Bumps on the Penis: How to Identify White Spots and Lumps

Pearly penile papules

Somewhere between 14% and 48% of men have them¹. Uncircumcised men far more often. They usually turn up in adolescence or your twenties, mostly before 40, then settle and fade a little as you age. You did not catch them. You cannot pass them on. Nobody inherits them, and hygiene has nothing to do with it.

Harmless is not the same as easy to live with, though. The appearance alone causes real anxiety for a lot of men, mostly because so few people have heard of the condition. Men worry that a partner will read the bumps as a sexually transmitted infection, or simply find them unattractive, and that fear does more damage than the papules ever do.

Nothing says you have to remove them. If you want to, a dermatologist will use a CO2 laser, a hyfrecator, cryosurgery or radiosurgery. All are routine and complications are uncommon. Expect $800 to $3,000, and no insurer will cover a penny of it. A PPP kit does the same job at home for a fraction of that. Every PPP removal method compared →

Tyson glands

Fordyce spots

Tiny white or pale-yellow dots, scattered rather than lined up. They tend to cover the shaft or the scrotum rather than clustering in one spot. These are sebaceous glands without hair follicles, sitting close enough to the surface to show through. Do not confuse them with ingrown hairs. Around 95% of adults have them somewhere on the body, women included. Check the inside of your lip and you will probably find the same thing. They get mistaken for pearly penile papules and for molluscum contagiosum more than anything else. If a dermatologist removes them it is usually with a carbon dioxide or pulsed dye laser, and it is done for appearance rather than health. Worth seeing someone if they change in appearance or start causing other symptoms.

Cysts

One or two firm lumps under the skin, never a pattern. They match the skin around them in colour and texture. They do not hurt. Check one next month and it will be the same size.

Four kinds turn up here. An epidermoid cyst is built from skin cells that were never shed. A sebaceous cyst is a blocked oil gland. Either can go red and inflamed. Congenital cysts, sometimes called median raphe cysts, are harmless in themselves but occasionally interfere with urinating. The fourth kind, epidermal inclusion cysts, can follow circumcision. You feel them moving under the skin. Harmless, but unsettling, because they slowly grow.

A urine test, blood work or a biopsy will rule out an infection or anything worse. From there it is usually antibiotics, or a small procedure to drain or remove the cyst. Keeping the area clean and going easier during sex stops them worsening.

Lymphocoele

A hard swelling that turns up on the shaft after sex or masturbation. A lymph vessel has been squashed and the fluid has nowhere to go. It can feel like a small marble under the skin. Alarming to find, and almost always gone within a few days.

Telling benign from serious

Most men find a lump down there at some point. The large majority are nothing. They come in every size and firmness, some fleshy, some hard like a plaque, some closer to a pimple, and they show up on the foreskin, the glans, the rim, the shaft, or under the skin entirely. Usually painless. Occasionally itchy or aching.

A doctor is looking for a different pattern. Something that keeps growing. Something that does not clear after treatment. And a specific set of symptoms alongside it: painful urination, swelling, bleeding, or swollen lymph nodes. One test you can do yourself is whether the lump moves. A benign lump slides under the skin. One that feels fixed in place needs looking at, because that is what separates an ordinary lump from penile cancer or a sarcoma.

If yours look different

Papules vary in size and number from one man to the next, but on any given person they all look much the same as each other. By early adulthood they have settled and will not change much again. If yours look different from one another, or have changed recently, get them confirmed by a doctor rather than assuming.

Genital warts

Their medical name is condylomata acuminata. HPV causes them, mainly types 6 and 11. Look at the arrangement. Warts turn up wherever they like, in uneven clumps, and they get bigger. Pearly penile papules do none of that. Run a finger over a wart and it feels rough, a bit like a cauliflower floret. Papules feel smooth. Warts can also appear on the scrotum, thighs, anus and around the mouth, and plenty of them are too small to see at all. Some men get itching, discomfort or bleeding with them.

Those two types account for roughly 90% of genital warts. Both are low risk and rarely lead to cancer. The ones to worry about on that front are types 16 and 18, which is the reason HPV vaccination exists.

