpatient. Sebaceous cysts generally do not require treatment and usually go away on their own.
Sometimes referred to as genital acne, this condition is characterized by lesions. This severe form of acne occurs deep within the skin around hair follicles or sebaceous glands. Scarring can occur after multiple recurrences. The lesions often become enlarged, bust open and then pus drains. This condition often worsens over time and treatment is necessary. Blackheads, red and tender bumps, leaking sores or bumps and pea-sized, painful lumps may also occur. When hair follicles and/or sebaceous glands become blocked with dead skin cells, fluid or other matter, this condition can occur. Medications are commonly used as treatments, including oral retinoid medications, immunosuppressant drugs or corticosteroids, tumor necrosis factor alpha inhibitors, antibiotics and non-steroidal anti-inflammatory drugs. In more severe cases, uncovering tracts or tunnels, incision and drainage or surgical removal may be necessary.
This condition is characterized by the hair follicle being superficially infected. Papules and pustules may occur on the scrotum. This condition can be uncomfortable and itchy. Treatment often include applying certain creams up to three times a day, such as erythromycin 2% or clindamycin 1%. Keeping the affected area clean is also important.
New Zealand Dermatological Society. (2005). Fordyce Spots. Retrieved on March 16, 2011 from the New Zealand Dermatological Society: https://www.dermnetnz.org/acne/fordyce.html
Tomecki, K.J. & and Cevasco, N.C. (2010). Common Skin Infections. Retrieved on March 16, 2011 from the Cleveland Clinic: https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/common-skin-infections/