Circumcised Vs Uncircumcised Men: Who Is More Predisposed to PPP?

Last updated: 2022-10-07

Beliefs in the urgency of male circumcision vary due to societal norms, culture, religion, and traditions. But there are added benefits to removing the penile foreskin, according to medical various medical studies.

Globally, about 38% of the male population are circumcised; an estimated three in every 10 males. Among Muslim and Jewish people, over 90% are circumcised due to their religious beliefs. Meanwhile, sociocultural factors are cited as the main reason for the circumcision rate of about 90% in the Philippines. This tradition is also encouraged in some African cultures, often as a right of passage for young and adolescent boys.

Some of these men may develop penile pearly papules (PPP) in their lifetime. Statistics vary, but it’s believed that up to 48% of men develop the condition at some point.

Despite its pervasiveness, researchers have yet to understand PPP fully. However, separate studies may have uncovered some aspects of this genital issue. Here are a few of them.

Man hands hiding pearly penile papules

Who may be predisposed to penile pearly papules?

The signs of PPP are tangible. These small growths may be whitish, skin-toned, or pinkish, and could range from one to three millimeters. Moreover, these tiny bumps are arranged in rows along the corona. They’re often mistaken for other conditions like genital warts or sexually transmitted diseases.

PPP risk factors: age, race, and uncircumcised males

Several things have yet to be understood about penile pearly papules. But many studies have found that PPP is less common in circumcised males. Before such findings, a 1977 study of 840 males had already cited that PPP is prevalent in African American and uncircumcised people.

Although conducted in 2009, a study exposes potential risk factors for pearly penile papules. A total of 258 participants were surveyed, 188 of whom were under 25 years old, and 70 were patients over 50. The study had the following results:

  • PPP prevalence was higher in men below 25 years (38.3% vs. 11.4% in men over 50)
  • Of the younger participants, PPP was more common in circumcised than in uncircumcised males (42.4% vs. 26.5%)
  • Bigger nodules were more common in younger than older males (8.5% vs. 1.4%)

The study also suggested PPP shrinkage in older men, which could mean that those with the condition may see fewer skin growths as they age. Additionally, this research and other studies that identify the same risk factors, namely age, race, and remaining uncircumcised, do not imply that you can’t develop PPP if you’re not predisposed to it. Conversely, it doesn’t follow that individuals with the said risks will grow these tiny genital bumps.

How do you get pearly papules?

Simply put, PPP could develop in males with penises, regardless of age, ethnicity, or sexual preference.

So, the next questions are: what causes PPP, and how do you get penile papules? Again, scientists have yet to determine the cause of PPP development in a male. One theory that seems to make sense to some is that these growths are part of human evolution.

A study suggests that penile pearly papules are the remains of the penile spine, evident in species of primates. However, the study is inconclusive as it couldn’t establish the presence and deletion of androgen receptor (AR) enhancers—responsible for penile spine formation in primates and mice—in the earlier human population. There has been no new and updated scientific evidence to validate this theory.

PPP isn’t contagious

PPP patients must realize that the condition isn’t considered a health problem. Because of the visible tiny bumps, pearly papules cause fear and worry among those with them. But various studies have classified penile pearly papules as skin or cosmetic issues rather than a health problem.

These small growths in the penile area aren’t contagious like genital warts and aren’t symptoms of a sexually transmissible disease or infection—so you can’t spread or get it from others who have PPP.

The bumps are also benign, meaning it’s not dangerous and won’t lead to cancer. For instance, there’s a difference between PPP development in men with partners with a cervical condition caused by sexually transmitted infection (STI), like human papillomavirus (HPV).

A person can’t develop these nodules from being sexually active or having poor personal hygiene, although one must keep their body clean to prevent other conditions.

When do pearly penile papules develop?

Various studies have also shown that PPP nodules often appear during puberty. Besides the 2009 research mentioned above, a study published in 2017 discovered that the average age for males with PPP was 21 years old. It also said the condition was most common in boys undergoing puberty, or those aged around 12 to 16, and young men.


Various health benefits are linked to male circumcision. According to CDC, three clinical trials revealed that circumcised males are less likely to acquire human immunodeficiency virus (HIV) and other sexually transmissible diseases.

Removing the penile foreskin may also help reduce the risk of developing penile pearly papules—a benign genital skin condition often mistaken for serious illnesses.