Children's Hospital Colorado

Penis-Scrotum Symptoms

Urgent or Emergency Care?

If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.

Help Me Decide

  • 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.

Go to ER Now

  • Not circumcised, and foreskin pulled back and became stuck on head of penis
  • Can't pass urine or can only pass a few drops

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

Care Advice

Treatment for Mild Rash or Itching of Penis or Scrotum

  1. 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.
  2. Clean the Area:
    • Wash the area once with soap to remove any irritants.
  3. 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.
  4. 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.
  5. What to Expect:
    • Small rashes from irritants should go away in 1 to 2 days with treatment.
  6. Prevention of Recurrent Symptoms:
    • Teach your son to wash his hands if they are dirty.
    • Have him clean his hands before touching his penis.
  7. 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 Questions

  1. 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.
  2. 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.

Erection Questions

  1. 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.
  2. Call Your Doctor If:
    • Erection lasts over 1 hour
    • Erection becomes painful


The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

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  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
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    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

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