What Are Pearly Penile Papules and Are They Normal?
A quick journey through Reddit reveals that most guys are fans of their penises. According to the forums, they spend a significant portion of their lives enjoying them, possibly referring to them as separate entities and potentially even naming them.
Being the No. 1 fan of your downstairs organ means you're likely to notice any changes in its appearance: bumps, rashes or discharge, for example.
If something does pop up on your penis, one of the best conditions you could hope for are pearly penile papules (PPPs).
What are pearly penile papules?
PPPs are a series of tiny, pearlescent or skin-colored bumps that typically affect younger men and teens after they hit adolescence. They usually encircle the corona, which is the ridge of skin at the base of the head that separates it from the rest of the penis. The location is one way doctors differentiate them from other conditions.
"They're benign, painless, dome-shaped lesions, usually white or pinkish, skin-colored, usually smaller in size, less than 1 millimeter," said Justin Dubin, M.D., a urologist and men's health specialist with Memorial Healthcare System in South Florida. "They're usually located—and that's kind of the key for helping identify these things, is the location—in rows around the corona of the penis, that area right below the tip, the glans."
The key word here is "benign." In fact, it's perhaps easiest to define PPPs by what they aren't:
- They're not cancerous.
- They're not sexually transmitted infections (STIs).
- They're not painful.
- They're not preventable.
- They're not transmissible, either orally or with penetration.
Another thing they don't do is go away on their own. It's long been believed that guys have them for life, although research indicates PPPs are less common in men older than 50, suggesting they may fade over time.
Papules on the penis are common. Medical literature suggests that anywhere from 14 percent to 48 percent of men get them, with the incidence being higher in uncircumcised men and Black men.
PPPs are also kind of a mystery. Some people theorize they're a genetic artifact still encoded in our DNA. It's possible they're vestigial remnants of old DNA that are related to the penile spines found in other primates, but no one can say for certain.
"We don't really know what causes them. They're not an STD or anything like that," said Neel Parekh, M.D., a male fertility specialist with Cleveland Clinic. "One theory is they might be an embryological remnant, but no one really knows for sure. But when guys see them, they think the worst. They want to make sure they're not a wart or another STD. But they're not painful, you can't transmit them and you don't need to do anything for them."
How to tell the difference between PPPs and HPV-induced genital warts
If you have papules on your penis, you've probably had them for a while, since your late teens or 20s. They typically don't just show up one day out of the blue, especially in older men.
But if you do notice a new development in the way your penis looks or feels, it's probably a good idea to see a doctor. It's better to be examined and reassured that something is benign than to be walking around fretting about something potentially more serious.
There are some clear distinctions between genital warts and PPPs that you can probably see for yourself. Genital warts usually have a dried-out, scaly appearance, whereas pearly penile papules are small, smooth, sometimes look shiny or oily, and generally only appear on the corona.
"Genital warts look more cauliflower-shaped with rough edges and they don't have that pattern of showing up around the corona like PPPs," Dubin said. "PPPs are consistently around the corona, they're smaller and relatively consistently look like small papules.
"The other thing guys need to know is there are other things that are similar, like molluscum contagiosum," Dubin added. "Usually, you see those in little kids, but you can get those as an adult, too. They're flesh-colored with a flat, dimpled dot in the middle of them. So that's another thing you may have that people get confused with PPP, and those are transmittable. So it's important to talk to your doctor."
Treatment of pearly penile papules
Once you've been diagnosed with PPPs, it's usually easiest to accept them and live with them.
It can't be reinforced enough: Penile papules are harmless and noncontagious. By some estimates, nearly half the male population has them. However, for some guys and/or their sexual partners, the appearance of PPPs is enough to seek medical advice and ask what can be done to remove them.
"It is important because there is something called venereophobia, an irrational fear of contracting venereal disease," Dubin said. "A lot of times, it's guys who are in a relationship and they're worried that their partner is going to think they're doing something with someone else or that they have warts."
In cases where someone's quality of life is compromised by penile papules, it is possible to have them removed with cryotherapy, which is the use of extreme cold to freeze and remove abnormal tissue. Another way is to use a laser to ablate and remove the papules while the patient is under anesthesia. That's the method Dubin prefers.
"The risks are really minimal," he said. "You might have some discomfort, some swelling, maybe some temporary redness, but overall, it works really well and it's very safe."
If anything changes in the appearance or feel of your penis, it's important to see a healthcare provider. Even with a benign condition like PPPs, if it's causing you distress, talk to your provider about your options.
However, it's equally important to remember that PPPs are harmless, common and something millions of guys around the world live with every day.