Pearly penile papules (PPP), also known as the “hirsutoid papillomas”, are the tiny dome-shaped or thread-like, flesh-colored bumps that appear on the penis (eg. shaft and head).
This male skin condition is more commonly found in boys after puberty and in young adult males. Men who have not been circumcised are more prone to develop pearly penile papules.
What Causes Pearly Penile Papules?
Contrary to the popular belief, pearly penile papules do not appear as a result of enhanced sexual activity or improper hygiene.
Pearly papules are merely a variation of the normal anatomy of the penile head. They are often described as the remnants of the primal structures called ‘penile spines’ which are found in other primates.
According to report published by the Addenbrooke’s Hospital of Cambridge in UK, a study on 200 men with pearly penile papules show:
- 73% with papules had only a few lesions of less than 1 mm in size,
- 19% had papules of less than 1 mm in size extending around the corona, while
- 8% had lesions greater than 1 mm in size extending around the corona.
What Are The Symptoms?
The only symptom is the presence of painless, skin-colored bumps along the glans of the penis. The papules are, otherwise, devoid of any symptoms, says Dermnetnz.
Dr. Swetha Sunny Paul shares more details of this skin condition in video below, that also shows pearly penile papules image.
Pearly Penile Papules On Shaft
The presence of papules on the shaft of the penis is rare, with the appearance of pearly penile papules on the penile shaft is often accompanied by typical papules on the penile head too.
The pearly penile papules are harmless and non-contagious. They do not represent any sexually transmitted disease (STD) since they are non-infectious in nature.
Presence of these bumps on the penile shaft can indicate another common condition called “ectopic sebaceous glands”. These glands, also called Tyson glands, are also skin-colored and can be mistaken for pearly penile papules. These glands do not require any treatment.
Papules on the shaft may also represent another anatomical variant called prominent sebaceous glands. These lesions are commonly known as Fordyce spots. They become more prominent upon stretching the skin.
Unlike pearly penile papules, squeezing these spots results in the expression of a thick, dense-white discharge.
Pearly Penile Papules On Head
The most common location of pearly penile papules is on the glans of the penis where they are arranged circumferentially in a ridge-like fashion near the sulcus that is located behind the glans of the penis. They may be present in one or more rows.
Microscopically, these papules are angiofibromas which are abnormally proliferated tiny blood vessels of the skin present in the background of fibrous tissue-one of the key structural elements forming the skin.
Pearly Penile Papules Removal and Treatment
There is no known preventive method for pearly penile papules, which is a rather harmless condition.
Reassuring the patient about the harmless nature of this condition helps the individual cope with it, however some patients are anxious to have them removed, mainly due to embarrassment and self-confidence.
The common procedures used for removing the papules include:
- Carbon dioxide laser vaporization
- Excisional surgery
For those who look for non-surgical solutions, you can >> check out this over the counter pearly penile papules removal cream and home remedy review guide here.
Pearly Penile Papules vs Genital Warts
In contrast to the neat arrangement of pearly penile papules in rows, the penile warts (Condylomata acuminata) are irregularly arranged. Their texture is also rough as compared to the smooth surface of papules.
As compared to the papules which are more commonly found on the glans of the penis, warts may be present anywhere along the shaft, head and even the foreskin.
Unlike papules which are non-contagious, warts are a sexually transmitted disease (STD) caused by the Human Papilloma Virus (HPV) and is highly transmissible.
Pearly Penile Papules vs Skin Tags
Skin tags, also commonly known as acrochordons, are commonly mistaken for pearly penile papules. As opposed to the papules which are more common in young men, skin tags affect middle aged men.
As compared to the dome shape of the papules, skin tags have a thin, rice-like appearance. The microscopic structure of the skin tags also differs from that of the papules.