Q: I am a 51-year-old man and I have had problems with sensitive skin since childhood. However, over the past four months, I have been coping with a skin irritation on my scrotum and crotch area.

The left and right side of my crotch has darkening skin which is also itchy and flakes when scratched. The irritation comes and goes but is more severe at night. On the scrotum, the skin is often unbearably itchy.

I do not think it is a sexually transmitted disease since I do not engage in sexual activity outside of my marriage. So far, the use of cortisone and antiseptic creams seem to have no effect. Do I have acute psoriasis or eczema?

A: This is not uncommon among men, young or old. Many men experience an itchy groin and/or scrotum from the following common conditions: fungal infection, eczema or skin irritation.

It may also be due to other skin problems but these three most probably account for the problem 90 per cent of the time.

The darkening of the skin can either be due to a long history of repeated scratching or the complication of the fungal infection or eczema. It might or might not fade with treatment, depending on its severity.

The problem is often aggravated by scratching knowingly or unknowingly during sleep.

A clinical examination and, if needed, laboratory investigations will give an accurate diagnosis. Keeping the groin dry and wearing comfortable briefs help soothe the area.

Dermatologists often prescribe anti-inflammatory steroids or anti-fungal creams for topical application, depending on the diagnosis.

Short courses of oral medication, like antibiotics or steroids, may sometimes be necessary. Above all, avoid scratching the groin or scrotum for any chance of improvement.

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Assistant Professor Wong Soon Tee

Assistant Professor Wong Soon Tee is a specialist in dermatology at Raffles Hospital

This story was first published in Mind Your Body, The Straits Times.