Under No Circumstances Should You Tan Your Balls

Fox News host Tucker Carlson can’t stop talking about balls. He’s deeply concerned about an alleged “crash” in testosterone levels among American men, so much so that he produced an entire documentary about it called The End of Men. The trailer, which dropped on Friday, shows a bunch of ripped, shirtless dudes doing man stuff: shooting guns, wrestling each other, chopping down trees, milking cows (???), and chugging raw eggs. Perhaps most notably, it also includes a shot of a fully naked guy blasting his genitals with a red light therapy machine.

Carlson has become a big proponent of so-called “testicle tanning”: exposing one’s nuts to infrared light in an effort to boost testosterone. He endorsed the practice during a segment of The End of Men with self-described “fitness professional” Andrew McGovern, who claimed that testicle tanning and red light therapy have “a massive amount of benefits.” Later on in the doc, Carlson pitched the idea to Kid Rock, for some reason, imploring him to “open [his] mind.”

“Don’t you think at this point, when so many of the therapies, the paths they’ve told us to take, have turned out to be dead ends that have really hurt people, why wouldn’t open-minded people seek new solutions?” Carlson asked. A seemingly baffled Kid Rock just shook his head and said, “I don’t know what the hell is going on in this world.”

There isn’t much research demonstrating that red light therapy has therapeutic benefits. The Cleveland Clinic notes that “the full effectiveness of red light therapy has yet to be determined.” We know even less about testicle tanning, specifically.

To get a better sense of what could happen when you zap your testicles with an infrared light machine, VICE called up Seth Cohen, a urologist and the director of the Sexual Dysfunction Program at NYU Langone Health. He weighed in on the alleged benefits of testicle tanning (spoiler: there probably aren’t any), and what could go wrong for those who try it (another spoiler: probably a lot).

VICE: As far as you know, does testicle tanning actually boost testosterone?

Seth Cohen: Based on literature, based on our knowledge of how the testicles produce sperm and testosterone, there’s nothing that would lead us to believe that any form of external light or phototherapy would raise testosterone levels. I’m not aware of any science, or data, or any journal publications proving that red light therapy improves male testosterone. 

You have to also realize that there are certain articles that are published [based on] “anecdotal data.” That basically means that one doctor saw this in his practice with 10 or 20 patients. That’s not something we are going to change our recommendations on. We change recommendations on medical therapies based on double-blind, placebo-controlled, randomized trials—large studies with thousands of patients. That’s where you’ll find if there’s really a statistically significant difference between red light therapy and a placebo. Could these men who underwent red light therapy and came out and felt stronger and more “manly”—could that have been a placebo effect? Of course it could.

Is testicle tanning potentially dangerous? If so, what are the risks?

From what I’ve read, it seems like this is used predominantly for wound care and skin care, which would make sense, because you’re shining this on your skin. But thinking that this is going to go deeper through the skin, through multiple layers, and then into testicles—I can’t see that working or happening. And, if it does, heat is harmful to the testicles. Prolonged heat can actually damage testicle tissue, lower sperm count, and be harmful for fertility. When we’re counseling our male patients on what to stay away from in terms of fertility preservation or family planning, we tell them to stay out of saunas, hot tubs, or any prolonged hot environment. I would include testicle tanning in that.

If [testicle tanning] is generating not only a red light beam on the scrotum but also generating heat, I don’t think that’s a good idea. Especially for fertility planning and fertility preservation. And then extrapolating how that would boost testosterone—I just don’t know. It doesn’t make any sense to me. There’s no physiological process whereby heating up the testicles produces more testosterone, to my knowledge.

I don’t know if red light has the same damage to skin as, say, sunlight or UV light, which can cause melanoma and different types of skin cancers. But if it can, then I would definitely recommend against it. Why would you want to risk getting some type of skin abrasion or skin cancer on your scrotum? It can happen. People have gotten skin cancer on their scrotums. People have gotten skin cancers on their penis. Even though we think of them as protected from the sunlight, it definitely can happen. So I certainly wouldn’t recommend it, unless I saw a peer-reviewed trial that showed that it was 100 percent safe, with very little to no risk of skin damage.

What other concerns do you have about the idea of folks exposing their genitals to red light therapy? 

I have to imagine there are different types of red lights. There are probably real red light therapy machines, and there are probably fake bulbs that are just projecting red as a color. It’s “buyer beware.” I’m sure the first company out there to develop this, that machine maybe cost $1,000, and you can only get access to it in a dermatology office. But maybe there are knockoffs online that you could buy for a couple hundred bucks, and who knows what that machine is doing to you? 

Is testicle tanning something that any qualified urologist would actually recommend to a patient?

If you go to any major academic center that has urologists who, I would hope, practice in a very ethical manner, I doubt you would get somebody who’s going to prescribe red light therapy to boost testosterone. I’ve never prescribed it to my patients, nor would I see myself doing it anytime in the future, until I saw some data behind it. If patients are wondering whether this is good for them, they need to speak to their doctor, speak to their urologist, and get an opinion on that. Get an opinion from your physician before you expose your body to chronic heat.

What are some proven, science-backed methods that people can use to boost testosterone?

This is something that men have been trying to do forever to feel younger, to have a stronger libido and maybe a better sex life. The only way we know to do that “naturally,” or by yourself without medical therapy, is with exercise, diet, and decreasing certain behaviors that are not healthy for the body, like smoking in excess, or drinking in excess, or drugs. For obese patients, weight loss has been shown to improve testosterone levels. Sleep is a very important, yet overlooked and underrated way of improving natural testosterone levels. When people burn the candle at both ends, or they’re stressed out, or they have multiple jobs, or they’re partying too hard at night, they wonder why they’re not performing very well. There are a lot of things we’re doing on our own, to ourselves, that are negatively impacting our hormones, and of course our other functions. 

There are a subset of men who were born with or develop low levels of testosterone. For those men, they may try a lot of these things—diet and exercise and sleep—and they still feel sluggish, and they still have sexual issues. Those men have to come in to their urologist or their primary doctor and seek treatment. But for the most part, in general, if someone is trying to boost natural levels of testosterone without having to go toward chemical and medical therapies, diet, exercise, weight loss, and sleep are the keys to that success. 

What do you think about Carlson’s concern that testosterone levels are allegedly dropping among American men? Is that something that is actually backed by research, and is that something to be worried about, in your view?

I don’t think there’s a lot of data to show dropping testosterone levels, nationwide or worldwide. There was an article that showed a slight decrease in fertility rates worldwide and sperm counts worldwide. But there were only one or two articles; there’s not a lot of data there to back that claim up. Am I worried about it? No. Do patients ask me about it a lot? Yes. But if you’re leading a fairly healthy life, your fertility shouldn’t be affected very much just because of these said trends in the world.

If a patient of yours came in and said, “Hey, I heard about this testicle tanning thing, and I want to try it,” what would you tell them?

I would tell them that there’s not a lot of data, at least that I know of, behind it. If they have the data or found the data, I’m happy to go over it and read it. But once again, buyer beware. I tell patients to treat their body and their sexual organs like a temple. When you’re young and you’re trying different types of things, some of them can have lasting effects. You want to have your fertility and your virility for life, and not mess around with things that potentially could hurt you now and hurt you down the road.

Drew Schwartz is a senior staff writer at VICE. Follow him on Twitter.