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Have small pinhead sized hard bumps on penile shaft. Should I be concerned?

Jul 2012
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Practicing since : 1993
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Hi. I have a couple of small pinhead sized hard bumps on my penile shaft. They have been there for months and do not hurt or cause discomfort. They are on the back near the foreskin as you see. Do I have any reason for concern? Thank you.
Posted Fri, 12 Oct 2012 in Penis Problems
Answered by Dr. Praveen Rodrigues 11 hours later
Hi there XXXXXXX
I would not say you have cause for concern but yes, they do need to be attended to. On viewing your photograph et al, i am of the opinion these are most likely genital warts. They are caused by a virus called HPV or human papilloma virus. I trust you have been sexually active. This is the most likely form of contact & aquisition of the infection in your case given the area involved. If so, you need to treat both yourself & your partner/partners'/spouse as the case may be. There are different approaches to treatment from the application of topical podophyllotoxin solution to the warts to destroy them to destroying them using cryotherapy (liquid nitrogen) or Electrotherapy (hyfrecator, heat basically) or removal with lasers. These are all office procedures, easily done under local anaesthesia perhaps even an anasethetic cream like EMLA by your local dermatologist. I would advice you to fix an appointment with your nearest dermatologist/venereologist & refrain from sexual contact until the problem is resolved or use protection (condom) in the interim. Please do not attempt to self-treat as it can have disastrous consequences unless under medical supervision (read: chemical burns) & please remember to treat your partner/s' as the case may be to prevent recurrences.
Do hope i have been clear, precise & helped you make an informed deciscion & wish you all the best going forward. As i said, the matter is not serious but does require your intervention at the earliest to set right.
Cheers & God Luck!
Dr Praveen Rodrigues MD
Dermatologist & Venereologist XXXXXXX Hospital, Bangalore, India.
Above answer was peer-reviewed by
Follow-up: Have small pinhead sized hard bumps on penile shaft. Should I be concerned? 15 minutes later
Hi Dr,

I have actually never been sexually active in the intercourse sense. Only occasional oral sex from females that are also very careful and get tested. Are you sure this appears to be HPV? I feel this is unlikely due to my sexual history
Also, I want to make sure you're seeing the two tiny pinhead dots in the front of the photo, not the rough area in the back of the photo. That area is the "line" that comes down the middle of the back of my penis and does appear to be something else without seeing the full thing. I am only referring to the 2 tiny dots in the front.
Answered by Dr. Praveen Rodrigues 2 hours later
Yes, i did notice the line AND the dots & as was hitherto unaware of your sexual history, was attempting to club the two & give you a single all encompassing diagnosis.
Yes, had considered that rough surface could very well have been an 'epidermoid nevus' & been there since birth or adolescence. If not, worth showing to a dermatologist.
Yes the 2 spots could very well be Fox Fordyce's spots or be Molluscum contagiosum lesions (less likely) or milium (again not as likely).
Oral sex does not preclude one from aquiring an STD especially one like HPV or Herpes both of which are more than likely(not suggesting here this is herpes for one minute).
Yes, will have to agree with you in the light of your history of limited sexual experiences, would have to revise my opinion & go with Fox Fordyce's as the first diagnosis.
However, there is a difference between viewing things on a photograph online & in person. I still recommend a look-see with your local dermatologist before treatment.
Either which way, the treatment options remain the same & i would still recomend getting rid of them.
Do hope this lends closure to your query. Glad to note you practice safe sex in a sense & are careful. Do hope these lesions are soon out of your way & wish you continued good health. Cheers!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by
Follow-up: Have small pinhead sized hard bumps on penile shaft. Should I be concerned? 25 minutes later
What relieving news!! Thank you for your revision of diagnosis.

Given my lack of sexual history combined with the "look" in the picture, what would you say the percentage is that it could actually be HPV? I've always heard it's really difficult for someone on the receiving end of oral to contract HPV. Is there truth to that?

I've had them there as long as I can remember. If I stretch the penile skin, I can really see dozens of them. Some just stick out more than others. They've always seemed to more or less just make up the upper part of my penile landscape. PS each bump has a tiny hair coming out of it as if it is a hair follicle. Does that solidify it as anything?
Answered by Dr. Praveen Rodrigues 22 hours later
Yes XXXXXXX .if you put it that way, then very much likely to be an epidermoid nevus & that is difficult to make go away but causes no problems & is not HPV :)
There is no such thing as recieving vs giving end being any more or less all depends if the skin is compromised at either end & if there is an admixture of blood & blood products.
Am happy we have reached a closure on the topic & all is well on the western front ;-) Cheers & do feel free to close the query as else it keeps popping in my inbox as a follow-up. Cheers & Good Luck!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by
Follow-up: Have small pinhead sized hard bumps on penile shaft. Should I be concerned? 1 hour later
Thank you!!! A couple final questions if you do not mind. Can these epidermoid nevus you speak of appear on the foreskin as well? I have noticed I have one there as well. Also, what causes them?

Finally, just for my own safety and education, how common is HPV transmission via oral and how risky is it? I am always about being safe.

Thank you for all your help and encouragement. You are a friend for life.

Answered by Dr. Praveen Rodrigues 42 minutes later
Yes the epidermal/epidermoid nevus may appear on the foreskin but it is rare.
They are a developmental issue much akin to any other 'mole' or 'nevus'.
There are no known specific studies or accurate figures for oral transmission of HPV to the best of my knowledge. Risk i mentioned is directly propotional to the presence of a 'break' in skin/mucous membrane barrier & the presence of admixture of blood products. I can only surmise that using a condom while having oral sex will be added protection but much like shakespeare's alcohol quote: 'increaseth the desire but taketh away from the performance' :)
Your most welcome. Stay safe & enjoy ur life! Cheers!
P.s..if done, please do close the query & give us a healthy rating;-) friend for life is good!
Above answer was peer-reviewed by
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