Doctor, what's this on my 'privates'?

Dr Pauline Williams-Green, Gleaner Writer

Matthew fidgets in his chair. He is anxiously waiting to be called by his family doctor. He enters the examination room. After the usual greetings and sharing of information about his new job at the bank, he launches into the reason for the visit. He has been noticing many tiny bumps on his penis. He is alarmed and feels certain that he has contracted a dangerous disease.

The doctor asks about his sexual practices. He is asked about the number of sexual partners. Is he using condoms consistently? Matthew is told to undress and he points at several rows of tiny skin-coloured pin-shaped bumps on his penis. "Are these warts?" he asks. The doctor smiles and answers, "No Matthew, these are pearly penile papules."

Pearly penile papules

Pearly penile papules are benign skin lesions which cause great anxiety to young men. These affect men in their 20s and 30s. They are found only in men and are twice as common in uncircumcised men, compared to circumcised men. They are considered harmless and a normal variant among men. They are unrelated to sexual activity and there is no evidence of sexual transmission. There is no relation to personal hygiene.

Symptoms and signs

Pearly penile papules appear as one or several rows of tiny, skin-coloured bumps. These may be smooth, dome-shaped or thread-like. They are located around the corona, in the groove near to the end of the penis. These bumps are painless and do not itch. They usually last throughout life but may gradually become less noticeable as the man ages.

Uncircumcised men with pearly penile papules may notice a build-up of smegma (cheesy-looking material) but this is easily removed by daily, careful hygiene. They are often confused with genital warts but there is no relation. There are no complications from this normal variant.

Medical care

Pearly penile papules are asymptomatic and really require no interventions. However, some men wish to have them removed. This can be done by carbon-dioxide laser therapy or surgical excision. There are no effective topical or oral treatments for the removal of these bumps. A dermatologist may be consulted if the diagnosis is not clear.

Matthew is relieved

Once Matthew is told about the benign nature of his condition, his anxiety evaporates. He now knows that the bumps have no relation to sexual activity. This condition is quite common and he has nothing to worry about. He feels comforted and leaves the doctor's office with a smile.

Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians. Email: yourhealth@gleanerjm.com.