Pearly Penile Papules vs. HPV: Symptoms & Treatment

Medically reviewed on Nov 17, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What are Pearly Penile Papules?
• What is HPV?
• How To Know If You Have Pearly Penile Papules vs. HPV
• Genital Warts vs. Pearly Penile Papules Treatment And Prevention
• How Can I Protect Myself And My Partners From HPV?
• Know Your Sexual Health Status With Everlywell
• Related Content

No one delights in finding unusual growths in private places, especially given that 1 in 5 sexually active Americans are estimated to be infected with a sexually transmitted infection (STI).[1] While some bumps aren’t dangerous, like pearly penile papules (PPP), others could be genital warts caused by the viral STI human papillomavirus (HPV).

HPV doesn’t have a cure, and unfortunately, only women and people AFAB can be tested for HPV (either at home or with a healthcare provider).[2] If you are a man or person AMAB, knowing the differences between pearly penile papules and HPV genital warts can help you assess whether you may be infected.

If you think you may have HPV, it’s important to reach out to a healthcare provider to discuss your treatment options. In the meantime, find out more about pearly penile papules vs. HPV genital warts below.

What are Pearly Penile Papules?

There are many clinical terms for pearly penile papules: papillomatosis, corona penis, corona capillitii, and so on. No matter what they’re called, all are non-pathological and are linked to no known health risks.[3]

Pearly penile papules are considered normal growths and are estimated to develop on as many as 48% of men and people AMAB.3 They typically turn up in adulthood, but they can arrive in late adolescence, too.[3]

You may be at a slightly more elevated risk of developing them if [4]:

• You are circumcised
• You have African-American ancestry

If your papules are causing you distress, a variety of procedures are available to remove them.[3]

Should I Worry About Pearly Penile Papules?

Not necessarily. Pearly penile papules are considered a normal morphological development of the penis. You’ll only need to seek treatment if they’re accompanied by other concerning symptoms such as [5]:

• Penile discharge
• Burning or pain when you urinate
• Itchiness or pain around the genitals
• Penile bleeding

If your papules are a recent development and you’ve noticed any of these additional symptoms, reach out to a healthcare provider. It’s very common to mistake genital warts or other growths associated with STIs for pearly papules.[3]

Can Women and People AFAB Get Pearly Penile Papules?

No, women cannot get PPP.3 Pearly penile papules only affect biological males. In fact, some researchers suspect they are vestigial of penile snipes, an anatomical trait possessed by many male primates to facilitate sex and reproduction.[3]

If you’re a woman and you notice what seems to be papules on your sexual anatomy, it’s best to reach out to a healthcare provider for assessment. What looks like papules may be genital warts caused by HPV, which both women and men can contract.

What is HPV?

HPV, or human papillomavirus, is the single most prevalent STI in the US. There are many different types of HPV, and many people aren’t aware that they have it since several HPV strains cause no obvious symptoms.[2]

Can HPV be cured with antibiotics? There is currently no cure for HPV, but there is an HPV vaccine that can prevent you from getting infected. A highly contagious viral infection, HPV, can be transmitted through [2]:

• Penetrative sexual contact (anal or vaginal)
• Oral sex

In the long term, certain types of HPV can cause genital warts. Other types of HPV have been linked to [2]:

• Cervical cancer – Women and people AFAB who have HPV are at a higher risk of developing cervical cancer in the future.
• Other cancers – Both men and people AMAB and women and people AFAB with HPV have a higher likelihood of developing throat, anal, vaginal, or penile cancer.

Many cancer-causing strains of HPV do not present with any symptoms. For this reason, women and people AFAB are encouraged to get regular Pap smears and HPV tests to ensure they aren’t at risk. [2]

Should I Worry About HPV Genital Warts?

So, how long do genital warts last? It depends. HPV and genital warts can go away on their own, typically after a period of 2 years.6 If you’re concerned about genital warts, there are both topical and surgical methods for removing them.

On the whole, preventative treatment options are the best measure of protecting you and your partners from both HPV and the genital warts they can cause. If you are a sexually active adult under the age of 45 and haven’t been vaccinated already, it’s highly recommended you get vaccinated.

How To Know If You Have Pearly Penile Papules vs. HPV

Many people with male reproductive anatomy develop genital warts and mistake them for pearly penile papules or other benign growths. If you notice any abnormal-looking or new growths on your penis, it’s a good idea to take an STI test, either with a healthcare provider or using an at-home testing kit. STI screening is the only way to rule out the possibility of having an STI.

