What Is Scrotox, It's Possible Effects, Risks and Why Men Are Having Botox Injected into the Scrotum. Here's What The Evidence Says
- Rick Howard
- Mar 29
- 7 min read
Updated: 4 hours ago
Scrotox is one of those treatments people often assume must be a joke, an internet trend or something invented by celebrities. At Mr Beautox Aesthetics in Worthing, I am often asked whether it is a genuine treatment and what it is actually intended to do.
What is Scrotox?
Firstly, the name "Scrotox" combines “scrotum” and “Botox”. BOTOX® is actually one specific brand of prescription-only botulinum toxin, so this article uses the term botulinum toxin when discussing the treatment generally.
Scrotox is a genuine procedure, although its memorable name can make it sound more established than the scientific evidence currently supports.
In simple terms, Scrotox is an off-label treatment in which prescription-only botulinum toxin is injected into the scrotal tissue.
The aim is usually to relax the dartos muscle, which causes the scrotal skin to tighten and wrinkle. Some published techniques have also treated the deeper cremaster muscles, which draw the testicles closer to the body.
Relaxing these muscles may allow the scrotum to appear smoother and sit in a looser, more relaxed position. Some men also enquire about the treatment because of tightness, retraction, sweating or discomfort.
However, Scrotox is not a licensed indication for botulinum toxin in the UK. Treatment techniques are not standardised, and good-quality clinical research remains extremely limited (AbbVie Ltd, 2026; Ramelli et al., 2020).
Why are men doing it?
Most enquiries tend to relate to one or more of the following:
a tightly contracted or wrinkled appearance;
wanting the scrotum to sit in a more relaxed position;
feelings of tightness or retraction;
sweating, moisture or rubbing;
or confidence about how the area looks.
The proposed effects are biologically plausible because botulinum toxin temporarily reduces signalling between nerves and muscles. However, plausible does not mean predictable, and it does not mean that every advertised benefit has been properly demonstrated in clinical studies.
Does Scrotox make the testicles bigger?
No. Scrotox does not enlarge the testicles.
Relaxing the surrounding scrotal muscles may allow the testicles to sit lower or appear more prominent. That can create the impression of a fuller or larger appearance, but the testicles themselves have not increased in size.
A published cosmetic case report described a smoother, more relaxed appearance and subjectively larger-looking testicles following treatment. However, that report involved only one patient, so it cannot tell us how consistent the result would be across a wider group of men (Ramelli et al., 2020).
Can Scrotox reduce sweating?
Botulinum toxin can reduce sweating by blocking the nerve signals that activate sweat glands. Its use for severe underarm sweating is supported by clinical evidence and appears within licensed UK product information (AbbVie Ltd, 2026).
That does not automatically prove how well it works for scrotal sweating.
Direct research objectively measuring perspiration before and after cosmetic Scrotox is lacking. The single-patient cosmetic report mentioned reduced perspiration, but this was not established through a controlled study or validated measurement.
It is therefore reasonable to say that reduced sweating is possible, but not that it is guaranteed or supported by strong Scrotox-specific evidence.
What does the cosmetic research actually show?
The most directly relevant published cosmetic paper involved a 44-year-old man who received injections into the dartos and cremaster muscles.
The patient reported satisfaction with the result, and the authors observed a smoother and more relaxed scrotal appearance. No immediate complication was reported.
But this was a single case, not a clinical trial.
The authors themselves stated that:
there were no established recommendations for cosmetic scrotal injections;
the risks were not adequately known;
long-term information was lacking;
and fertility required particular consideration.
They did not recommend the procedure for men of reproductive age because of the uncertainty surrounding fertility (Ramelli et al., 2020).
This is useful early evidence that the procedure can produce a visible effect. It is not enough to establish an average result, an ideal dose, a reliable complication rate or long-term safety.
What about research into scrotal pain?
Botulinum toxin has also been studied for chronic scrotal pain, but those studies should not be presented as proof that cosmetic Scrotox works.
A small open-label pilot study involving 18 men reported reduced pain in some participants after botulinum toxin was used as a spermatic-cord block. Benefits had largely returned towards baseline by six months (Khambati et al., 2014).
However, a later randomised, double-blind trial involving 64 men found that adding botulinum toxin to local anaesthetic was not superior to local anaesthetic alone for pain control (Dockray et al., 2020).
These studies involved spermatic-cord blocks for chronic pain. They did not investigate superficial cosmetic treatment for appearance or sweating, so the results cannot simply be transferred from one procedure to the other.
Scrotox should also not be treated as a substitute for medical assessment of unexplained scrotal pain.
How long does Scrotox last?
The effect of botulinum toxin is temporary.
The published cosmetic case remained visibly improved at three months, and the procedure was repeated after the effect declined at around six months. However, that was one patient.
There are currently no robust cosmetic studies establishing the average duration of Scrotox across a larger patient group.
The most accurate answer is therefore:
The effect may last for several months, but the average duration of cosmetic Scrotox has not been reliably established.
Individual results may vary according to the product used, dose, injection technique, muscles treated and individual response.
Does Scrotox affect testosterone, sex or fertility?
There is no good clinical evidence showing that Scrotox increases testosterone, improves erections, enhances orgasm or improves sexual performance.
There is also insufficient human evidence to confirm that scrotal or peritesticular botulinum toxin injections have no effect on fertility.
A 2026 systematic review found that human studies had generally not measured semen quality, reproductive hormones, testicular temperature or fertility outcomes. Animal research raised possible concerns with higher-dose or anatomically close exposure, but those findings cannot be directly translated into a known level of risk for human cosmetic treatment (Azeem et al., 2026).
The honest conclusion is not that Scrotox has been proven to cause infertility.
