Pearly penile papules (PPPs), Fordyce spots and Fox-Fordyce disease are all distinctly different things. PPPs and Fordyce spots are natural ornaments of the penis, while Fox-Fordyce disease is an itchy sweat gland blockage.
Confused yet? Let’s explain.
Fox or Fordyce?
Fordyce spots
Fordyce spots are visible oil glands that don’t contain hair follicles (which most other oil glands do) found in the mouth and genital mucosa, also known as your wet bits. Almost everyone has Fordyce spots, but they are not always visible (then they are simply an oil gland).
Seeing an oil gland within the mucosa – now a Fordyce spot – is considered normal, and the spots are in no way a disease. American dermatologist John Fordyce named Fordyce spots after himself, as is the proud scientific custom.
Fordyce spots are small yellowish or white areas along the mucosa or wet-dry ridge (vermilion border) of the lips, glans or shaft of the penis, or the vulva and vagina. You might have one Fordyce spot visible or many (50-100). It’s much easier to see Fordyce spots when stretching the skin.
While Fordyce spots are normal, they can look similar to other conditions, including sexually transmitted infections. If you’re concerned, get checked, remembering biopsy is seldom required, so no invasive tests – just your doctor’s eyes. Fordyce spots are harmless and do not require treatment. Do not pick at Fordyce spots! They are not a pimple.
If Fordyce spots are causing a cosmetic concern, a CO2 laser or electrosurgery can remove the visible spots.
Fox-Fordyce disease
Fox-Fordyce disease is when sweat is trapped in a hair follicle by a keratin plug. The blocked sweat duct ruptures and leaks, causing intense itching and inflammation. The itching can be severe. American dermatologist George Fox and his pal John Fordyce discovered the condition.
Fox-Fordyce disease is not an infection of Fordyce spots; they share a name because John Fordyce was the doctor who had the honour of naming both things after himself.
Fox-Fordyce disease mainly affects 13-35-year-old women, not men, older women, or children, and is linked with stressed or anxious emotional states, hot temperatures, hormones, sweat components and laser hair removal.
Fox-Fordyce disease presents with small dome-shaped flesh or reddish-coloured bumps around hair follicles in the pubic area, underarms and around the nipples (the only places these special apocrine sweat glands appear on our bodies).
With Fox-Fordyce, almost all the hair follicles in the area will be affected, not just a few, and it’ll occur on both sides of the body. Sweating may slow or stop in the area due to the blockages. Fox-Fordyce treatments include liposuction of the sweat glands or other dermatological treatments.
So what are PPPs, then?
Pearly penile papulessmall harmless skin growths
PPPs are dome-shaped skin-coloured bumps located in a neat row or series of rows around the head of the penis, like a row of pearls (sort of). PPPs are not a disease and have nothing to do with either Fordyce spots or Fox-Fordyce disease.
Between 8-43 per cent of penises will exhibit pearly papules, being more common in those not circumcised. They reduce in visibility with age. PPPs do not cause any symptoms but can cause some emotional distress due to the visible bumps on the head of the penis. Some men aren’t fond of their PPPs and opt to have them removed.
Quick facts on PPPs
- Normal anatomic variant
- You did not cause these
- Easy to diagnose by a trained eye
- Quick and easy to remove using laser
- Fade as you age
- Not contagious
- Not infectious
- Not caused by sexual activity or masturbating
- Not related to hygiene
- Not malignant or pre-malignant
Comparison chart of Fordyce spots, Fox-Fordyce disease and PPPs
| Fordyce spots | Fox-Fordyce disease | PPPs | |
| Symptoms | None | Itch, inflammation | None |
| Colour | Yellowish or white | Flesh or reddish | Flesh |
| Number | 1 or more | 50-200+ | 20-50 |
| Location | Mouth, genitals | Armpits, pubic area, nipples | Head of the penis |
| Shape | Pinhead | Dome | Dome, star |
| Size | 1-3mm | 1-5mm | 1-4mm |
How to get rid of PPPs at our Melbourne clinic
While pearly penile papules do not require medical treatment, however, it can soothe a furrowed brow to have PPPs removed. Dr Michael Rich removes pearly penile papules at ENRICH Clinic in Melbourne using precise laser treatment.
The treatment leaves the penis clear of the PPPs, with a short and usually straightforward recovery. Book a consultation with Dr Rich and walk out without your pearly papules.
Book a consultation with Dr Rich to discuss your concerns.
ENRICH Clinic
*With all surgeries or procedures, there are risks. Consult your physician (GP) before undertaking any surgical or cosmetic procedure. Please read the consent forms carefully and be informed about every aspect of your treatment. Some surgeries have a mandatory seven-day cooling-off period to give patients adequate time to be sure of their surgery choice. Results may also vary from person to person due to many factors, including the individual’s genetics, diet and exercise. Before and after photos are only relevant to the patient in the photo and do not necessarily reflect the results other patients may experience. Ask questions. Our team of dermatologists, doctors and nurses are here to help you with any of your queries. This page is not advice and is intended to be informational only. We endeavour to keep all our information up to date; however, this site is intended as a guide and not a definitive information portal or in any way constitutes medical advice.
