Patient: I am a 68-year old crane operator. I sit for long hours every day in the hot sun erecting the Honolulu Rail. The past 2-years I have been experiencing a foul, musky, cheesy odor emanating from my scrotal area. Sometimes it feels slimy in the crotch area between my pubic area/scrotum and my upper thigh. I religiously shower with an antibacterial soap (Safeguard) and routinely apply 1% Clindamycin after showering as a topical treatment. It does seem to help. I will not let anyone perform oral sex on me as I am both self-conscious of the aroma and do not want to possibly spread whatever it is that I have by masking the aroma temporarily, and having intercourse is a definite no-no.What can I do to alleviate whatever the hell it is that I have going on? PS. I have notice that I am now getting several small skin tags in my left groin area too which may or may not be related to the funky smell.
Symptoms: Pungent aroma, slimy moisture and occasional itching/burning.
Doctor: I believe everything will be fine, it might be simply a combination of sweat, bacteria, shed skin and water that hides between the thighs just below the scrotum and smells foul. It can also be due to a substance called ‘smegma’ produced by the minute microscopic protrusions of the mucosal surface of the foreskin whose function ironically is to clean the male organ but immediately smells like a pack of decaying musky/fishy/cheesy once it is not thoroughly cleaned off daily. I understand, male genital odor builds up to become completely unbearable as men grow older. Male genital odor can pose adverse effects to one’s self-esteem and can also be a complete turn off to one’s partner, due to which you are avoiding sexual activity. It is suggested that shaving and cleaning your genitals, in between your legs and your anal area is essential. Clean in between your legs and under the scrotum till it is completely dry after taking a bath. Most men when cleaning up after bathing, do not pay attention to cleaning down there, till it is dry. Any moisture still remaining there would eventually settle there and mix with dead skin and skin excretes and smell. The scrotal area is to be washed till it is dry and given about 5 minutes space before putting on your briefs or boxers Any moisture still remaining there would eventually settle there and mix with dead skin and skin excretes and smell. Dusting powder or baby powder to prevent friction may be used. You must wear something airy so that your genitals breathe at night.The anal region must be cleaned after defecating with soap and water as against tissue papers alone. Fecal matter still lying around the anus would get stuck in the hairs around that region and produce a very unpleasant smell. You may take a bath twice every day and also after a strenuous activity, paying attention to your inner thighs, your armpits, behind the knees and the back of the ear-all enclosed areas. If you have foreskin, pull it back and wash the penis carefully as well. Finally, it may be an ‘intertriginous dermatitis’ with maceration due to which it could smell foul Abetamethasone cream with an antibacterial cream and a moisturiser may be applied on a daily basis and it will be fine then. Skin tags are not related to this odor of yours and they can be permanently excised. Hope it is useful.