Genital area lesions

Pearly penile papules

The papules are small (0,5 mm to 4 mm in size) dome-topped bumps, pearly or flesh-coloured, situated circumferentially around the corona or sulcus of the glans. They may appear as one or several rows around the corona of the glans. They tend to occur in a few - more than ten percent of healthy teen males. The papules are more often met in those men who have not been circumcised. Pearly penile papules do not have viral etiology, and so they are not contagious.

Differentiating: genital warts, molluscum contagiosum (water warts).

Treatment: The lesions are harmless and do not require any treatment. If patients consider them aesthetically displeasing, the papules may be removed by dermatologist using a CO2 laser.

Fordyce spots

They appear as small, painless, pale or white spots or bumps 1 to 3 mm in diameter and may occur in the following areas:

- the glans penis (Tyson's glands),
- shaft of the penis,
- the skin of the scrotum or the labia,
- the inner surface and borders of the lips,
- areola (Montgomery glands),
- the eyelids ( Meibomian Gland Dysfunction).

They occur in about 80% of adult males and also in females.

Fordyce spots are caused by disorders of sebaceous glands, which are usually associated with hair follicles. They occur when sebum gets trapped in the hair follicle-lacking glands and finds no outlet to get discharged from the body. This results in the formation of small, pale bumps of sebaceous masses. Fordyce spots are not associated with any disease or illness and are only considered as an aesthetic concern. They are not infectious and their occurrence is natural.

Differentiating: pearly penile papules, molluscum contagiosum (water warts).

Treatment: There are no medical indications for the treatment of Fordyce spots. If they are of cosmetic concern (anxiety about the appearance of penis and potential or real reaction of a sexual partner), then vaporization treatment with the CO₂ laser may be applied.

Genital warts (venereal warts)

Genital warts are caused by human papillomavirus (HPV), most often transmitted trough sexual contact. Typically, they develop on warm and moist surfaces, such as: under the foreskin, on the sulcus of the glans, on the opening to the urethra, on the penile shaft, on the vulva, on the female perineum, inside the vagina (on the wall of the vagina and on the cervix). In homosexuals, genital warts are frequently found around the anus and rectum. The time from infection to occurrence of the lesions may last 1-6 months. Veneral warts may persist for several years.

Symptoms: Genital warts are small, soft, pink or red papules, sometimes in a cauliflower-like, pedunculated form. They may occur singly, but are more often found in clusters. Veneral warts infection gives no symptoms, however, sometimes the warts may cause itching, redness, discomfort or even pain.

Treatment: The course of treatment depends on the sizes and locations of the lesions. Although they might be physically removed, the virus is still present in an organism and may cause frequent recurrence of warts. Pregnant women with genital warts require special treatment. Small warts may be treated with topical agents. In some cases, they are electrocoagulated or liquid nitrogen cryosurgery is performed, which is also considered effective. Bigger lesions sometimes require surgical removal. Definitely, the best and most effective treatment method for getting rid of warts is their vaporization with CO₂ laser. The therapy leads to elimination of the lesion, however, it might happen, that it will need to be repeated after a few weeks. As it happens with other types of warts, removing a few warts may cause spontaneous withdrawal of the remaining growths. During the treatment, patients are required to restrain from sexual activity.