Pearly Penile Papules

Also known as Hirsutoid papillomas, pearly penile papules (PPPs) are very small (between 1 and 4mm), white- or flesh-coloured lumps or spots that develop around the head (or corona) of the penis. These can sometimes appear beneath the foreskin, in one or several neat rows. It’s believed they once had a biological function, but now serve no purpose. They do not require medical treatment treatment, but if they do change drastically or cause any further symptoms such as pain or discomfort, you should speak to your doctor incase it’s a sign of an underlying problem.

Pearly Penile Papules are very common with between 14 and 48 per cent of men getting them. They’re most likely to be present in men who have not been circumcised, but you can still get them if you have been circumcised.

There are no symptoms associated with Hirsuitoid papillomas, they are an anatomic variant (a small and harmless difference between bodies). They are not painful, itchy or infectious and they do not affect sexual performance. They cannot be transmitted between partners, and are not caused by poor hygiene, sexual activity or masturbation.

If you do get symptoms like these and have pearly penile papules, it’s unlikely they’re causing them, so you should speak to your doctor. These symptoms can be caused by other conditions and it’s important you get checked if you’re uncomfortable or concerned.

Pearly penile papules are most commonly developed during late puberty, and as you grow older, they usually fade.

There are no complications associated with pearly penile papules, and they are benign (non-cancerous). If they do break open through scratching or picking, keep the area clean and covered to prevent infection, just as you would any skin. It is advisable to avoid sexual contact if you have broken skin on your penis, as open sores leave you at greater risk for contracting STIs. If you are worried that you may have an infection, you should speak to your doctor.

If you think you have pearly penile papules, but you’re not sure, you can try using our photo diagnosis service. Here, a doctor can discreetly and confidentially diagnose the issue and there’s no need for any face to face appointments.

Many men are anxious about the small growths, as they can be confused with other conditions and infections. If you do notice new growths, we always advise getting them checked to make sure it’s nothing more serious.

Genital warts or pearly penile papules?

Genital warts are caused by the human papillomavirus (HPV) and are considered a sexually transmitted infection. They are shaped much more inconsistently than PPPs – they look more like tiny cauliflowers – and can spread to other areas of the genitals. And while genital warts can be itchy, they’re usually not painful, which can be similar to PPPs.

Molluscum contagiosum or pearly penile papules?

Molluscum contagiosum are caused by a poxvirus and affects the entire body, not just genitals unlike PPPs. They appear as bumps, but the spots are much larger than PPPs and are sometimes pitted. They are often itchy, and don’t tend to spread to the genitals unless it’s been passed on through sexual contact.

Fordyce spots or pearly penile papules?

Like pearly penile papules, Fordyce spots are benign and normal, and almost everyone has them. They are visible oil glands that don’t contain hair follicles, and appear as tiny yellow or white bumps on the penis, but in a more scattered fashion than PPPs. In women, they appear on the vulva or vagina.

You do not have to see a doctor about PPPs. They are entirely harmless, non-infectious and have no symptoms.

However, as pearly penile papules can be confused with other sexually transmitted infections (STIs) such as herpes, ulcers, viral skin infections or even cancer, they sometimes cause concern or anxiety. If you are worried about a spot, lump or growth on your penis, you should contact your local GP or visit a sexual health clinic. A doctor should be able to diagnose PPPs simply by an examination, but if there’s any concern, they will take a sample of skin tissue for biopsy.

Our Superdrug doctors can carry out an online diagnosis for skin conditions. All you need to is:

• upload two photographs of the affected area,
• A doctor will review these and get back to with a diagnosis and treatment recommendations within 24 hours.

If the doctor can not diagnose the issue from the photos, you will be given clear advice on what to do next.

There is no medical reason for PPPs to be treated, and you should not use any over-the-remedies to remove them as this can cause irritation or scarring.

However, very rarely, if PPPs are causing you to feel distressed, a doctor may recommend the following methods to remove them. It’s important to know that these methods run the risk of replacing the pearly penile papules with scars.

Laser surgery

One of the more common and effective methods used to remove PPPs, infra-red rays are used to remove the growths using heat damage. It not only removes the growths, but also smooths the skin.

Electrodessication and curettage

An electrode is used to deliver a high frequency electric current to super-heat a targeted area of skin. Curettage is the process of scraping off the tissue with a delicate curette tool. An electrosurgical device may be used to cauterise the wound, forming a tiny scab. The process takes no more than 30-35 minutes, and healing takes 1 to 3 weeks. Side-effects can include scarring.

Radiosurgery

Radiation is used to damage the skin cells that make up the papules, and causes them to fade. The process takes no more than 15-25 minutes, and healing takes 1 to 3 weeks. Side-effects can include scarring.

Cryosurgery

This technique uses liquid nitrogen at extremely low temperatures to freeze targeted areas of tissue. The pearly penile papules’ cells are destroyed. The process takes no more than 15-20 minutes, and healing takes 1 to 3 weeks. Results are variable; after multiple treatments, typically 80-90 per cent of the PPPs are removed. Side-effects can include scarring.

There is no way to prevent PPPs. And, as they are harmless and a normal anatomic condition, there’s no reason to attempt to prevent them.