What is Scrotox? Why gay men are getting Botox down there

What is Scrotox? And why are people getting it?

Scrotox is a cosmetic procedure where Botox is injected into the scrotal area in order to paralyze the dartos muscle.

“This dartos muscle is the superficial smooth muscle layer of your scrotum that contracts and wrinkles your scrotal skin,” said Dr. James J. Chao, a board-certified plastic surgeon and cofounder of VedaNu Wellness. “When you paralyze that muscle with Botox, your scrotal skin droops lower, becomes smoother and tightens less.”

Some men are choosing to get Scrotox for purely aesthetic reasons — the testicles will look smoother and hang lower — but there are also medical reasons to get it done.

“It makes sense as part of the greater movement of men spending more money on cosmetic treatments overall,” Chao said. “The cosmetic male grooming industry has been growing about 8 to 9 percent annually for the past several years and ‘downstairs aesthetics’ are starting to drive a portion of that growth. That being said, Scrotox can also be also used to treat a medical condition known as scrotal hyperhidrosis, which is basically just a clinical way of saying you sweat a lot down there. Injections can reduce sweating, which means less chafing and irritation when you’re working out or in hot weather.”

Not only can Botox be used to decrease sweating, but it can also reduce pain and discomfort in the scrotal area if you have an overactive cremaster muscle, which causes frequent involuntary contractions. “If a person experiences tightness or hypertonicity in these muscles, it can be used as a treatment to decrease pain,” Eve Hall, a sexual health physical therapist, sex educator, and host of the Please Me! Podcast with Eve.

How much does it typically cost?

You should expect to pay between $500 and $1500 for a Scrotox treatment, and you’ll want to make sure you go to a reputable injector, even if that means paying a little more. The procedure itself only takes 15 to 20 minutes to complete, and you should begin to see results within 10 to 14 days.

“The price will vary based on where you live, how experienced your injector is, and how many units are administered,” Chao said. “The average cost is $750-$1,000 for 75-100 units. Since results last three to four months, you would need to get the procedure done three to four times a year to maintain your results.”

How does Scrotox impact your sex life?

According to Chao, there is anecdotal evidence that some men have more sensitivity during sex after getting Scrotox, although no formal study has been done.

“The thought is that by relaxing the scrotal skin, there is more surface area for the penis,” he said. “This allows more nerve endings to be exposed which may enhance sensation. Of course, it is worth being transparent here: there are currently zero studies or clinical trials that evaluate how Scrotox may or may not improve sexual function. Any claims about improved erections, orgasms, sensitivity or anything along those lines are purely anecdotal at this point.”

Your sex life may also improve if you are getting Scrotox to reduce pain. “If you have any pain syndrome, you can expect the pain to decrease and your ability to participate in sexual activity can be enhanced,” Hall said.

Are gay men more likely to get Scrotox?

Chao said that while he doesn’t have any formal data about whether gay men are getting Scrotox more than straight men, gay men tend to be early adopters of new cosmetic treatments, and they are far more comfortable talking about it.

“From what I’ve seen practicing aesthetic medicine, men who identify as gay have been trendsetters when it comes to cosmetic treatments,” he explained. “Several cosmetic and grooming industry sources have reported that gay men felt grooming was much more important and performed more grooming activities than their straight counterparts. Having open conversations about aesthetics and skincare has been accepted by the LGBTQ+ community for a long time.”

Since gay men are driven by aesthetics and body image, it makes sense that Scrotox would become popular, especially since it can impact one's sex life in positive ways.

“I do think gay men tend to place more focus on appearance than the average person,” Hall said. "With that in mind, it’s likely a conversation happening more within the gay community, as this group is often more open-minded about out-of-the-box sexual experiences and generally more willing to try new things.”

Are there any side effects?

Most people will experience only minor bruising, swelling, and discomfort for 24 to 48 hours and can resume normal activities almost immediately. In rare cases, patients may experience temporary numbness or an asymmetrical appearance in the level of wrinkling or cause one testicle to hang lower than the other. Before you get Scrotox, you should do your research about the procedure and make sure you are going to a reputable injector.

“There is also some animal based-research that suggests injecting high doses of Botox into the scrotal region can impact sperm motility and count,” Chao warned. “We need more human trials, but if you’re looking to have kids in the near future, it might be worth waiting on Scrotox.”

Hall also said that while men may end up loving the procedure because of how it makes them look, and the increased sensitivity they feel during sex, you don’t want to get caught in the trap of always chasing aesthetic perfection.

“While some people may experience increased pleasure following the procedure, it is temporary — so will you be chasing that aesthetic long term? If this is rooted in insecurity, it may be more beneficial to work on the psychological aspects of self-acceptance and body positivity rather than continually investing in something that reinforces it.”

Sources cited:

Eve Hall is a sexual health physical therapist, sex educator, and host of the Please Me! Podcast with Eve.

Dr. James J. Chao is a board-certified plastic surgeon and co-founder of VedaNu Wellness.