Pearly Penile Papules: Causes and Concerns

There are pimples on the glans and foreskin?

I have bumps on my glans and also on my foreskin.
There are many small white bumps that are not painful.
Recently, the weather has been hot, and I’ve noticed that after rinsing with cold water, the bumps seem to shrink.
I have never had sexual intercourse but have engaged in masturbation.
Sometimes my urine is white and sometimes yellow.
This condition has persisted for several months.
I had a few bumps that I saw a year ago; they are not very uniform in shape, but they do not resemble cauliflower.
Could this be pearly penile papules?

Nǐ hǎ, 10~19 year old female. Ask Date: 2008/08/03

Dr. Li Yilun reply Urology

If the small papules you mentioned are located in the coronal sulcus (the groove between the glans and the shaft of the penis), your issue is likely penile pearly papules.
This condition does not affect your health or physiological function, and if there are no symptoms, treatment is not necessary, so there is no need to worry.
Approximately 10% of males may develop penile pearly papules.
These small papules are typically arranged in rows (circumferentially) along the coronal sulcus of the penis, ranging in size from pinhead to millet-sized, and are skin-colored or light pink.
They cannot be washed or scraped off, and they are painless and itch-free, representing a benign skin condition.
The exact cause is still unclear; however, it does not impact the patient's overall health, urinary function, or sexual function, and it is not contagious.
No treatment is required.

According to an article published in the International Journal of Dermatology in March 2004, the reported incidence of penile pearly papules based on surveys of adolescents and college students is 15.2%.
A sexually transmitted disease clinic in Singapore reported an incidence of 14.3%, while a urology clinic in Cambridge, UK, reported an incidence as high as 48%.
These statistics indicate that the occurrence rate is not low, and many individuals seek medical advice due to concerns about sexually transmitted infections.
Penile pearly papules can occur in individuals aged 11 to 52 years, with a higher prevalence in adolescents and young males.
In terms of ethnicity, they are more common in Black individuals and those who are uncircumcised.
The color of penile pearly papules can be pink, white, yellow, with transparent ones being less common.
They typically measure 1 to 2 millimeters in width and 1 to 4 millimeters in length, appearing as small, round papules arranged in single or double rows along the coronal sulcus of the penis.
They usually have no symptoms and are often discovered incidentally by patients.
In terms of pathology and etiology, penile pearly papules present as angiofibromas and commonly occur after puberty, with a decreasing incidence as age increases.
The presence of penile pearly papules does not seem to serve any specific function and is currently believed to be unrelated to sexual activity.
They may be considered a vestigial structure inherited from our animal ancestors, and some scholars view them as a normal variant (similar to variations in height among individuals).
Using PCR technology, it has been found that there is no DNA of human papillomavirus present in the lesions (human papillomavirus is the culprit behind viral warts and condylomas).
Sometimes, a differential diagnosis with ectopic sebaceous glands may be necessary.
If there are any doubts, it is advisable to consult a dermatologist or urologist.

In terms of treatment, usually, a detailed explanation is sufficient, and active treatment is not necessary.
If the patient insists on treatment, options include cryotherapy with liquid nitrogen or laser treatment.
Electrosurgery, curettage, or surgical excision are also possible treatment methods, but they may result in scarring.

Reply Date: 2008/08/03

More Info

Pearly penile papules (PPP) are small, benign, dome-shaped bumps that typically appear around the corona of the glans (the head of the penis). They are usually white or skin-colored and are often mistaken for sexually transmitted infections or other skin conditions. However, it is important to understand that PPP is a normal anatomical variant and not a disease.
The exact cause of pearly penile papules is not well understood, but they are thought to be related to the natural anatomy of the penis. They are most commonly seen in young adult males, particularly those who are uncircumcised. The presence of these papules is not associated with any pain, discomfort, or other symptoms, which aligns with your description of the bumps being small, white, and painless.

In your case, the fact that you have noticed these bumps for several months without any change in their nature (i.e., they are not painful or itchy) is a strong indicator that they are likely pearly penile papules. The observation that they seem to shrink in size after exposure to cold water may be related to the contraction of the skin and underlying tissues, which can temporarily alter the appearance of the papules.

Regarding the color of your urine, it can vary based on hydration levels, diet, and other factors. Clear urine typically indicates good hydration, while darker urine can suggest dehydration or the presence of certain substances. If you notice persistent changes in urine color, especially if accompanied by other symptoms such as pain or discomfort, it would be wise to consult a healthcare provider.

It's also important to differentiate PPP from other conditions that may present with similar symptoms, such as genital warts (caused by the human papillomavirus), folliculitis, or other dermatological issues. Genital warts typically have a cauliflower-like appearance and can be itchy or painful, which is not the case with PPP.
If you have concerns about the appearance of the bumps or if there are any changes in your symptoms, it is advisable to consult a dermatologist or a urologist. They can provide a definitive diagnosis and reassurance. In most cases, no treatment is necessary for pearly penile papules, as they are harmless and do not require intervention. However, if they cause you anxiety or concern, there are cosmetic procedures available to remove them, although this is typically not recommended unless absolutely necessary.

In summary, based on your description, it is likely that you are experiencing pearly penile papules, which are a normal and benign condition. Monitoring your symptoms and maintaining good hygiene is important, and if you have any further concerns or if your symptoms change, seeking medical advice is always a good course of action.

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