I have a pimple-like bump on the scrotum with hard white stuff under it. What could it be?

Hello,

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These are infections of hair follicles, which are similar to pimple only. It is usually not concerning but should be treated with antibiotics. It looks quite localized and uncomplicated from the picture (attachment removed to protect patient identity). So in my opinion, you should go topical antibiotics like Clindamycin or Mupirocin ointment three to four times a day for 5 days. However, if you notice it is not responding or spreading, and develop pain, swelling, and fever then you will need oral antibiotics like Augmentin (Amoxicillin and Clavulanic acid). Important thing is to keep good hygiene and keep the area dry with frequent use of powder. Do not use steroid ointment. I hope this helps. Thank you.