A detailed explanation of the bumps on the glans penis, ‘Pearly Penile Papules (PPP)’.

At our clinic, we receive numerous consultations regarding 'Pearly Penile Papules (PPP)'.

It can occur regardless of age (in most cases, it has been present since childhood) and rarely improves naturally.

Pearly Penile Papules (PPP) are small protrusions that appear along the corona of the glans penis. Many men are concerned about this condition. In this article, we will provide a detailed explanation of the causes, treatment methods, and prevalence among Japanese men.

1. Cause The exact cause of Pearly Penile Papules is unknown, but it is not associated with sexually transmitted diseases or cancers. Moreover, it is not related to sexual activity or personal hygiene habits, and there is a possibility that it might be linked to genetic factors or the development of the penis.

The size and number of papules vary among individuals, and most people considering treatment are concerned about its appearance.

2. Prevalence among Japanese Men Pearly Penile Papules are a common phenomenon observed in men worldwide, and the prevalence rate varies depending on the race and region. According to research, approximately 10-20% of adult Japanese men have PPP[^1]. This figure is slightly lower compared to Western countries, but it's significant enough for Japanese men.

Considering that 1 to 2 out of 10 people have it, it's understandable why many opt for treatment.

It's important to note that it's not a disease, so even if it's not removed, there's no impact on the body.

3. Treatment for Pearly Penile Papules PPP is harmless, and there's no medical necessity for treatment. However, some people desire treatment for aesthetic reasons or due to psychological distress.

Laser Treatment: A method using a CO2 laser to burn off the PPP. This method often provides lasting results[^2]. We also use this treatment method at our clinic. There are very few cases of recurrence, and improvement is possible with a single treatment.

Surgical Removal: A method to physically excise the papules. If performed correctly, there's a low risk of recurrence. We don't recommend this method due to its invasiveness and downtime, but in rare cases where papules have grown in clusters, removal may be considered.

Cryotherapy: A method using liquid nitrogen to freeze the PPP and remove it later. Multiple treatments might be necessary, and it's not highly recommended.

Topical Treatment: Some creams and gels might help improve the appearance of PPP, but the effectiveness varies among individuals. We recommend against using over-the-counter drugs like "Ibokorori" as there have been cases where PPP enlarges after use.

When selecting a treatment method, we will consider the severity of the symptoms, potential risks, and costs, so if you have concerns, please feel free to consult us.

4. Other Bumps that Can Appear on the Male Genitalia Genital Warts (STD) Cause: Human Papillomavirus (HPV) infection. Characteristics: Small bumps or warts that appear on the penis, glans, scrotum, and perineum. They often have a cauliflower-like appearance.

Fordyce Spots (Non-infectious) Cause: Cluster of sebaceous glands. Characteristics: Small white or flesh-colored granular protrusions on the shaft or glans of the penis. They are harmless and usually don't need treatment.

Scrotal Calcinosis (Non-infectious) Cause: Formation of small cysts on multiple parts of the skin. Characteristics: White nodules that appear mainly on the scrotum. They can enlarge over time, but some may not grow at all.

Syringoma (Non-infectious) Cause: Small cysts formed inside the skin. Characteristics: Small bumps or nodules that might appear on the shaft of the penis.

Cyst (Non-infectious) Cause: Blockage of Bartholin's gland. Characteristics: Primarily occurring in women's genital areas, but similar symptoms can appear near the scrotum in men.

Folliculitis (Non-infectious) Cause: Infection of hair follicles by bacteria. Characteristics: Red inflammation or bumps around the scrotum or genital area.

Skin Cancer Cause: Excessive exposure to ultraviolet rays or genetic factors. Characteristics: Abnormal growth or color-changed bumps or skin changes that might appear on the penis, scrotum, or surrounding areas.

Among these bumps and protrusions, some are harmless while others might require treatment. If you notice any changes or symptoms on your genitalia, we recommend consulting a dermatologist or physician promptly. Avoid self-diagnosis or self-judgment.

5. Conclusion Pearly Penile Papules are a concern for many men. However, they are harmless, and there's