PPP: Pearly Penile Papules Facts and Treatment - Verywell Health
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Pearly penile papules (PPP) are small growths that can appear on the penis. They may be pearly white, pink, or yellow in color and are a small dome shape measuring only a few millimeters wide and long.
PPPs may appear in rows near the head of the penis. The appearance of these growths can be distressing for both the patient and their sexual partner because they can be mistaken for sexually transmitted infections (STIs) like genital warts. However, PPPs are harmless, not contagious, and not associated with sexually transmitted infections.
This article will discuss the causes of pearly penile papules, how to identify them, and treatment options.
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Symptoms
Pearly penile papules are not accompanied by any symptoms other than the appearance of small, dome-like growths on the penis.
These growths might appear in adolescence or in early adulthood. They are not cancerous and usually aren't itchy or painful.
Typically, the papules are:
- 1 to 2 millimeters wide
- 1 to 4 millimeters long
- Pearly white, yellow, or pink
- Shaped like a dome or threadlike
- Arranged in rows on the head of the penis
- Symmetrical
In some cases, the papules will appear in a single line circling the head of the penis. But in other cases, there may be a number of rings of papules.
PPPs are commonly mistaken for genital warts, but are not associated with warts or sexually transmitted infections.
Pearly penile papules are believed to occur in 14% to 48% of males.
Effect on Sex
Although pearly penile papules are both harmless and asymptomatic, their presence can cause distress for those who have them.
A study of 95 men with pearly penile papules found that 38% were worried or concerned about the presence of the penile papules, and 17% wanted to have them removed.
Those who discover they have pearly penile papules may experience feelings of anxiety, fear, or worry that they have a sexually transmitted infection.
This common misconception can lead to problems with relationships, as the possibility of an STI may raise questions about cheating.
Pearly penile papules do not have any impact functionally on the penis, or on sex. In theory, they shouldn't impact sexual experiences in any way. They are not contagious and have nothing to do with sexually transmitted infections.
Although pearly penile papules might not physically have an impact on sex, those who experience them (as well as their partners) may find the stress associated with them leads to problems with intimacy, trust, and a lowering of quality of life.
Causes
The reason some people develop pearly penile papules and others don't is unknown.
These growths are considered a normal variant in the skin that may be the result of:
- Overgrowth of collagen in a specific area
- Overgrowth of dilated blood vessels
- Overgrowth of fibroblasts, a connective tissue cell
PPP or Genital Warts
Although commonly mistaken for STIs like genital warts, pearly penile papules are not caused by sexual contact or infection, and they are not contagious.
Pearly penile papules are clinically distinguishable from genital warts in a number of ways:
- Cause: Genital warts are caused by the sexually transmitted infection, human papillomavirus (HPV). Pearly penile papules are not caused by a sexually transmitted disease and are considered a natural skin variation.
- Appearance: Genital warts are bumpy with a cauliflower-like appearance, whereas pearly penile papules are smooth, symmetrical, and dome-like.
- Location: Genital warts can be found around the penis, mouth, tongue, lips, throat, scrotum, anus, thighs, and groin. Pearly penile papules only occur on the head of the penis.
- Transmission: Genital warts are contagious and can be passed on to others. Pearly penile papules can not be spread to others and have nothing to do with sexually transmitted infections.
Treatment
Pearly penile papules are harmless and can be left alone.
You should never try to pop or pick a pearly penile papule as this can cause damage and scarring.
Over-the-counter wart treatments should never be used on penile papules because they can cause irritation, scarring and are not intended for use on the penis.
Some people may find the presence of penile papules highly distressing and will seek treatment to have them removed. Treatment options include:
- Cryotherapy: Liquid nitrogen is used to burn off the affected tissues. This can be a painful procedure.
- CO2 laser: Heat from the laser causes the affected tissue to evaporate.
- Electrodessication and curettage: This procedure uses a special surgical device to remove the papules.
Many of these treatment methods can be painful and may require multiple attempts. Risks of treatment include:
- Scarring
- Infection
- Changes to skin pigment
- Recurrence of papules
- Bleeding after procedure
A Word From Verywell
Pearly penile papules are benign, dome-shaped growths that may appear around the head of the penis. Though commonly mistaken for genital warts, they are not related to a sexually transmitted infection and can't be passed on to others. It is believed they are a naturally occurring variation in the skin and are harmless.
If you or a sexual partner develop pearly penile papules, it can be distressing. But remember that these growths are not contagious, do not impact the function of the penis, and do not cause any other symptoms. The growths should go away on their own, but if you find that the pearly penile papules are impacting your quality of life, make an appointment to discuss removal options with your healthcare provider.
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