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What Causes Black Spots On The Scrotum and How To Get Rid of It?

Black Spots on the Scrotum are something that many men complain about across the United States. The primary cause for these spots is a medical condition called angiokeratoma of Fordyce. The primary constituents of these spots are blood vessels that have expanded or dilated to an extent that they can be seen by the naked eye on the skin surface in the form of spots. Angiokeratoma was first described as a medical condition back in 1896. The root cause of this condition even now is not yet clear. However, the risk of an individual getting this condition increases with age. There is no evidence to suggest a genetic link to the development of this disease.[1]

This condition is relatively benign and there are hardly any complications related to it even though at times the lesions can bleed. The lesions that cause Black Spots on the Scrotum are slightly raised and feel rough when palpated. They are usually purplish to dark red in color with a blackish tinge to it. While they most commonly occur in the scrotum, they may also appear on the shaft of the penis and the inner part of the thighs.[1]

Black Spots on the Scrotum are not a cause of worry, especially if there are no symptoms associated with it. This article highlights some of the prominent causes of Black Spots on the Scrotum and different ways to manage the condition.[1]

What Causes Black Spots On The Scrotum?

As stated, angiokeratoma of Fordyce is the main cause of Black Spots on the Scrotum but what causes this angiokeratoma is still a matter of ongoing research. Some researchers however believe that elevated pressure of the blood in the scrotal veins can play a role in the development of angiokeratoma of Fordyce causing Black Spots on the Scrotum.[2]

Researchers also suggest certain risk factors that also play a role in an individual having Black Spots on the Scrotum. These factors include having a history of hemorrhoids. People with a known diagnosis of irritable bowel syndrome are also at increased risk for developing angiokeratoma of Fordyce resulting in Black Spots on the Scrotum. People who are chronically constipated also are at increased risk for having Black Spots on the Scrotum.[2]

According to research, the primary risk factor for angiokeratoma of Fordyce is a history of Fabry Disease. It is an extremely rare condition and affects only about 1 in 60,000 males across the world. It is a genetic condition and results due to mutation of the GLA gene which functions by producing enzymes that break down fat. A defective GLA gene results in the fat not being broken down completely causing accumulation of fat throughout the body. This ultimately affects the functioning of the heart, nervous system, and the kidneys.[2]

It also tends to increase the blood pressure in the veins of the scrotum causing angiokeratoma of Fordyce resulting in Black Spots on the Scrotum. Fabry Disease has two forms namely the classic and the late onset form. The symptoms of the classic form of Fabry Disease can be evident right from childhood and tend to progress rapidly. In late onset Fabry Disease, the accumulation of fat is much slower and the symptoms present much later in life by the third or the fourth decade.[2]

How To Get Rid of Black Spots On The Scrotum?

Coming to the treatment of angiokeratoma of Fordyce causing Black Spots on the Scrotum, if there are no associated symptoms and the spots do not bother the patient then no treatment is required. However, if the spots look unsightly and are disturbing to the patient then a consultation with a physician is required to discuss different ways on clearing away these dark spots.[2]

There are various options available for removal of Black Spots on the Scrotum. These include

Electrodesiccation & Curettage: This procedure involves using local anesthesia around the area of the spots, and once the anesthesia takes its effect then gently scraping the spots off from the surface of the skin.[2]

Laser Treatment: As the name suggests, this procedure involves use of laser beams to completely destroy and remove the enlarged tissues that are causing these black spots.[2]

Cryotherapy: This procedure involves freezing of the tissue that are responsible for causing the black spots are frozen and then removed. This procedure is quite easy and healing is also very rapid.[2]

In cases where Fabry Disease is responsible for causing Black Spots on the Scrotum, then it requires much aggressive management. Fabry Disease requires injection of a drug called Fabrazyme which replenishes the deficient enzyme that breaks the fat in the body thus increasing the ability of the body to break down fats much better.[2]

Fabry Disease also causes pain in the upper and lower extremities. This can be treated with either Neurontin or Tegretol. Once Fabry Disease comes under control, the Black Spots on the Scrotum also gets treated.[2]

In conclusion, Black Spot on the Scrotum is a harmless condition and in majority of the cases does not require any treatment unless they look unsightly or disturbing to the individual. However, if an individual observes Black Spots on the Scrotum it is better to get in touch with a physician to get a definitive diagnosis and rule out conditions like Fabry Disease which may have far greater implications on the overall health of the individual.[1,2]

There are a variety of treatments for Black Spots on the Scrotum not resulting from Fabry Disease. They include cryotherapy, laser treatments, and electrodessication. All these treatments are noninvasive and are extremely effective in getting rid of Black Spots on the Scrotum.[2]

However, if Black Spots on the Scrotum are caused by Fabry Disease then it requires more aggressive and prolonged treatment. This is because of the deficiency of the enzyme that breaks down fat in the body which has to be replenished by medications. If Fabry Disease is left untreated, then it may result in increased risk for the individual having cardiovascular diseases, renal failure, or even stroke. Some studies have linked Fabry Disease to onset of depression as well.[2]

In case if an individual is diagnosed with Fabry Disease then joining a support group is always beneficial as they allow them to connect with other people who have the same condition and understand different ways of coping with the disease. Aside from this, Black Spots on the Scrotum are completely benign and should not be a cause of worry for the affected individual.[2]


Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 26, 2021

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