Many home treatment regimens online wrongly claim that pearly penile papules are essentially sebaceous cysts and go on to recommend that you “drain” your papules by squeezing, heating or needling them. Here’s why this advice is not only ineffective but also extremely dangerous.
Our skin has two main types of glands:
Sometimes the pore that leads to the sebaceous gland becomes blocked and oil secretions become trapped under the skin. This results in a small sac filled with trapped oils to start growing under the skin, creating a visible bump on the surface. This oil-filled sac is called a sebaceous cyst and indeed it can sometimes look like a penile papule.
Sebaceous cysts are completely different from pearly penile papules
Though they may look similar, pearly penile papules are nothing like sebaceous cysts. There are a few key differences between the two:
However the biggest reason why pearly penile papules are not sebaceous cysts…
Since sebaceous cysts are filled with trapped oils, one common treatment approach is to make a small incision on the cyst and drain its liquid contents. Based on the faulty logic that pearly penile papules are basically sebaceous cysts, some treatment protocols wrongly recommend that you use the same treatment approach and “drain” your papules by either using small needles or squeezing them.
However, since pearly penile papules have a solid fibrotic core rather than an oil filled one, needling, heating or squeezing them doesn’t lead to any kind of drainage. If anything, it causes a significant amount of pain and the act of introducing a sharp foreign object into the penile tissue can trigger inflammation, potentially cause an infection and can even result in the permanent scarring of your penile tissue.
This is a common mistake that even some doctors make and since many natural substances are used as genital wart remedies, PPP sufferers often give these products a try in hopes of “shrinking away” their papules. The truth is, pearly penile papules are nothing like genital warts and even natural genital wart remedies can cause penile tissue damage.
Genital warts are the result of a sexually transmitted infection caused by the human papillomavirus (HPV). A wart forms when HPV causes the outer layer of your skin (epidermis) to thicken and experience a fibrous overgrowth.
The main reason why pearly penile papules are sometimes confused with genital warts is because genital warts can also form on the penile head and they can be similar in size as well. However, that’s where the similarities end.
Tend to form in small clusters of three to four
They tend to be localized to one small region of the penis
The top of genital warts have a cauliflower-like shape
Tend to form in greater numbers
They tend to be spread out in rows of 1 to 3 around the outer edges of the penile head
Pearly penile papules have smooth, dome-like tops
Besides their many differences, one key distinction between genital warts and pearly penile papules is that genital warts form when the outer layer of the skin (epidermis) becomes fibrous and pearly penile papules form when the inner layer of the penile tissue (dermis) becomes fibrous.
This may seem like a small difference but it completely changes the equation when it comes to treating the problem properly. Since genital warts are limited to the outer layer of your skin, you can get away with using harsher methods for breaking down the fibrous overgrowth.
This immediately rules out the use of harsh substances typically used to treat genital warts because in order to breakdown the deep fibrotic core, these substances must first bore through the sensitive penile surface. Then if these substances do manage to get past the surface, they are likely to cause widespread damage to the blood vessels in the dermis. This is why many PPP sufferers that use genital wart remedies often end up experiencing deep tissue injuries that don’t heal well.
When most people first notice their penile papules, they are often alarmed since their penile bumps look similar to genital herpes blisters. In a state of panic many then turn to products and remedies that are meant to treat their “blisters” only to experience even greater damage to their penile tissue.
Their crucial mistake? They made the common error of confusing pearly penile papules with genital herpes…
Genital herpes is a common sexually transmitted disease caused by the herpes simplex virus. During the sufferer’s lifetime the condition goes through periods of outbreaks (when the genitals develop blisters) and dormancy (when the symptoms subside).
While the blisters that occur during genital herpes outbreaks may resemble pearly penile papules, one simply needs to wait a few weeks to confirm if their penile bumps are indeed the result of genital herpes. That’s because genital herpes blisters tend to eventually break open and become raw sores that are often painful. These sores can take weeks to fully heal. Pearly penile papules on the other hand never break open nor do they hurt (unless you purposely pick at them or treat them with harsh substances).
Also, genital herpes blisters tend to form in small clusters localized to one small area of the penis unlike pearly penile papules that tend to be spread out in organized rows around the outskirts of the glans.
Common remedies for genital herpes involve applying therapeutic oils with antiviral properties (for ex. tea tree oil) to the blisters so that they heal faster. The fact is, neither are pearly penile papules caused by a virus nor do they ever burst open into exposed sores that need healing.
The antiviral protection that some of these therapeutic oils provide don’t do anything to get rid of your papules because the underlying cause (the fibrotic clumps in the deeper layers) remains untreated.
This particular confusion has lead to more penile tissue injuries than any other common misconception. That’s because while skin tags do share some similarities with pearly penile papules, skin tag treatments are extremely damaging to the glans.
Skin tags are deflated balloon-like growths that develop in areas of our body where the skin typically rubs against itself (such as the underarms and buttock folds). If you looked at a skin tag under a microscope you’d notice that its outer surface is abnormally overgrown and its deeper layers have collagen fibers inside.
Some people point to the fact that since both pearly penile papules and skin tags have a fibrous core, using skin tag treatments on your papules should help eliminate them. Unfortunately, this logic is flawed and in reality skin tag treatments are damaging to the penile tissue.
