Bumps on Scrotum: Potential Causes and Treatment Options

A scrotal mass is an abnormality that appears on the scrotum (the bag of skin that hangs behind the penis).

Although the swelling isn’t always a critical problem, it could be a sign of a much more serious health condition. 

But, these testicle abnormalities are not very rare. The incidence rate of testicle problems has skyrocketed in the last 50 years. In comparison, the prevalence rate of testicular cancer has gone up 3-to-4 fold since the 40s. Now, there are millions of people suffering from all kinds of testicle abnormalities.  

However, most people don’t realize the sheer impact testicle problems can have on their overall health. If left untreated, they can worsen over time and cause stress, lack of self-confidence, and relationship issues. 

If the lump is an abnormal tissue or an accumulation of fluids, it can become hardened, inflamed, and swollen. In some cases, these masses may be cancerous, which could drastically impair your testicle health and function. 

That’s why it is essential to monitor the health of the penis. Regular doctor exams and self-examination are the keys to recognizing early scrotum issues and getting on-time treatment. Here is what the bumps on the scrotum mean and how to treat them. 

How to Recognize a Testicle Abnormality?

The symptoms of a scrotal mass depend on the type of problem you have. Some may be more uncomfortable and painful than others. But, overall, the typical signs include:

  • Sudden testicular pain 

  • Abnormal lump

  • Dull ache that makes the scrotum feel heavier

  • Radiating pain in the lower back, abdomen, or groin

  • Hard, swollen, or tender testicle

  • Hard, swollen, or tender epididymis 

  • Inflamed and red skin 

  • Vomiting 

  • Nausea

Note: If the swelling is the result of an infection, then you may also experience blood or pus in the urine, change in urinary frequency, and fever. 

Possible Causes of Bumps on the Scrotum

There are three types of lump causes: common, less frequent, and extremely rare. It’s vital that you recognize all of them if you are concerned about your testicle health. Here is a quick overview of the various causes of scrotum bumps. 


The moment a scrotum vein expands or becomes swollen, this condition can occur. This common vein abnormality only affects the testicle and typically appears on the left side of the scrotum. 

It is recorded in 15% of healthy men, 80% of men with secondary infertility, and 35% with primary infertility. This scrotum problem can be classified into 3 grades:

  • Primary (Grade 1) – when the bump becomes visible during the Valsalva maneuver (a breathing technique that slows down the heart; done by holding the nose and breathing out through the mouth).

  • Secondary (Grade 2) – when the bump is very easy to spot with or without the Valsalva maneuver.

  • Tertiary (Grade 3) – when the bumps are incredibly easy to detect with a simple visual scrotum inspection.

The bump is quite like a varicose vein, but only appears on the affected testicle. Even though this testicle problem may not be a serious health issue, it’s still a good idea to consult a doctor and get a proper diagnosis. 

Hydrocele and Spermatocele

Over 30% of the adult male population have spermatoceles (an epididymal cyst). While congenital hydrocele prevalence rate is 1% in adulthood and 6% at birth. 

When there is a cyst growing in the epididymis (also known as the tube inside each testicle that is packed with unused sperm and fluid), that’s when spermatocele develops. Both hydrocele and spermatocele terminology refers to the abnormal fluid collection in the scrotal sac.  

Due to an undescended testicle, patients can experience an inguinal hernia. This can appear when a tiny component of the intestine drops all the way to the testicles. It can create a lump. The hernia can only happen in the male population. 

Even though the aetiologies are different, hydrocele and spermatocele often require surgical treatment. The scrotal lump can cause some level of pain and feels like an unnatural firm bump under the scrotum skin. This kind of testicle cyst isn’t cancerous. However, it can get bigger and result in swelling, discomfort, and a lot of scrotum pain. 


The scrotum is packed with hair follicles. Each scrotum hair follicle is prone to pimples and bumps for all kinds of reasons, such as:

  • Blocked pores

  • Dirt and oil build-up

  • Ingrown hair

Their circular and bumpy shape is like a regular pimple that appears on the face or back. In some cases, it can be as simple as a red lump, while in others, it could have a discolored form. 

The simplest way to spot a pimple would be to analyze the surface of the affected area. The skin around the abscess will be greasy and very oily. If there is some pus that dried out, it would appear in a much darker color. These are often minor problems and tend to go away on their own. 

Sebaceous/Epidermal Cyst

When there is too much fluid or air in the sebaceous gland, a sebaceous cyst can appear. The gland, also known as the sebum, is used to store oil and keep the skin protected, coated, and safe. When these substances have nowhere left to go or can’t leave the skin, the inflamed cyst starts to form.

The moment the gland becomes enlarged, affected individuals can also experience Fordyce spots. They look like white-yellowish spots and are harmless. Unfortunately, they can pop up anywhere on the skin, that includes the penis as well. 

When the cyst is benign, it is not a severe issue. But, they can turn into cancer and affect the testicle health. Although that happens in 1% to 2% of all intratesticular tumors, it is in your best interest to get a regular check-up.

Genital Herpes    

Herpes that affect the genitalia is a typical sign of an STI (sexually transmitted infection). They can cause uncomfortable scrotal swelling. When you scratch the herpetic sore too often, it could turn into a blister and ooze out infected fluids. 

This will spread the infection onto each testicle and affect the scrotum. If you are infected with a genital skin tag, genital wart, or herpes, you should avoid having unprotected intercourse. 

