as a urologist i see a lot of patient with growths or bumps on the penis

some patients ask do I have cancer? do I need a biopsy? 

Most patients with a classic wart or HPV do not need a biopsy, patient who are uncircumcised or recurrent growths may consider a biopsy.

Freezing a wart with liquid nitrogen, cauterization, or topical treatments like aldara (imiquimod topical cream)

if you have a wart get to a doctor and have it treated.  A biopsy is not a  bad idea but no always necessary

thanks for all of stories and questions I hope this site can help you fight your personal war on warts. 

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Pearly penile papules are small raised nodules (bumps), usually 1-2 mm in size, which are located around the rim of the penis head in the form of string of pearls.  Usually developing during adolescence, they have been reported in up to 35% of males. Uncircumcised men are more likely to have pearly penile papules.  Very often these lesions are confused with genital warts, although there is no known link between warts and pearly penile papules.

Pearly penile papules are NOT cancer and are NOT spread via contact or sex. Most men with penile papules do not seek medical treatment.

Men do not need to have them removed but some men feel uncomfortable having spots or dots on the penis.  Some men are worried that a partner my not have sex with them because they look like warts or other sexually transmitted bumps such as herpes.

Many treatment methods have been tried, including circumcision and freezing. But these methods had proven to be either ineffective or have side effects.

Until recently,burning and carbon dioxide laser were considered the most effective treatment options.

Radiofrequency surgery was introduced into dermatology, it became a great option to remove unwanted papules effectively, safely, and with no scarring or bleeding.  Originally used to remove papules on the nose or other small bumps radiofrequency removal is an effect technique.   Because radiofrequency uses radio waves and not electricity, there is less damage to surrounding tissue and its small and light hand-piece allows for more precise and complete removal.

Usually one treatment is enough to remove all penile papules.

Treatment area is numbed with lidocaine cream making the area not sense pain or heat.   The skin takes a week to ten days to heal.  Patients can resume daily work activities that same day but we encourage no sexual relations until the healing process is finished

In a previous post, we discussed penile pearly papules.

Lichen planus can also cause bumps on the penis.  This condition is an inflammatory condition - NOT an STD.

Classical lichen planus is characterized by shiny, flat-topped, firm papules (bumps) varying from pin point size (‘guttate’) to larger than a centimetre. They are a purple colour and often are crossed by fine white lines (called ‘Wickham’s striae’). They may be close together or widespread, or grouped in lines (linear lichen planus) or rings (annular lichen planus). Linear lichen planus can be the result of scratching or injuring the skin. Although sometimes there are no symptoms, it is often very itchy.

Lichen planus may affect any area, but is most often seen on the front of the wrists, lower back, and ankles.  They are also commonly found on the penis.

Sometimes it may be necessary to take a skin biopsy to confirm the diagnosis.  One of the best treatments for lichen planus on the penis are injections with cortisone.

Jessica writes:

“I got married 8 months ago, and 2 months ago, for the first time ever i was diagnosed with HPV. According to the Dr, it didnt necessairly come from my hubsand, but i cant help feel like it did. Thankfully, i have no genital warts or currently any cancer causing lesions, but i Do have a brand new, first time ever skin wart on my knee. Ive just started liquid nitrogen treatment for the removal of that.
Im increadably disspaointed, and borderline terrified. This is a first for me, and while some people say “its no big deal”- to me it is a big deal. this is something ive never had to deal with before and to make it worse, i know next to nothing about the Virus. Ther are so many different websites on it that have s many different opinions, i hardly know which one to believe!!

I think the next best step for me is education myself on this virus, how to treat it, and how to NOt spread it!”

Thanks for writing!  First off… you have found a good place to discuss your concerns.  Please do not be terrified.  Warts are quite common.  Instead… lets get educated!

Your Doctor’s advice is correct.  The wart did not necessarily come from your husband.  You may be able to blame him for lots of things… but you can’t point a finger at him for this one.  Further, the type of wart that grows on the skin is typically a different strain of virus than that found in the genital areas.

There are many treatment options for common warts, and Liquid Nitrogen is often a good place to start.
Best of luck, and keep us updated!

Peri-anal warts are a serious condition – with multiple treatment options.  There is a significant risk of developing anal cancer if these are not treated.  In fact, this risk may be greater than the risk of developing cervical cancer (which is what PAP smears check for.)  Though we typically do not test for the presence of HPV on the penis, it is very important to check for HPV in and around the anus in patients at risk (ie: those who have had anal sex).

Since it is difficult to examine yourself in this area, it is most important for you to get examined by a physician if you feel any growth, bump, roughness, or experience any bleeding from the area.