Treatment is either something you apply or something a doctor does. Topical options include imiquimod, podophyllin, and trichloroacetic acid, which coagulates the protein inside infected cells. On the procedure side: liquid nitrogen to freeze them off, carbon dioxide laser to burn them out, or straightforward surgical removal. Warts are contagious, so waiting them out is not really an option.

If this is what is worrying you, one number helps. Only about 1% of men with pearly penile papules also have genital warts. Having one tells you nothing about the other. Full comparison: PPP vs genital warts →

Genital herpes

The herpes simplex virus causes it. Small blisters appear in clusters, burst, and leave tender ulcers behind. Two things set herpes apart. It hurts. And it disappears and returns. Harmless bumps do neither.

A first outbreak takes two to four weeks to clear. Later ones are milder and faster. How it presents varies enormously between people, and some men barely notice it at all, which is a large part of why it spreads so easily.

No cure exists, but antiviral medication genuinely helps. Take it during an outbreak and healing speeds up. Taken daily as suppressive therapy it reduces how often outbreaks happen and lowers the risk of passing the virus to a partner. Worth discussing properly with a doctor rather than managing alone. Full comparison: PPP vs herpes →

Molluscum contagiosum

Smooth, firm domes, white, pink or skin-coloured, each with a small dent in the middle. That dent is what tells you. A virus causes it and skin contact spreads it, sex included. It is not cancerous.

Left alone it clears in six to 12 months², sometimes longer. It also turns up on other parts of the body and affects women and children, so it only counts as a sexually transmitted infection when it appears in the genital area. If waiting does not appeal, a doctor can remove them with a topical medication, cryotherapy, curettage or laser. Go sooner if your immune system is compromised, since a secondary infection may need antivirals or antibiotics. And use a condom while you have it.

Lichen planus

Purple or white ring-shaped patches, or flat-topped shiny bumps, usually on the tip. On the shaft and scrotum it can appear as ring-shaped lesions with violet to white edges and a darker centre, formed where several small papules have merged. This is inflammation, not an infection.

It accounts for 7.3% of nonvenereal genital skin conditions in men³. Do not just put up with it. It itches, it burns, and it can interfere with sex. A doctor will normally prescribe a topical corticosteroid, usually clobetasol.

Peyronie's disease

Not a bump exactly, though it feels like one. Scar tissue builds into a hard plaque inside the shaft. You will usually feel it before you see it, running your fingers along the skin when soft.

The problem shows up during an erection. Everything around the plaque stretches. The plaque does not. So the penis bends at that point, or dents inward. It can hurt, and it can make sex difficult. See a doctor, because there are treatments that work.

Penile cancer

Rare, but the reason not to ignore something unusual. It affects the skin of the penis and the foreskin⁴. The thing to watch for is a growth or sore that will not heal. Bleeding. Skin that has changed colour or thickened. Pain, or a discharge that smells bad. Anything still there after a few weeks needs looking at. Treatment is surgery, radiotherapy or chemotherapy, and catching it early changes the outcome enormously.

Are bumps on the penis normal?

Usually, yes. The three commonest causes are anatomy rather than a problem. None is contagious, infectious or inherited. Pearly penile papules alone turn up in 14% to 48% of men.

How do I know if a bump is an STD?

Position and pattern. The harmless ones sit in neat rows or matching pairs and never change. Warts turn up unevenly and grow. Herpes hurts, vanishes, then comes back. Anything painful, itchy, bleeding or spreading is worth a doctor. One caveat: an infection can sit alongside perfectly harmless papules, so symptoms deserve checking even when you are sure what your bumps are.

What are the white bumps on the head of my penis?

In rows around the rim of the head, almost always pearly penile papules. In a matching pair either side of the frenulum underneath, Tyson glands. Scattered on the shaft instead, probably Fordyce spots. None of the three is anything to worry about.

Will they go away on their own?

Pearly penile papules, Tyson glands and Fordyce spots stay put, fading a little with age. Molluscum clears within a year. A lymphocoele goes in days. Warts and herpes need treating.