The Boys' Growing Up in the Lord

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I have what I have been told are clogged sweat glands on my scrotum. They do not hurt or itch and they are not blistered or red. They are small (no bigger than an eraser head) and somewhat hard -- they started showing up after a lot of football practice (wearing my cup). They are not going away. What are the possibilities that they are "just clogged sweat pores"?

Rick (age 18)

The medical term for clogged sweat glands is called "hidradenitis suppurativa." It is similar to acne, which are clogged oil glands, but in this case it is the sweat glands which are clogged. Like acne it starts out as a red spot that swells (as the gland produces sweat with no place to exit). Over a period of hours, to sometimes days, it continues to swell until the surface finally breaks and clear or yellow fluid seeps out. Because the surface skin tears, it can cause scarring.

The problem is divided into three stages. In the first stages, a person gets firm swellings about the size of a pea (about a quarter inch to a half inch across). These often rupture and leaves no scars. However, new swellings occur in adjacent areas and because the skin is already loosen by early swellings these can get to golf ball size. Some become interconnected. This is stage two. When it appears broadly, it is called stage 3. This site shows images of mild to severe cases on the underarms: http://www.dermnetnz.org/acne/hidradenitis-suppurativa.html but the same can happen around the groin. If your diagnosis was accurate, then you are in the early first stages of this problem.

It is not caused by improper washing. It is something some people are prone to have. People with a lot of acne seem to have it more often.

There is not much in the way of treatment, other than giving antibiotics to prevent or reduce infections developing in the clogged glands. The condition is know to flare up, last for several years, and then mysteriously goes into remission. Meanwhile steps are recommended to avoid trapping sweat against the skin, such as tight clothing (like your jock strap). Tight clothing also rubs against the skin, and irritated skin is more likely to break out. The medical journals also strongly recommend that areas affected not be shaved as shaving irritates the skin.

I would recommend talking to your doctor about whether you should continue football practice for the near term. It would also be good to see a specialist in dermatology for a second opinion about whether you really have clogged sweat glands. Meanwhile, wear as loose clothing as you can, such as loose boxer shorts and light-weight, loose pants. At night, sleep with nothing on below the waist or wear very light, very loose shorts. If you do have this condition, the scaring can get severe. It would be better to avoid sports that require a jock strap than to suffer with the scarring which is basically permanent.