Getting treatment for genital warts or HPV is important.  Doctors can burn, freeze, cut or scrape away unsightly bumps.  The virus associated with HPV stays in the body like other viruses do.  Just like cold sores a new eruption can happen without a repeat exposure.  Someone who doesn’t have visible warts can still give someone else the virus during unprotected sexual contact.  While antibiotics can treat some sexual transmitted infections getting treated for genital warts does not constitute a cure.  Some cases of warts don’t progress at all.  Others grow to be big, painful and even disfiguring. 

Most patients are happy to have the growths treated and there partners or new prospective partners wont see the warts.  A responsible adult should use condoms to prevent sexually transmitted infections, HIV and warts. 

While we can make the warts disappear there is no guarantee the warts won’t have the last laugh.

Genital Warts are among the most prevalent sexually transmitted diseases, but people lack the right information to help prevent or treat this condition. Clear, correct, updated information regarding human papillomavirus (HPV) and genital warts is difficult to find. The result is that a lot of myths and misconceptions regarding genital warts abound. In some cases, these mistaken beliefs may even do harm. Inaccurate information may have several physical and emotional ramifications on the sufferer. For instance, he/she may suffer from severe anxiety over his/her condition, doubt the faithfulness of his/her partner, undergo an expensive and painful treatment that could otherwise have been avoided, or worst of all, neglect having his/her condition treated and risk his/her health.

This article tackles the most common misconceptions and busts these myths in order to make more people understand genital warts and HPV better.

Myth: Only women can carry HPV and have genital warts.

Fact: The chances of men and women having HPV and genital warts are more or less equal. However, the symptoms of genital warts appear more on women because their anatomy provides a better breeding ground for the virus. The warm and moist environment of the vagina makes it an attractive location for the virus to reside in and multiply.

Myth: I can only get genital warts by having unprotected sex.

Fact: It is no doubt that having unprotected sex increases your chances of getting HPV. HPV can also be transmitted by direct skin contact. Thus, some forms of protection like condoms won’t guard you against some STDs because they don’t cover the entire genital area. It can also be passed on through oral sex, resulting in warts in the mouth and throat. Moreover, some studies have shown that HPV can be spread through contact with infected objects such as contaminated medical equipment and bath towels.

Myth: If I don’t see genital warts, it means that I don’t have HPV.

Fact: HPV, when passed on, can be in a latent or incubation phase that can last for a few weeks to even several years. Thus, symptoms of genital warts won’t manifest right away. A carrier may never know that he/she has the virus. In fact, experts estimate that only around 1 percent of all Americans who are sexually active have visible warts. 

Myth: Genital warts appear only on the head of the penis.

Fact: Genital warts can appear anywhere – on the head, shaft, scrotum, or even the thighs or lower abdomen.  Here are some warts on the shaft.

As a parent of a school-age daughter, I haven’t decided what to think about the new cervical cancer vaccine. That’s why I was interested to learn the shot may soon be given to boys primarily to benefit girls.

Merck’s Gardasil vaccine is approved for use in girls and women, ages 9 to 26, to protect them against the human papillomavirus, or H.P.V., which causes cervical cancer. Girls can be vaccinated when they are as young as 9, although it’s recommended for 11- and 12-year-olds, before they are sexually active.

But as my colleague Jan Hoffman reported yesterday in the Sunday Style section of The Times, the vaccine could be approved by 2009 for boys as well. Although Gardasil also protects against genital warts, which are not life-threatening, the primary reason to extend approval to boys would be to prevent them from transmitting the virus to girls, thereby slowing the rates of cervical cancer. The concept is called “herd immunity.”

And the story raises the difficult question: Will parents of sons consent to a three-shot regimen that has been marketed as benefiting girls?

The story talks to parents who have mixed feelings about the idea, questioning whether they would subject their boys to a vaccine that ultimately wouldn’t benefit their son’s health. What would you do? Would you give your son a shot to lower a woman’s risk for contracting cervical cancer? Hypothetically, would you give your daughter a shot that could lower a man’s risk for prostate cancer?

source: NY Times

Penile pearly papules are tiny bumps on the rim of the glans or head of the penis.  It is common for young men to be concerned about the dots because they look like warts or other growths.  They are usually very small a couple of millimeters in diameter and are clear or pearly in appearance.  If you have these don’t be alarmed.  A note of caution just because you have pearly papules doesn’t mean you can ignore other bumps or lesions on your penis.  Everyone who is not practicing safe sex and notices lesions that are suspicious should seek medical attention.