That said, it can be helpful to know how pearly penile papules and HPV-related genital warts differ. A few common traits of pearly penile papules are [4]:

• Opaque white, pink, or yellow in color
• Shaped like a dome
• Typically approximately 1 to 2 millimeters in diameter
• Typically 1 to 4 millimeters tall

One of the most distinctive qualities of papules is their patterning: they typically form a ring around the glans or head of the penis. Under a microscope, some people compare them to “cobblestones.” To the naked eye, they may resemble sea anemones.[4]

HPV genital warts look very different. These tend to be [7]:

• Brown, pink, or flesh-toned in color
• Clustered in small clumps or scattered around your genital area [8]
• Either smooth or rough in texture

Many people describe genital warts as having a cauliflower-like structure that’s less consistent than the pattern of pearly penile papules.[7]

Most importantly, genital warts are often noticed by itching around the genitals. They may also bleed when you have sex. Since they’re not an infection, pearly penile papules do not disrupt your sex life or cause physical discomfort.[3]

Genital Warts vs. Pearly Penile Papules Treatment And Prevention

While you’ll need to speak to a healthcare provider to treat HPV, many of the same procedures are used to physically remove both HPV-caused genital warts and pearly penile papules. These include [4]:

• Cryotherapy – Cryotherapy is considered one of the most effective ways of removing growths, both pearly penile papules and genital warts. The procedure involves “freezing” off the growths with liquid nitrogen, which may need to be performed over several appointments. The procedure requires anesthesia and can cause some side effects, like scarring or pigmentation issues.
• Electrocautery – Also called ‘electrodesiccation,’ this procedure involves the use of electricity to remove growths. It often takes less time than cryotherapy, but it can result in scarring or anatomical abnormalities.
• Laser therapy – Various types of lasers may be used to remove both warts and papules. It’s a great method if your growths cover more surface area, though it can be more expensive than methods like cryosurgery.[8]

Pearly penile papules must be removed procedurally. However, HPV genital warts may respond well to topical medicines in addition to procedural interventions. Some common medicines that are used include [9]:

• Imiquimod (Aldara or Zyclara) – These support your immune system to get rid of genital warts faster. However, they shouldn’t be used if you’re about to have sex, as the chemicals used may make condoms or diaphragms less effective.
• Podofilox (Condylox) – This dispels genital warts by physically breaking down the tissues that comprise them. Depending on where your warts are located, these medications may be applied either at home or with the help of a healthcare provider. Importantly, neither should ever be applied to any external genital warts found in your vagina or on the cervix.

In many cases, topical treatments of external genital warts can be highly effective, helping them heal in just a few months.

How Can I Protect Myself And My Partners From HPV?

Though pearly penile papules aren’t contagious, genital warts and the HPV strains that cause them are. Apart from getting vaccinated, there are several ways to limit you and your sexual partner(s)’ risk of infection [2]:

• Get vaccinated – HPV vaccines can help protect you from 9 strains of HPV, as well as complications they can cause like cancer and genital warts.[2]
• Use protection – Latex condoms and dental dams can help protect you from passing both HPV and genital warts to your partners.
• Limit your sexual partners – The Centers for Disease Control and Prevention (CDC) states that entering a long-term, monogamous partnership is one of the best ways to reduce your risk of catching or spreading HPV.
• If you’re a woman or person AFAB, book regular exams – Women and people with female anatomies can take HPV at-home tests and get Pap smears and pelvic exams regularly to test for early signs of cervical cancer.[2]

Know Your Sexual Health Status With Everlywell

Whether you’re confident about your STI status or you or a partner is contending with odd lumps and bumps, regular STI testing is the cornerstone of sexual health.

With Everlywell, all genders can screen for up to 6 common STIs comfortably at home. Women and people AFAB can even use the Everlywell at-home HPV Test to screen without visiting a healthcare clinic.

Each Everlywell test is processed by CLIA-certified labs, with physician-reviewed results you can trust. You can even meet virtually with a clinician, who can talk to you about your symptoms and provide STD treatment online. Take control of your sexual health with Everlywell.

Related Content

Skin Tag vs. HPV: Symptoms & Treatment Options

Can HPV Come Back?

HPV vs. HIV: Comparing Sexually Transmitted Infections (STIs)

References

1. STI Prevalence, Incidence, and Cost Estimates. Centers for Disease Control and Prevention. Published January 25, 2021. URL. Accessed November 6, 2023.
2. HPV and cervical cancer: What you need to know. NIH MedlinePlus Magazine. April 16, 2020. URL. Accessed November 6, 2023.
3. Love LW, Badri T, Ramsey ML. Pearly Penile Papule. PubMed. Published 2023. URL. Accessed November 6, 2023.
4. Honigman AD, Dubin DP, Chu J, Lin MJ. Management of Pearly Penile Papules: A Review of the Literature. Journal of Cutaneous Medicine and Surgery. 2019;24(1):79-85. doi:https://doi.org/10.1177/1203475419887730URL.
5. Pearly Penile Papules: Causes, Symptoms & Treatment. Cleveland Clinic.. Last reviewed August 5, 2022. URL. Accessed November 6, 2023.
6. STD Facts - Human papillomavirus (HPV). Centers for Disease Control and Prevention. Published January 19, 2021. URL. Accessed November 7, 2023.
7. Mayo Clinic. Genital Warts - Symptoms and Causes. Mayo Clinic. Published 2016. URL. Accessed November 6, 2023.
8. Genital warts: Signs and symptoms. AAD. URL. Accessed November 6, 2023.
9. Genital warts: Diagnosis and treatment. AAD. URL. Accessed November 6, 2023.