Over 15 years treating patients with Pearly Penile Papules (PPP), Dr. Groff has compiled a list of frequently asked questions which his patients have asked him. It is Dr. Groff's goal to help you understand pearly penile papules and carbon dioxide CO2 laser treatment by answering all your PPP questions and concerns. After reviewing these FAQ, it you still have a question or a concern, please feel free to contact Dr. Groff by completing the "Ask Dr Groff" form.
For your convenience, you can search within the frequently asked questions, as well as, expand all of the answers for easier reading.
PPP have no symptoms except for the appearance of the papules on the penis. They do not cause any pain, itching or burning. Pearly penile papules are not contagious in any way. If you are experiencing pain, burning or itchiness, please seek your doctors advice. You probably do not be pearly penile papules.
Pearly penile papules are not a sexually transmitted disease (STD). You did not get pearly penile papules by sexual contact. There is no risk of passing PPP on to your sexual partner. PPP has nothing to do with sexual activity or personal hygiene.
Pearly penile papules are commonly mistaken for genital warts, even by physicians. Penile pearly papules are not genital warts. Genital warts is a sexually transmitted disease and is contagious. Genital warts may look like small, flat flesh-colored bumps or have a cauliflower like appearance that can develop on or around the genitals. It is very important to seek out the expertise of a board certified dermatologist if you are not sure of your condition. It is imperative to get an an accurate diagnosis so you can select the correct treatment, if needed.
Unfortunately, there are internet scams selling topical creams which claim to be able treat PPP. However, topical creams do not work and can cause undesirable side effects. The safest and most beneficial treatment to remove pearly penile papules is with a CO2 laser.
Pearly penile papules are very common and effect approximately 25-30% of men, especially among men in their twenties and thirties. Pearly penile papules are more common in uncircumcised men. Getting circumcised will not remove your PPP.
PPP are considered totally harmless. This condition is considered a “normal variant” that does not need treatment. By not treating your PPP, there is no risk to your health. Your PPP will not spread to other parts of your penis and will typically stay on the rim and underside of the tip of the penis. Some men do suffer psychological distress over the condition and decide to treat their PPP because they feel social and sexual embarrassment.
There are many home remedies that claim to be able to eliminate pearly penile papules. In my experience, home remedies for pearly penile papules are just not effective. Home remedies will often irritate the area and can cause permanent damage. By using home remedies, men risk making their condition worse by developing scarring issues, inflammation, loss of sensation, infection, bruising, numbness, and other serious side effects. I believe CO2 laser removal is the most effective way to clear the condition safely and quickly.
Like most things in life, experience matters. When seeking a doctor for treatment of pearly penile papules, find a Board Certified Dermatologist that can provide you many examples of his work treating pearly penile papules. If the doctor cannot show you at least 20 “before and after” photos of his patients treated with pearly penile papules, then his experience is likely limited. If you do not go to a doctor experienced with removing pearly penile papules with a CO2 laser, you can get scarring and major complications. Keep looking for a board certified dermatologist with experience and do not compromise your care for cost or distance. It is too risky. Many of my patients fly in from around the world to be treated by me.I do not live near your offices in San Diego, CA or Lancaster, PA so I will have to travel a long distance to get your free consultation and treatment. I think that it is well worth me having treatment with you because of your extensive experience with PPP but is there anyway that you can do the consultation and treatment on the same day?
I certainly understand your inconvenience to travel a long distance to see me. Any patient that has an issue with travel, I will accommodate their schedule by having the consultation and treatment on the same day. Please complete the Contact Form with all you information including your preferred schedule. I will get back to you as soon as I review your information.
No. The private consultation with me is free. The laser treatment, follow- up visits and any re-treatments are all included in just one fee.
I use the latest generation Lumenis UltraPulse CO2 laser to painlessly and permanently remove the pearly penile papules. This carbon dioxide laser has a beam that is as wide as the tip of a sharpened pencil. This laser allows me to remove each papule without damaging any normal skin on the penis.