It is that reproductive safety has not been adequately established in humans.
Anyone currently trying to conceive or hoping to preserve future fertility should discuss this uncertainty fully before considering treatment.
What are the known and unknown risks?
Because cosmetic Scrotox research is limited, no reliable percentage can currently be given for Scrotox-specific complications.
Potential short-term risks associated with injections and botulinum toxin include:
pain or tenderness;
swelling;
bruising or bleeding;
redness or irritation;
altered sensation;
local infection;
an uneven or unsatisfactory result;
excessive or insufficient muscle relaxation;
and the treatment having little or no noticeable effect.
Botulinum toxin can also very rarely produce effects beyond the intended injection area. Official product information advises seeking urgent medical help for symptoms such as difficulty swallowing, speaking or breathing (AbbVie Ltd, 2026).
The absence of serious complications in a small case report does not establish that serious or uncommon complications cannot occur.
When is a cosmetic consultation not the right first step?
Scrotox is not intended to diagnose or treat unexplained testicular symptoms.
A new lump, swelling, persistent ache, change in the shape or feel of a testicle, or one testicle becoming noticeably larger should be assessed medically.
Sudden severe testicular pain, particularly with nausea, vomiting or abdominal pain, requires urgent medical attention because it can indicate testicular torsion or another serious condition (NHS, 2023).
Cosmetic treatment should never be used to disguise or delay the assessment of symptoms that may have a medical cause.
My evidence-based conclusion
Scrotox is a genuine procedure with a credible mechanism.
Relaxing the dartos, and in some published techniques the cremaster muscles, may produce a smoother, more relaxed scrotal appearance. Reduced sweating is also biologically plausible.
But the marketing has moved much faster than the research.
At present:
direct cosmetic evidence is largely limited to case reports;
there is no standardised treatment protocol;
average duration has not been reliably established;
complication rates are unknown;
and human fertility safety has not been adequately studied.
That does not mean the procedure can never produce a worthwhile result.
It means anyone considering it deserves a frank discussion about the limited evidence, realistic expectations and remaining uncertainties, rather than exaggerated claims or guaranteed outcomes.
Frequently asked questions
Is Scrotox an approved treatment?
Scrotox is an off-label use of prescription-only botulinum toxin. Cosmetic injection into the scrotum is not a licensed UK indication.
Off-label prescribing does not automatically mean that a treatment is unlawful or inappropriate, but it does mean that suitability, evidence, risks and uncertainty require careful individual assessment.
Does Scrotox make the scrotum hang lower?
Relaxing the scrotal muscles may create a looser or more relaxed position. The degree of change is not predictable, and strong clinical evidence establishing the average result is not currently available.
Does it make the testicles bigger?
No. It may change their apparent position or make them look more prominent, but it does not enlarge the testicles themselves.
Can it stop scrotal sweating?
Reduced sweating is possible because botulinum toxin can inhibit sweat-gland activity. However, direct controlled studies specifically measuring Scrotox for sweating have not been published.
How long does it last?
The effect is temporary and may last several months. Reliable studies establishing an average cosmetic duration are currently lacking.
Does it affect fertility?
Human fertility safety has not been adequately established. Men trying to conceive or wishing to preserve future fertility should treat this uncertainty seriously and discuss it during consultation.
Does Scrotox improve sexual performance?
There is no reliable evidence showing that it improves erections, libido, orgasm, testosterone or sexual performance.
Concerned about scrotal tightness, sweating or appearance?
A private consultation provides an opportunity to discuss your concerns, identify symptoms that may require medical assessment and consider the available options.
Any treatment would only be considered following an individual assessment of suitability, risks, fertility considerations and realistic outcomes. Visit www.mrbeautox.co.uk, email hello@mrbeautox.co.uk, or call or message 07902 245304 to arrange a private consultation.
Written by Injector Rick at Mr Beautox Aesthetics, Worthing.
Because sometimes the most ridiculous-sounding treatments still deserve honest, evidence-based information.
References
AbbVie Ltd (2026) BOTOX 200 Allergan Units powder for solution for injection: Summary of Product Characteristics. Available at:
Accessed: 25 July 2026.
Azeem, A., Sharma, A.C., Garchitorena, J.M., Boukind, A., Omari, I.H. and Nigro, N. (2026) ‘Scrotal botulinum toxin exposure and male fertility: Mechanistic insights and clinical evidence’, Cureus, 18(3), e105904. doi: 10.7759/cureus.105904. Available at:
Accessed: 25 July 2026.
Dockray, J., Aljumaily, A., Lau, S. and Jarvi, K.A. (2020) ‘A randomized, double-blind, controlled trial shows that onabotulinum toxin A nerve blocks do not provide improved pain control in men with chronic scrotal pain’, Journal of Urology, 203(4), pp. 767-772. doi: 10.1097/JU.0000000000000658. Available at:
Accessed: 25 July 2026.
Khambati, A., Lau, S., Gordon, A. and Jarvi, K.A. (2014) ‘OnabotulinumtoxinA nerve blocks provide durable pain relief for men with chronic scrotal pain: A pilot open-label trial’, Journal of Sexual Medicine, 11(12), pp. 3072-3077. doi: 10.1111/jsm.12707. Available at:
Accessed: 25 July 2026.
NHS (2023) Testicle lumps and swellings. Available at:
Accessed: 25 July 2026.
Ramelli, E., Brault, N., Tierny, C., Atlan, M. and Cristofari, S. (2020) ‘Intrascrotal injection of botulinum toxin A, a male genital aesthetic demand: Technique and limits’, Progrès en Urologie, 30(6), pp. 312-317. doi: 10.1016/j.purol.2020.04.016. Available at:
Accessed: 25 July 2026.
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