When Martin, a thirty something businessman, came to my office you could tell that he was feeling quite uneasy. He thought that he had a very uncommon request. He said, „Doctor, you know, I have these bumps on my penis. I have them since I am 14 years old, but now they are starting to bother me. Could you please remove them?“. He had searched the internet and had learned that he had a noncontagious skin condition: pearly penile papules. After an examination with a dermatoscope I confirmed his diagnosis. I asked him, why he wanted me to remove the harmless bumps on his penis. He answered, „I recently broke up with my long-term girlfriend, who found my skin condition a bit yucky, but she had told me that she got used to it. Now I am dating another woman, but I am afraid that she might find it off-putting as well. And I do not want to have to explain to her what I have, when we get intimate.“
Martins request actually was not uncommon at all. At puberty three to four out of ten men develop small skin colored growths at the ridges of the glans penis. These bumps are called pearly penile papules (PPP) or hirsuties coronae glandis or
. PPP usually are arranged circumferentially in one or several rows around the corona glans penis and the frenulum. They are about one millimeter in size, but sometimes can be several millimeters long. They can be red, skin colored or white. Usually, PPP are painless but they can get irritated by sexual activity. PPP are not contagious and do not develop because of poor hygiene, although uncircumcised men display them more frequently. Sometimes PPP are mistaken for a sexual disease, e.g. genital warts. If men request removal of PPP, it is usually because the bumps get irritated by sexual intercourse. Also many men feel uneasy with the appearance of their genital. They fear being rejected in an intimate situation when they do not want to explain that these bumps are completely harmless and are not contagious.
PPP can not be removed at home safely. However, websites on the internet may suggest using a cream, a solution, a cloth or an ice spray. In fact, these do-it-yourself treatments can cause significant harm and can lead to infection and skin necrosis. An experienced dermatologic surgeon should be consulted to make the correct diagnosis und to obtain advice about the appropriate treatment. Dermatologic surgeons have the expertise to diagnose skin growths correctly. Moreover, they have extensive training in removing skin growths from the genitalia and they are experts in giving a painless local anesthesia. Radiofrequency surgery is a treatment method with a high cure rate for PPP. These medical radio waves pulsate up four million times per second and deliver their energy very selectively. So it is possible to gently remove every single papule in local anesthesia. In experienced hands side effects of this treatment are very rare and may include scarring, sensitivity changes or recurrence.
It took about ten days for Martins wound to heal. When he returned to my office four weeks after the procedure he smiled and looked relaxed. He did not have to explain anything to his new girlfriend.
Robert Kasten, M.D. is a German board certified dermatologist and dermatologic surgeon. He is a member of the American Society of Dermatologic Surgery. After serving in the Ludwigshafen Clinic of Dermatology, he founded a private practice in Mainz, Germany. He specializes in dermatologic surgery and cosmetic dermatology.
Website: www.drkasten.com, www.haut-mz.de,