What are pearly penile papules?

Pearly penile papules (PPPs), also known as genital angiofibroma or histoid papilloma, are benign, small growths occurring in clusters or rows on the head of the penis. Typically, they are flesh-coloured or white and look like pimples, but the size and colour can vary depending on the individual.  

Are pearly penile papules an STD or STI? 

PPPs are not a sign of an STD, or any other bacterial or fungal infection. They can, however, be confused with an STI such as genital warts because of their appearance. If they are asymptomatic, they are likely to be PPP but if you are experiencing other symptoms, like itching or discomfort, it is advisable to seek medical attention. 

How common are pearly penile papules? 

PPPs affect roughly between twenty and thirty percent of the general male population. They typically appear in adolescence or early adulthood and are less common the older a man gets. Women can also develop something similar on their vulva, called irsutoid papillomas or vestibular papillomatosis.  

What are the main symptoms of pearly penile papules?

PPPs are small, round growths measuring roughly 1mm each. They are not contagious, and they are not associated with irritations or infections. They can, however, cause psychological problems like anxiety or low self-confidence.  

What causes pearly penile papules?  

The cause is unknown; they are deemed to be a normal skin variation and can’t be prevented. They are more likely to develop in men who are not circumcised.  

How are pearly penile papules diagnosed?  

They can be diagnosed with a simple physical examination done by a specialist, who will also rule out the possibility of other STDs, such as genital warts or molluscum contagiosum (which can cause itching and infections) with a peniscopy, a visual examination of the skin of the penis. 

Do pearly penile papules go away by themselves?  

Typically, PPPs are life-long. In some cases, they may disappear on their own, fading with age. Even if they may cause some embarrassment in men, pearly penile papules are not a health threat and they do not need to be treated.  

How are pearly penile papules treated?  

A person with PPPs may find them aesthetically displeasing and want them removed. Although PPPs can be surgically removed, it is not very common. Currently, the most effective treatments that aim at improving the appearance of the genital area include: 

• CO₂ laser vaporises all the papules in a single session, lasting less than 30 minutes 
• Electrodessication uses a tiny electrical needle to destroy each papule with an electric shock. This procedure has no side effects. 
• Cryotherapy uses liquid nitrogen targeting the papules which will then naturally fall off. 
• Curettage is the surgical removal of the affected area. 
• Radiosurgery can target the damaged skin cells causing them to fade.  

While these surgeries are considered safe, it is worth noting that they each carry risks. 

Can you remove pearly penile papules yourself? 

Do not try to remove PPPs at home by yourself. Avoid using over-the-counter medications, such as treatments for genital warts, as they may result in skin irritation and scarring.  

Which doctor should I talk to about pearly penile papules?  

If you have pearly penile papules, you should see a dermatologist, an andrologist or a gynaecologist. 

What is the prognosis of pearly penile papules? 

Pearly penile papules do not pose a threat to your overall health, they are just a cosmetic defect.