Hirsuties papillaris penis are skin lesions on the edge of the male glans that resemble wart-like hornicles and may extend over the foreskin ligament. The anomalies have no pathological value, but correspond to a harmless atavism. Treatment is not covered by health insurance because there is no need for therapy from a medical point of view.
What is hirsuties papillaris penis?
In hirsuties papillaris penis or hirsuties papillaris coronae glandis, wart-like skin changes form at the edge of the glans, which can appear white, skin-colored or reddish. In the German-speaking world, the tiny warts are sometimes also referred to as Hornzipfeln or Hornzipfelchen. The warts can extend from the edge of the glans to the foreskin band of the penis. The horn-like tiplets are also called papillae coronae glandis, papillomata coronae glandis or penile papillomas. Papillomas are benign tumors. In a narrower sense, however, hirsuties papillaris penis is not a phenomenon with disease value. Thus, there is basically no question of a tumor disease. The horny lobules are relatively common in Germany and occur in about 20 percent of all pubescent boys. Worldwide, about 40 percent of all males are affected. Analogously, there is a similar wart disease of the female sex, Hirsuties papillaris vulvae, in which the tiny warts form in the vulva area. The female variant is much rarer compared to the male variant. However, hirsuties papillaris vulvae also do not have disease value.
Causes
Hirsuties papillaris penis are often associated with the wildest speculations about possible causes. Some sufferers believe it is a malformation. Other patients assume a sexually transmitted disease. Still others recognize in the horny tips the symptom of another disease or attribute the condition to a lack of hygiene. None of these is true. Instead, the phenomenon is a simple atavism, which has no disease value. An atavism is always spoken of when anatomical features of the phylogenetic ancestors are re-formed on an individual of modern times. Since the features do not serve any function in the present stage of male development, the horny lobes have probably regressed in the course of evolution. Hirsuties papillaris penis count in this context similar to the rudiments to the evolutionary evidence and are a normal atavism appearance. However, since they do not affect all males, they are occasionally perceived as deformities or disfigurements.
Symptoms, complaints, and signs
Patients with hirsuties papillaris penis discover skin changes on their genitalia that look like horn-like cusps. The changes are small in size and can vary in color. In addition to white horny cusps, reddish or skin-colored cusps may be present. In most cases, the skin changes are concentrated around the edge of the glans. Only in exceptional cases is a larger field affected. For example, some patients discover horny lobules with an extension from the glans edge to over the foreskin ligament. The wart-like formations do not cause any accompanying symptoms. They neither hurt nor cause itching. Since it is not a symptom of a superordinate disease and likewise not a disease in its own right, those affected remain largely asymptomatic. However, most patients are ashamed of the abnormal change, especially during puberty, and should consider treatment for this reason.
Diagnosis and course of the disease
Because of its typical appearance, the diagnosis of hirsuties papillaris penis turns out to be relatively simple. There is little chance of confusion with the so-called Fordyce’s glands in the form of free sebaceous glands, confusion with sebaceous cysts, or misdiagnosis as contagious genital warts. The diagnosis from the atavism is made by the dermatologist. Differentially, the phenomenon should be distinguished from molluscum contagiosum, which occur mainly in isolated forms on the shaft of the penis and bear a centrally located dent. Differentially relevant may also be a differentiation from lichen ruber, bowenoid papules or condylomata lata of syphilis.The prognosis for patients with hirsuties papillaris penis is excellent.
Complications
Hirsuties papillaris penis causes abnormalities of the male sex organ. Usually, these abnormalities do not lead to any particular discomfort or complications and for this reason likewise do not need to be treated. However, they can lead to aesthetic discomfort and thus cause a reduced self-esteem or inferiority complexes in men. As a rule, the quality of life and life expectancy are not reduced or limited by hirsuties papillaris penis. Affected persons suffer from small spots on the glans penis. However, these small spots do not lead to pain or itching and therefore do not represent a particular restriction in everyday life. Especially in children and adolescents, however, these complaints can lead to feelings of shame and insecurity, so that treatment is often necessary. Without treatment, the patient may experience limited sexual development. Treatment completely removes the discomfort, so there are no further complications or changes to the skin. However, the formation of scars may occur. Usually, before the treatment, a doctor explains the possible risks of the procedure.
When should you go to the doctor?
