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Wart-like structures on the penis
The term “horn tip”, sometimes also “horn tip” (lat. Hirsuties papillaris coronae glandis), refers to wart-like structures that have a whitish, skin-colored or reddish color and can appear from the edge of the glans to the foreskin band of the penis. It is often assumed that these are classic warts or a sexually transmitted disease or that they result from a lack of hygiene. However, this is not correct, because the small papules are just an evolutionary holdover (atavism), similar to strong body hair. Accordingly, they are neither dangerous nor contagious, but can at most be inherited.
Symptoms of horny tips
Horn tips usually show up in the form of small, up to a few millimeter long pimple-like changes in the ring groove on the edge of the glans or the transition between the glans and penis shaft. The outside of the horn tip is often reminiscent of small warts and can either be white, skin-colored or reddish in color. In rare cases they can also appear as small skin-colored or white spots on the glans.
The small raised nodules or skin pieces are typically arranged in rows (“papillae”), with up to three rows from the edge of the glans to the foreskin band. The expression can be very different: in part they appear in the form of fewer, smaller, barely recognizable points, in other cases their number can also be a few hundred.
About 10 to 20% of men are affected by the phenomenon. They usually arise during puberty. Skin changes are less common in circumcised men, although there is still no complete scientific explanation for this phenomenon.
In very rare cases, similar skin changes appear in women, which are referred to as "hirsuties papillaris vulvae". In these cases, the female tips appear in the area of the external female genitalia (vulva) or in the area of the vaginal vestibule, the so-called “vestibulum vaginae”, the gap-shaped space between the small labia. In contrast to genital warts, which appear unstructured, the papillae are arranged more symmetrically here, and in addition they are usually pink in women without whitish spots. In many mammals, tails are a very pronounced phenomenon, since they act as adhesive organelles during sexual intercourse.
Cause of horn tip
The small wart-like papules are not - as is often assumed - a sexually transmitted disease, a malformation or the result of poor hygiene. They are also not a symptom of viral diseases such as genital warts, genital warts or an infection with Human Papilloma Viruses (HPV).
However, these assumptions do not apply, because the skin changes only represent a harmless "atavism". This means a developmental holdover that was previously only known from past generations, such as hair on the back or on the whole body. Accordingly, horn tips can be inherited in principle, but are in no way dangerous or contagious.
Since there is no (contagious) danger from the corners, there is usually no medical need to remove them. They are considered an "anatomical variation" and a so-called "normal finding". The situation is different, however, if the wart-like changes in the skin are ignited by physical stimuli such as pressure, heat or cold, causing swelling, bleeding or sensitivity disorders - because then there is a medical indication for removal.
Removal of the horn tip
Even if they are not a problem from a medical point of view, many men feel disturbed or sexually impaired by the wart-like skin changes, for example because the partner is unsettled or makes derogatory comments. Likewise, the skin changes with a strong expression can simply be perceived as unattractive - accordingly, removal from cosmetic aspects is definitely a sensible option for those suffering from severe suffering.
The intervention is usually done using a laser, alternatively there is the option of "electrocautery", in which alternating current is passed through the body at high frequency in order to remove the horny bits individually and at certain points. Neither treatment method usually causes pain. Minor complaints can only arise during anesthesia with an anesthetic ointment, which makes the affected areas insensitive.
If the tips are very small, experts believe that laser treatment should be avoided - because in such a case the effort usually exceeds the benefits. Possible complications and remaining scars should be considered with such an intervention.
Since there is usually no medical need for removal, the treatment costs must be borne by the patient himself. The cost per laser treatment is around 300 euros, but in some cases it grows again after the treatment, so that a new intervention is necessary.
Due to the typical appearance in the form of rows of raised small nodules or bits of skin, it is hardly possible to confuse them with other phenomena such as the "Fordyce glands" (free sebum glands on the penile skin) or the contagious genital warts. However, since a confusion with so-called "Dellwarzen" on the penis shaft (Molluscum contagiosum) and the skin changes in the sexually transmitted infectious disease syphilis is quite possible, a dermatologist should always be consulted.
Help with problems caused by small horns
Corners can be a big problem for men, because sexual contacts can quickly lead to insecurities or misunderstandings, for example if the small wart-like pieces of skin are mistaken for an STD. A strong expression can become problematic, for example because the person concerned is unsure whether there is perhaps “something serious” behind it or whether difficulties arise with regard to dealing with their own body and sexuality.
Accordingly, a dermatologist should be consulted in case of uncertainties or questions of all kinds. In addition, those affected should keep in mind that this is not a contagious, dangerous disease and an open discussion with the partner often helps to clarify uncertainties and misunderstandings.
On the other hand, self-treatment, for example with conventional wart remedies containing salicylic acid, is not recommended. This can quickly irritate and damage the sensitive genital mucosa and thus lead to inflammation and severe pain. (No)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Social Science Nina Reese, Barbara Schindewolf-Lensch
- Professional Association of Pediatricians e. V .: The male genital (accessed: July 31, 2019), kinderaerzte-im-netz.de
- Prof. Dr. med. Peter Altmeyer: Hirsuties papillaris penis D29.0 (access: July 31, 2019), enzyklopaedie-dermatologie.de
- Gasser, Thomas: Basic knowledge of urology, Springer, 6th edition, 2015
- Aldahan, Adam S. / Brah, Tara K. / Nouri, Keyvan: Diagnosis and Management of Pearly Penile Papules, American Journal of Men's Health, 2016, journals.sagepub.com
- Bylaite, Matilda / Ruzicka, Thomas: Pearly Penile Papules, The New England Journal of Medicine, 2007, nejm.org
- Sapra, Priya / Sapra, Sheetal / Singh, Amanda: Pearly Penile Papules Effective Therapy With Pulsed Dye Laser, JAMA Dermatology, 2013, jamanetwork.com
ICD codes for this disease: D29ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.