When Tom* first got Botox, he had no idea that it would become a “gateway into the cosmetic world.”
The 44-year-old construction worker had become increasingly conscious of his appearance during the pandemic, with so much time spent at home out of his usual routine. In 2023, he decided to bite the bullet and get Botox injected in his forehead and around his eyes. He loved how smooth it made his skin look.
Then, in the autumn of 2025, Tom met with Dr Aamer Kahn, co-founder and medical lead of Harley Street Skin, who mentioned that Botox could stop sweating, too. Tom was intrigued. He joked that he could do with it in his balls, because he gets “quite sore in between the legs,” not knowing that you could really get Botox below the waistline. Then Dr Kahn suggested Scrotox.
Tom loved the idea of not having the “rub, rub, rub” sensation when he walked, which irritated his thighs. He booked himself in for a procedure.
Tom is one of a growing number of men who have decided to get Scrotox — a treatment that involves injecting the neurotoxin botulinum toxin (Botox) into their scrotal sack. The procedure, which costs around £1,200 a pop and lasts for about 3 to 4 months, can relieve scrotum pain and discomfort. However, in recent years, Botox practitioners have seen a rise in men requesting the treatment for cosmetic reasons, with patients seeking a less wrinkled and lower-hanging scrotum.
On the day of his Scrotox treatment, Tom said that a practitioner put EMLA, a local anaesthetic cream in his scrotal area, which made it numb and cold. The pain that followed wasn’t excruciating, but uncomfortable. “It was just like lots of scratches,” Tom reflected, like crawling “through a rose bush.”
Afterwards, Tom was surprised to discover that there were other benefits to the procedure. He was already meticulous about manscaping his genitals, making sure that his testicles were hairless. Now, his balls were smoother, “more hangy”. He felt more confident. Sex with his wife, whom he’d been married to for about twenty years, felt better, too (there is no scientific evidence that Scrotox enhances sexual pleasure, however, this has been reported anecdotally).
Male intimate treatments “through the roof”
In recent years, Botox use has been on the rise among men, with a 70 per cent jump in male aesthetic treatments since 2021, according to the British College of Aesthetic Medicine.
“The interest in male intimate treatments has gone through the roof,” Dr. Richard Viney, a urology surgeon at Eve Clinics, told The Standard. He said that he tends to do around four to five Scrotox procedures a month, compared to one or two a year about three years ago. Requests for other cosmetic procedures, such as scrotum filler and penile scar treatment, have also become more common.
Sometimes patients want Scrotox for medical reasons, such as chronic scrotal pain and tightness. Botox blocks the release of acetylcholine, a neurotransmitter that makes muscles contract, which helps relax muscles in the area. Other patients have crotch rashes or fungal infections from excess sweating and get Scrotox to reduce perspiration, because it can inhibit sweat glands.
One of Dr. Viney’s patients was a man named Edward*, a 40-year-old software developer, who struggled with excess sweating from his scrotum, resulting in painful rashes. The perspiration made him feel self-conscious. He’d be out with friends, worrying: “Do I smell? Are people going to notice anything?”
Since the procedure, he’s able to go on holiday, walk long distances and go sightseeing without feeling paranoid. “Everything is a bit more positive in life because I just don't have that worry in the back of my head,” he told The Standard.
Dr. Viney says that staff at his clinic will have “a wet shoulder from someone having a cry”, every other week. “A lot of it's because they feel validated,” he says.
“They're just grateful that someone's going to listen to them and offer them some solutions,” he says, “There's so much invested mentally and emotionally from these young men in their penises.”
Patients as young as 19
Dr Khan has also seen a “tremendous increase” in requests for Scrotox, with a boom in bookings after 2020. Many of these requests are from men who have gotten divorced during the pandemic, and now want “less wrinkling” and a more “youthful” looking scrotum. However, Dr Kahn has also seen “a shift towards younger people” wanting intimate treatments.
“A lot of people who come with anxieties around the size of their sexual organs is based around this unrealistic perception that's been touted around the media,” he says. If a young person wants the procedure for aesthetic reasons, he said he will often turn them down and connect them with a psychologist instead.
However, Dr. Viney says that deciphering a patient’s intention is easier said than done. While the majority of patients requesting Scrotox say that they want it for physical reasons, such as scrotal pain, he reckons that some are motivated by aesthetics but are too embarrassed to admit it.
“I just wonder whether they're using that to hide the real reason, which is the fact they just want a more impressive scrotum when their underpants come down,” he says.
Dr. Viney said he’s had patients as young as 19 asking for Scrotox, who say that they had wanted it for years but can only now afford it.
“Very few [men] will come in and off the cuff say: ‘I want this because I want my scrotum to hang lower,’” he says, “most will beat around the bush with a complex and relatively convoluted story of a variety of ailments that they believe that this treatment will fix”.
He theorises that “dick pics”, people sending photographs of their penis to romantic prospects, may have something to do with it, as people may want to make their genitalia look “trimmer than usual”.
Backstreet Botox
With social media and pornography continuing to propagate unrealistic body standards for people of all genders, it’s likely that the demand for intimate cosmetic treatments will only continue to rise. But amidst a cost-of-living crisis, some Brits are taking cosmetic procedures into their own hands, with a backstreet Botox industry on the rise.
Earlier this year, the UK Health Security Agency (UKHSA) issued a warning about practitioners injecting patients with suspected fake Botox, following 38 cases of botulism poisoning in England linked to unlicensed Botox-like jabs between 4 June and 14 July.
Even when injected properly, Scrotox can cause tightness, numbness, temporary bruising, and asymmetry. Scrotox can also affect temperature regulation, which can affect sperm production and fertility.
If Botox is injected in an unclean environment, it can result in severe infection.“Some of the Botoxes that they're using are more than 2000 times more concentrated the ones we use,” Dr Kahn says, adding that DIY Botox can be fatal. “We need that medical understanding of what the consequences can be.”
Given those risks, if you’re thinking of injecting anything into your scrotum, it’s definitely worth speaking with a medical professional before you do.
*Names have been changed.