With a hirsuties papillaris penis, a visit to the doctor is not mandatory. The skin changes on the penis have no disease value and can do without medical treatment. Normally, no other health abnormalities develop. A shortened life expectancy is also not to be expected. A visit to the doctor is only necessary if the visual blemish of the horn-like formations becomes a psychological problem for the person affected. If there are stressful emotions such as feelings of shame or disgust, it is advisable to see a doctor. If there are partnership problems, withdrawal behavior or avoidance of interpersonal contacts, there is a need for action. If the skin changes lead to a change in behavior or personality, a doctor should be consulted. In case of abnormalities such as depressive phases, melancholy or an aggressive appearance, a doctor should be consulted. If sexual dysfunction occurs due to hirsuties papillaris penis, a visit to the doctor is recommended. If the skin lesions are scratched open or damaged wantonly, health problems may result. If inadequate wound care is provided, pathogens can enter the organism and lead to further diseases. A check-up visit to a doctor is necessary, as in severe cases there is a risk of blood poisoning. A visit to the doctor should therefore be made if pain sets in, there is redness of the skin, itching or the development of pus.
Treatment and therapy
From a medical point of view, there is no need to treat hirsuties papillaris penis. Removal of the wart-like formations does not need to take place, nor does drug treatment. However, if the patient is uncomfortable with the horny lobules, treatment should still be considered to ensure carefree sexual development. Since there is no medical necessity for treatment, the cost of treatment for hirsuties papillaris penis is not covered by health insurance. In most cases, patients therefore decide against removal as soon as they are made aware of the sometimes high prevalence and harmlessness of the skin lesions. In individual cases, patients decide to have the corneas removed for purely cosmetic reasons. The removal is usually performed in the course of laser treatment or cryotherapy. The patient is under local anesthesia during the removal. The treatment is performed by the dermatologist or plastic surgeon. The removal is preceded by an explanation, which points out the risk of disturbing scarring. Once this education is done, the number of people willing to undergo treatment is reduced again by at least half.
Outlook and prognosis
Hirsuties papillaris penis is a phenomenon without disease value. In 30 to 40 percent of all men, the so-called horny lobes can form on the glans during puberty. This is an ancient hereditary condition that can occur in one in three men. Extremely rarely, women also suffer from horny spots on the vagina.Since hirsuties papillaris penis is not a disease, it does not need to be treated. However, the horny papules can lead to psychological stress. This is especially true when large papules appear. These are perceived by many men as unaesthetic and abnormal. In some cases, this gives rise to the concern that it is a serious disease that is contagious. More often, however, horny tips cause a feeling of shame in front of the partner. The suspicion arises that the partner might find the papules off-putting and contagious. This distress may lead to erectile dysfunction in the male. In this sense, Hirsuties papillaris penis then does have a disease value. In some cases, however, purely psychological care no longer helps. In such cases, cosmetic surgery is often the first remedy. In most cases, the surgical removal of the horny tip goes well. However, in a few cases scars remain, which are also unaesthetic and can lead to functional limitations of the penis. Moreover, after surgery, recurrence of the papules is also possible.
Prevention
Hirsuties papillaris penis cannot be prevented, as it is a harmless atavism.
Aftercare
There are usually no special measures of direct aftercare available to the affected person in the case of hirsuties papillaris penis. The disease itself does not necessarily need to be treated, as it does not threaten the life of the affected person and is usually only an aesthetic complaint. Therefore, in the case of Hirsuties papillaris penis, no direct treatment is necessary unless it is absolutely desired by the affected person. The disease itself can be alleviated by a simple surgical intervention. The procedure usually proceeds without complications. Afterwards, the affected person should protect and care for the area around the penis particularly well. It is often necessary to take antibiotics to prevent inflammation. The affected person should take these regularly and also in the correct dosage. Furthermore, some controls by a doctor are also useful after the procedure. If the Hirsuties papillaris penis is not treated, it can possibly lead to psychological upsets. In many cases, intensive discussions with one’s partner or with the family help in this case, so that depression or other psychological upsets do not occur.
This is what you can do yourself
Usually, no special therapy or treatment is needed for hirsuties papillaris penis. Since in most cases the affected person also does not suffer from any particular discomfort or pain, there is also no need to take self-help measures to treat this condition. However, many sufferers may feel ashamed of the condition. In any case, the affected person should talk about these feelings of shame with his or her own partner in order to avoid further psychological complaints or depression. Contact with other sufferers or talking to a doctor can also considerably reduce and limit these feelings of shame. Above all, the partner must offer the patient support and strengthen self-esteem. Although no treatment is necessary, hirsuties papillaris penis can be removed by surgical intervention. In this case, no particular complications occur and there is usually a positive course of the disease. The formation of scars can be prevented by the affected person taking care of the skin after the surgical procedure and keeping it moist. There are no special self-help options available to the patient. However, the disease does not limit life expectancy.
