Pearly Penile Papules (PPP)

PPP, officially known as Hirsuties papillaris genitals, are small fleshy bumps that form at the corona of a penis. They are given such name because they often appear in small rows like strings of pearls.

PPP is not a disease though this condition is very common and affects approximately 25% of men worldwide. Some studies showed that they are more common in uncircumcised men. However, you have absolutely nothing to worry about since they do not cause any pain, itching or burning. They cannot be spread through sexual contact.

Causes

What are the causes?

There is no known cause of PPP. They are considered a normal finding and they are totally harmless.

What are the symptoms?

The pearl-like fleshy bumps or lesions 1 to 3 mm in diameter most commonly develop on men in their 20s and 30s, and will fade and decrease in frequency when men get older. They do not cause any pain, itching or burning. They are not contagious. They cannot be spread through sexual contact since they are not a sexually transmitted disease (STD).

Consequences

It is unsettling for any men to discover any unfamiliar bumps on his penis. Though the condition is not asymptomatic and not a STD, it is often mistaken for genital warts causing worry and psychological distress to men who develop it. Many are kept in the dark for information, such as its effect and treatment, is limited online.

Some men learn to live with it after learning the condition is not harmful, while others avoid sexual contact out of embarrassment and fear of rejection. PPP can affect self-esteem and social interaction in some men. They also cause an “unpleasant sensation” in others.

5 Common Misconceptions
  1. Genital Warts – They are not genital warts. They are not a sexually transmitted disease. They may appear infected, but they are not.
  2. Male Yeast Infection – They are not yeast infection (e.g. candidiasis). Symptoms of such infection are: red-looking glans, white and thick urine, some or severe itching on glans or penises.
  3. Fordyce Spots – PPP are more like Fordyce Spots. However, the former are for ectopic sebaceous glands, while the latter are skin outgrowths.
  4. Common Warts – They are not common warts and so you should not try to remove them with wart removal products or you may risk getting an infection.
  5. Other STDs – They are not sexually transmitted disease, like gonorrhea and others.
Treatment

Many try to “cure” their PPP using topical creams, wart removal products and home remedies due to various reasons, such as cost and shyness. Some try to pick them or squeeze them. However, none of them are proven effective. It is recommended that you stay away from these methods as they will not get rid of PPP, but often irritate the area.

It is possible to remove the bumps for cosmetic reasons. At this point, the most effective treatment is removal through Carbon Dioxide (CO2) Laser.

CO2 Laser Treatment Removal: this method targets fleshy bumps at the corona of the penis and removes them using a carbon dioxide laser without causing damages to the surrounding skin. Before surgery, an anesthetic cream or an injection of local anesthetic is used to numb the penis for pain control. Patients can return to most normal activities immediately, while sexual activity usually after 2 weeks (varies among patients).

Before

After

Photo Courtesy of Dr. Groff, board-certified Dermatologist