Pearly papules are bumps of skin located on and around the head of the penis (the sulcus or corona). Technically known as hirsuties papillaris genitalis (called ‘lesions’ or ‘papules’ for short), they are surprisingly common and found in up to 30% of men. They often appear in several rows which wrap completely around the penis head.

The good news:

They’re not an STD/STI – nobody can catch them from you or you from them.
Pearly papules are purely cosmetic. The rest of your body is safe.
The bad news? Well, there really isn’t any. The medical profession considers them a ‘normal variation’ of the skin. You can have them removed as you would an unwanted mole.

One study of 200 men, nearly half of whom had pearly papules, gives us an idea of what to expect on average. About 72% of the men with papules had only a few less than 1 mm in size; 20% had small rings of pearls extending around the corona of the penis; and only 8% had papules greater than 1mm in size extending around the corona.

Causes and risk factors
While pearly papules are not themselves an STD/STI (and are not caused by an STD/STI), the true cause is unknown at this time. Papules are:

More common in adult men under middle age (in their 20’s or 30’s)
Less common in older men (over 45)
More common in uncircumcised men
There has been speculation that they may be genetic, but this is as yet unconfirmed. There are no known risk factors that make papules more likely to occur.

Looks and psychology
Although perfectly normal, many men still find this condition embarrassing when with their partners.

In the study above, at least 30% of the men experienced concern at their presence, and about 25% felt embarrassed by them. 75% of men with the larger papules wished to remove them, while only 14% of men with the smaller papules wanted to do so.

In contrast, one internet survey found that when asked, 85% of women didn’t think papules were anything unusual – they’d seen them before and thought nothing of them.

That said, leaving papules untreated can for some men have negative effects on their confidence and feeling of well-being, and for this reason they might be removed.

The first step is to see a dermatologist, who can give you advice for your particular situation. For removal they may suggest a number of different treatments including drugs, laser surgery, or cryosurgery (freezing).

Drugs that have been tried include doxycycline and podophyllin. Doxycycline is taken orally and podophyllin applied topically (directly to the skin). Neither one produced satisfactory results.

Much more common is CO2 laser surgery. Treatment by carbon dioxide laser has been successful, but comes with the standard surgical risks including infection, bleeding, scarring, bruising, and potential nerve damage. That said, it is reportedly the best surgical removal option. There is a recovery period required, together with some level of swelling, redness, and scabbing. But full healing takes only 1-2 weeks to complete, and no time off work is usually required for the recovery.

Finally there is cryosurgery, or freezing using a liquid nitrogen gun. Two treatments are given at intervals of 1-2 months. Each treatment consists of two freeze-thaw cycles that last under 20 seconds each.

Other (less common) methods that have been attempted include electrodessication with curettage and excisional surgery, both of which report successful removal.

Although some men don’t like the look of pearly papules, they aren’t dangerous, infectious, or debilitating. On the other hand, removal appears safe too – so t is mostly a matter of personal choice (rather than health) whether to remove them, or not.

Considering that some men modify their members for pleasure and fashion (penis piercings), you may just keep your ‘pearls’ for the time that they last, making them a part of your sexuality. Or like most, you can completely ignore them.

In the end, if you feel it will improve your sexuality removal appears to be a safe option. What matters most here is that you feel comfortable with your own appearance and sexuality.

Posted: 27 Sep 00:21