I do not use any injections. A strong topical numbing cream is applied to the penis for approximately one hour before the procedure. My patients tell me that they do not feel any pain during the procedure.
Most patients go back to work the next day and experience very little, if any discomfort while healing. It is reasonable to expect some swelling and crusting after your treatment while you are healing. Most men are healed in 1-2 weeks and can resume sexual activity.
The CO2 laser treatment will not alter the penis sensation or sensitivity. I have had no patients develop scarring, loss of sensation, infection, or any other serious side effect or complications. This treatment will not alter the function of the penis in any way. Your penis will function exactly as before the treatment.
When this treatment is performed by a board certified dermatologist who is well trained and experienced with the CO2 laser, it is safe, painless, and extremely effective. Just like with any medical procedure, the skill and experience of the doctor is paramount to the success of your PPP treatment.
CO2 laser treatment is intended to permanently remove the papules. However, if a patient's papules grow back, I would be happy to treat the patient again at no cost.
There are 2 other options:
Electro surgery with curettage involves high-frequency electrical current that dehydrates the papules then a curette is used to scrape away the tissue of the penile papules. The wounds are cauterized to stop bleeding and seal the wound. Depending on doctor's skill and use of the curette, this method can result in scarring and loss of elasticity of the skin after the healing phase.
Excisional surgery involves removal of the penile papules surgically. Additional tissue surrounding the penile papules may be cut away resulting in severe scarring. Infection is a possible complications from this procedure.
No, you do not have PPP. PPP are small, flesh-colored small dome-shaped bumps, or papules that look like skin tags that form around the rim and underside of the tip of the penis. There is another type of "normal" variant that can also be confused for pearly penile papules. If you have pimple like structures either singularly or in clusters on the shaft of the penis or on the scrotum then this is not pearly penile papules. These are commonly known as 'Fordyce Spots' or 'Sebaceous Prominence'. Fordyce Spots are not contagious, cancerous and are not a sexually transmitted. PPP and Fordyce Spots pose no health concern beyond cosmetic and psychological concerns. Fordyce Spots are different and more difficult to treat than pearly penile papules. Fordyce Spots can be treated with the CO2 laser but could leave tiny scars. I do treat Fordyce Spots so please contact me if you need my help.I have small bumps on my penis head and initially thought it was PPP. I tried everything to get rid of my bumps including all the home remedies from tea tree oil to topical creams and it still persists. One of my bumps has a small hole in it now. I had a test to confirm that I am STD free so I wonder what to do now. Any suggestions?
You may have pearly penile papules. I would like to help you but I would need to evaluate your condition to determine if you have pearly penile papules. If you do have pearly penile papules then the best treatment is CO2 laser. I have treated over 1000 patients with this condition with no problems or no complications. Topical creams and "home remedies" do not work and can cause permanent injury. It sounds like one of these home remedies that you used put a hole in a papule. Be wary of false claims for home remedy treatments on the internet. If you want my help, please complete the Contact Form and include pictures.
I am sorry that you had a bad experience. I can only assume that the dermatologist was not experienced treating pearly penile papules with a CO2 laser or this dermatologist did NOT use a carbon dioxide CO2 lasers. Not all laser will remove pearly penile papules. I use the latest generation laser, the Lumenis UltraPulse CO2 laser. I have over 45 lasers in my practice, and by far, Lumenis UltraPulse CO2 laser does the best job removing pearly penile papules. This laser has a beam that is as wide as the tip of a sharpened pencil and I can precisely vaporize each papule without damaging any normal skin on the penis. I have many patients contact me for help because of a “botched” laser treatment for their pearly penile papules. Yes, I can retreat your condition, please contact me.
I am sorry to hear that you have been living with this condition. First I need to diagnose your condition to make sure that you have pearly penile papules. The cost for the treatment varies based on the severity of the person's condition. Please call for a free consultation appointment or complete the contact form and include pictures if you have them. I would like to help you and look forward to meeting you.