Penile Pearly Papules: Causes and Treatment Options

Coronal groove nodule

Doctor, I have a hard lump at the lower edge of the coronal sulcus.
It only becomes noticeable and painful during intercourse in the later stages of an erection; otherwise, when not erect, there is no lump.
The doctors I consulted said they couldn't see anything when I wasn't erect and suggested it might just be a blood vessel, saying there's nothing to worry about.

K AI, 20~29 year old female. Ask Date: 2020/03/22

Dr. Li Xinyi reply Urology

It could be chronic microtrauma, such as soft tissue inflammation caused by vigorous sexual activity, which may result in a slower recovery.
If there are any concerns, it is advisable to visit a urologist for an in-person examination and discussion with the doctor.

Reply Date: 2020/03/22

More Info

Pearly penile papules (PPP) are small, benign growths that typically appear around the corona of the glans (the head) of the penis. They are often mistaken for other conditions, but they are generally harmless and do not require treatment unless they cause discomfort or anxiety for the individual.

Causes of Pearly Penile Papules
The exact cause of PPP is not fully understood, but they are thought to be a normal anatomical variation. They are more common in uncircumcised men and are believed to be related to the natural development of the skin in that area. PPP is not caused by any sexually transmitted infection (STI) or other medical condition, and they do not pose any health risks.

Symptoms and Diagnosis
Pearly penile papules are usually painless and do not cause any symptoms other than their appearance. They are small, dome-shaped, and typically white or skin-colored. The fact that you experience discomfort or pain during sexual activity, particularly when the area is engorged, may suggest that there is another underlying issue, such as irritation or inflammation of the skin or the presence of another condition.

When a healthcare provider examines the area, they may not see the papules if the penis is not erect, as these structures can be less prominent when not engorged. This can lead to confusion during diagnosis. If the discomfort persists, it’s essential to communicate this to your healthcare provider, as they may need to conduct further examinations or tests to rule out other conditions.

Treatment Options
In most cases, treatment for pearly penile papules is not necessary. However, if the papules are causing discomfort or if there is a concern about their appearance, there are several treatment options available:
1. Laser Therapy: This is a common method for removing pearly penile papules. It is a minimally invasive procedure that can effectively reduce or eliminate the papules.

2. Electrosurgery: This technique uses electrical currents to remove the papules. It is also effective but may require local anesthesia.

3. Cryotherapy: This involves freezing the papules with liquid nitrogen, which can also be effective in reducing their appearance.

4. Topical Treatments: In some cases, topical treatments may be prescribed, but these are less common for PPP specifically.

When to Seek Medical Attention
If you experience persistent pain, swelling, or any changes in the appearance of the papules, it is crucial to seek medical advice. Other conditions, such as cysts, infections, or sexually transmitted infections, may present with similar symptoms and require different treatments.

Conclusion
Pearly penile papules are generally harmless and do not require treatment unless they cause discomfort or distress. If you are experiencing pain during sexual activity, it is essential to discuss this with your healthcare provider, as they may need to investigate further to ensure there are no other underlying issues. Always prioritize open communication with your healthcare provider to address any concerns you may have regarding your sexual health.

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