Testicular Mass

A testicle budge can happen as a result of an infection, excess fluid, or swelling. Also, if you’ve had a traumatic injury, it may directly impact the blood flow to the testicles, like is the case with testicular torsion

The problem causes an uncomfortable bump, swelling, and pain, which will need adequate treatment. But, in some cases, the testicular mass is the result of a testicular tumor. If you notice a mass in the scrotum, contact your doctor to get a proper diagnosis. 


If a bacterial infection has affected the reproductive system, the testicles become vulnerable to inflammation. Swelling in the lymph nodes will start to form close to the groin. In most patients, the puffiness appears in one testicle, but it’s not unusual for the bacteria to affect them both. 

Orchitis causes painful ejaculation and urination. It may also result in penile discharge, groin inflammation, and bloody pee. It is easy for most patients to get rid of the symptoms once the infection has been treated. But, to avoid any serious damage to each testicle, it is essential to get on-time treatment. 

There are all sorts of infections that can cause the exact same problem. Take the molluscum contagiosum, for example. This is a typical skin infection triggered by a virus. It can cause a tiny (1/8inch) round bump in the pubic area. The bump can be itchy and painful. Avoid scratching the affected spot to prevent spreading the infection. 

Testicular Cancer

Testicular cancer could appear in both testes. Experts estimate that 8,000 to 10,000 men develop this type of cancer annually. 

In a major portion of patients, cancer begins with a tiny tumor inside the testicle. Luckily, the cure rate for the testicular tumor is relatively high and can be over 95%. The sooner the cancer is treated, the bigger the chances of stopping the spreading and removing the tumor completely.

Idiopathic Scrotal Calcinosis (SC)

When there are big discolored bumps that grows outside the scrotum, people experience SC. This condition is extremely rare and less likely to happen compared to cancer or orchitis. However, it can be a pressing matter if left unmanaged. 

The testicular lump can range from 1mm to a couple of centimeters. The lesion is not always painful, but the look and shape of the testicles will change. Since the condition affects the scrotum’s outer skin layer, the lump is a lot more visible and may impact your confidence and sex life. 

Nevertheless, it is still critical to see a doctor so they can rule out any cancerous tissues. They will suggest an ultrasound scan to diagnose and observe the reproductive organs for any abnormalities. 

Treatment Options

Most testicle bumps need minimal or no treatment. Still, some patients with serious scrotum conditions, like infections or cancer, will need more rigorous treatment therapies. The type of treatment you receive depends on the state of your testicle bump. The causes have a major role to play. 

For example, if a viral infection causes the lump, you will need a proper antibiotic ointment or antibiotic therapy to treat the infection. This is a practical option when dealing with minor health problems.

The doctor may also suggest pain medications, rest, and ice therapy. These are the go-to choice when looking to reduce the inflammation and get the scrotum skin back to normal. This will help regain normal testicles function and enjoyable sex life.

Serious infections or health conditions will need more invasive treatments. When the testicle problem is benign (non-cancerous), the mass could be surgically repaired, drained, and removed. This is a typical approach when the scrotum problem is too severe, uncomfortable, and painful. 

Particularly in the case of a tumor. The doctor will use surgical incisions to remove the spermatic cord from the affected area, like with varicocele surgical clamping. The doctor can clamp the affected blood vessel and restore regular blood circulation.

But, if the lump is caused by cancer, options like chemotherapy and radical inguinal orchiectomy can help. With on-time treatment, cancer can be treated successfully.

When to Book a Doctor’s Appointment?

Before you contact an expert:

  1. Do a testicular self-exam Touch and feel the testicles.

  2. Examine the scrotum pouch under the penis and look for physical changes.

  3. If any abnormalities cause discomfort or pain, particularly something that feels like a lump or a bump, contact a doctor. 

Even if it may not be a severe issue, like cancer, for example, you still need to get a check-up. Doctors suggest that you get the testicles checked once a year. This will help you avoid cancer or other complications. 

Final Thoughts

In most cases, a scrotum lump is nothing to be concerned about. Pimples and bumps tend to disappear on the scrotum on their own. But, if you are feeling some discomfort and pain, it may be a good idea to ask the doctor/urologist for antibiotic treatment.

However, if the scrotum bumps are disruptive, extremely uncomfortable, and causes pain, you need to get checked. It could be a sign of cancer or possibly serious complications. With regular check-ups and adequate treatment, you can prevent these issues from getting any worse. 


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  2. Bader Alsaikhan. (2016). Epidemiology of varicocele. National Institutes of Health. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770482/
  3. Tim Jewell. (2019). What the Bump on Your Scrotum Might Be and How to Treat It. Retrieved from: https://www.healthline.com/health/bump-on-scrotum#potential-causes
  4. Mayo Clinic. (2020). Scrotal masses. Retrieved from: https://www.mayoclinic.org/diseases-conditions/scrotal-masses/symptoms-causes/syc-20352604
  5. Cleveland Clinic. Spermatocele. Retrieved from: https://my.clevelandclinic.org/health/diseases/17492-spermatocele
  6. Mahesh M. Thapa. (2009). Epidermoid Cyst of the Testicle. National Institutes of Health. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897973/
  7. Johns Hopkins Medicine. Testicular Cancer Statistics. Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/testicular-cancer/testicular-cancer-statistics
  8. WebMD. Testicular Exam. Retrieved from: https://www.webmd.com/men/testicular-exam#1
  9. American Urological Association. (2020). Hydrocele. Retrieved from: https://www.auanet.org/education/auauniversity/education-products-and-resources/pathology-for-urologists/testis/non-neoplastic-conditions/hydrocele
  10. Boston Children’s Hospital. (2019). Molluscum Contagiosum. Retrieved from: https://youngmenshealthsite.org/guides/molluscum-contagiosum/

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