Let’s consider two of the most common skin tag treatments:
Cryotherapy which attempts to break down skin tags by exposing them to freezing temperatures
Essential oils (for example tea tree oil) that attempt to treat skin tags by causing the tissue to literally wither away
While both these treatments work well for skin tags, there are two reasons why you should never expose your penile tissue to them:
Skin tag treatments are too harsh on the penile tissue. In fact, skin tag treatments are intentionally designed to be harsh because skin tags form on parts of our body where the epidermis is much thicker.
On the other hand, penile papules have a very thin and exposed epidermis which can be easily damaged by cryotherapy and abrasive essential oils.
Skin tag treatments take the wrong approach. Skin tag treatments work by breaking down the tissue from the outside-in. While this approach is effective on skin tags, it is a poor strategy for PPP removal because the outer surface of our papules is extremely sensitive. The only way to properly treat penile papules is to do it from the inside-out. In other words, directly target the fibrotic clumps in the deeper layers so that the papules start regressing naturally.
Some PPP home treatment regimens recommend constantly washing your papules with clarifying soaps, scrubbing them and even using pore unclogging strips to treat your pearly penile papules. This approach is based on the reasoning that pearly penile papules look similar to blocked follicles and washing, scrubbing or unclogging them with sticky strips should help ‘release’ the trapped oils and allow the papules to settle back down.
This reasoning is absolutely flawed and has no scientific basis. If anything, this treatment method can disrupt your penile tissue’s natural physiology.
Hair follicles are the small sacs embedded in our skin from which our hair grow. Sometimes these follicles can become clogged with dirt, bacteria or oils leading to a small bump under the skin. Some consider it a mild form of a sebaceous cyst (mentioned above).
The part of the penis where pearly penile papules form does not have any hair follicles to begin with. There is no pore that can be blocked and no trapped oils that need to be released. Instead pearly penile papules form when our body develops clumps of fibrotic tissue under the glans and not because of blocked follicles.
The top surface of our glans is made up of exposed mucosal tissue that lacks the tough outer layer of dead skin cells found over the rest of our body. Because of this our penile surface is unusually bare and sensitive to even over-the-counter products that are often recommended online as PPP cures.
Clarifying washes meant for removing excess dirt and oil from the skin tend to strip away the protective secretions of our glans and deplete its moisture barrier. These products are also too alkaline and have a pH disrupting effect on the penis which can irritate its surface and make it vulnerable to infections.
Pore unclogging strips can also be very irritating to the penile mucosa because they directly adhere to the exposed mucosal surface and rather than remove any blackheads, they can peel away surface tissue, resulting in pain and injury.
Worst of all, since none of these treatments do anything to target the fibrotic clumps under your penile papules, using them does not result in any permanent reduction in papule size.
Molluscum contagiosum is a viral skin infection that is sometimes confused with pearly penile papules because it also results in flesh colored, dome-like lesions that look similar to PPP.
Some treatments for molluscum contagiosum call for the use of astringent chemicals to shrivel up and dissolve the raised lesions. It is important to note that these chemicals can be extremely irritating to the penile surface and cause the lining of the glans to erode. Repeated use of these harsh substances can even result in a scarring of the glans which can look much more unappealing than the pearly penile papules themselves.
Lichen nitidus is an inflammatory disease that also results in papules. The reason some people confuse them with PPP is because these papules also tend to be small, uniform and flesh-colored.
One common treatment for lichen nitidus involves applying topical steroids to the papules to reduce the inflammation. However, the same approach is ineffective for PPP removal because there is no inflammation involved in the development of pearly penile papules. Moreover, steroid creams should never be applied to penile skin because they cause a thinning of the epidermis. This makes the glans surface much more prone to irritation and increases the absorption of the steroids into your blood stream (which can disrupt your hormonal function).
Since most PPP sufferers first notice their papules around their teenage years, many end up comparing them to another skin condition that is equally common around that age - acne. Guided by sheer intuition, many try to treat their penile papules with acne products. These products include salicylic acid, benzoyl peroxide, spot treatments, etc. Unfortunately, these products do nothing to eliminate the papules and often end up further damaging the penile tissue.
Pimples form when your hair follicles become clogged with dirt, dead skin cells or oil. However, since our glans has no hair follicles, it can’t form pimples. This makes most acne products irrelevant for PPP removal because they either focus on unclogging non-existent blocked pores or clearing absent hair follicles of oil and dirt.
Instead, the focus during PPP removal should be on safely dispersing the fibrotic clumps under the papule surface so that they can naturally regress back down and disappear.
Most importantly, acne treatments simply aren’t well suited for application to the penile mucosa. These products often deplete the protective moisture barrier on the penile surface and make the glans more vulnerable to dryness, irritation, infections and injury.
When pearly penile papules were first being studied, it drew scientists to compare them to similar penile structures in other animals. Indeed certain animals, such as cats and chimpanzees, have similar structures on their glans called penile spines.
In these animals, penile spines play a possible role during mating. For example, in insects and bats penile spines act as clamping structures and in cats and chimpanzees they act as stimulatory structures.
Based on these observations in other animals some have jumped to the conclusion that pearly penile papules may also play a role in sexual reproduction in humans and should be left untouched.
However, recent studies have now shown that in fact pearly penile papules do not play any role during sex and getting rid of them does not cause any decline in sensation or sexual function.
If anything, the presence of pearly penile papules can cause significant distress to the sufferer and papule removal can actually alleviate this distress, significantly improving your quality of life.