If your teen is sexually active, they might be afraid they have a sexually transmitted infection (STI). However, these bumps are completely normal and not a sign of infection (note that other types of bumps may be due to infection and need medical treatment) or uncleanliness. They are also not cancerous and are not precancerous lesions. While the condition is considered common, it is unclear exactly how many men have pearly penile papules, which are also called hirsuties papillaris genitalis or hirsutoid papillomas, or why they occur.
Symptoms
Pearly penile papules are benign, small (1 to 2 mm) round bumps that are attached to the rim of the head of the penis. These bumps, which may seem to appear suddenly, can be the color of the skin, translucent, white, yellow, or pink. The bumps can sometimes go all the way around the rim of the head of the penis, and the bumps can form multiple rows around the head of the penis. They are not painful, swollen, or itchy.
Causes
The causes of pearly penile papules are poorly understood. However, research suggests that they can occur in anywhere from 14% to 48% of men. Studies suggest that they show up more often in uncircumcised men than in circumcised men. These bumps tend to appear when a man is in their late stages of puberty.
Differential Diagnosis
There are several other conditions that can produce bumps on the penis, some of which do need treatment. A doctor or pediatrician can determine whether these might be the culprits instead of pearly penile papules. Some potential other causes of bumps on the head of the penis include the following:
Psoriasis
Psoriasis is a skin condition that may either cause tight red patches or raised white bumps on the skin, including on the head of the penis.
Lichen Sclerosus
Lichen sclerosus is a skin condition that causes patches of white, shiny skin, typically in the genital or anal area. These patches may be itchy or painful.
Fordyce Spots
Fordyce spots are enlarged sebaceous glands (which secrete an oily serum to keep skin healthy). The bumps are yellowish or white and can also occur on the shaft of the penis. Like pearly penile papules, this condition is harmless and does not require treatment.
Tyson Glands
Tyson glands are also raised sebaceous glands and appear as yellow or white papules. These are also not of medical concern.
Molluscum Contagiosum
Pearly penile papules can also resemble molluscum contagiosum, a viral condition that is common in children and poses no harm. While it can be contracted through sexual contact in teenagers and adults, it is usually transmitted through casual contact in children (for example, sharing a towel with someone who is infected). In molluscum, the bumps are firm, dome-shaped, and have a dimple in the center. They may itch but are painless, and can be found in numerous places on the body, including the genitals, face, neck, arms, hands, abdomen, and inner thighs. Generally, this rash resolves on its own, but a dermatologist can provide treatment if the rash is not clearing, or to prevent further spread of the rash.
Genital Warts
Pearly penile papules can also resemble genital warts which are caused by human papillomavirus—the most common sexually transmitted infection. Genital warts may appear as a single wart or a collection of warts around the penis. They may be smooth or have a cauliflower-like appearance, and they are variable in whether they clear, get bigger, or stay the same. Treatment varies based on the number of warts present and their location.
Treatment
Because these bumps on the penis are not caused by an infection and are not painful or uncomfortable, they do not need to be treated or removed. They will frequently become less noticeable as a man gets older. However, cosmetic treatments are an option. Some men who have them are embarrassed by the bumps because they are afraid someone will think they are an STI. Because teens tend to be very concerned about their bodies, they may be particularly uncomfortable with not having the papules removed. Most studies suggest that a carbon dioxide (CO2) laser is the best and most effective treatment for the removal of these pearly penile papules. Other treatment options include radiosurgery, cryosurgery, and excisional surgery. Note that there are risks in treating these bumps, including that trying to remove them can cause scarring or infection.
Coping
While it is a harmless condition, pearly penile papules can affect self-esteem and body image. Understanding that these bumps are completely normal and common may improve a person’s self-esteem and comfort level around accepting the papules as they are. Know that each person’s body is different and having these bumps is just one variation that some men have. Additionally, as noted above, this condition will likely go away with time as well.
A Word From Verywell
While pearly penile papules are a harmless, common condition, you’ll want to make sure that’s what you (or your teen) have. So, if you see bumps on your penis, contact your pediatrician or family healthcare provider. Only someone who has actually seen the papules can accurately diagnose what they are and rule out other potential causes. Additionally, you’re having sex and are afraid you might have an STI, it’s important to see your doctor. Even if you have pearly penile papules and not an STI, be sure to talk to someone you trust to discuss how to avoid getting a sexually transmitted infection.
