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Everyone is familiar with pimples, a condition that affects the oil glands of the skin. We are not worried if a pimple occurs on our nose or cheeks, but what if a pimple pops up on the penis or testicle? Is that still normal? What to do in this case?

A pimple is the result of a blockage of the skin's pores, and it can happen anywhere on the body: on the face, back, legs, and even genitals and elsewhere. Pimples are a common and frequent condition that affects the oil glands of the skin: oil glands are found in every hair follicle and when they become clogged or inflamed, they can lead to pimples breakouts. [1] Pimple-like lumps and bumps on the genitals, whether they are singular or multiple, are another story. They somehow tend to cause alarm. Skin problems are common, and skin problems on the genitals are no exception.

Are pimples on the penis and testicles normal?

Yes and no. Some types of so-called pimples and bumps are normal and represent a very common condition, but in some cases, those bumps can be dangerous and demand prompt medical attention. 

People do often get pimples or “septic spots” on their faces and on other parts of the body, such as the back, legs, buttocks, and yes, even pimples on the penis and testicles. They typically occur during the teenage years, but it is also possible that men will experience pimples at some time later in their life. [1]

When a small pimple appears on the penis or testicle, this is usually not a serious matter and no treatment is needed. Statistics claim that eight out of ten men will experience some kind of pimples on penis and/ or testicles at some time in their life.

However, it is important that you do not squeeze the spot, because you may spread infection and also it is advised not to have sex with anyone until a pimple is healed, up to 10 days. [2]

But the fact is that if the affected spot isn’t healing, it is not wise to sit at home miserable, ignoring the situation and hoping that they will just go away. If something that you think is a pimple hasn't gone away within a week or if you notice any new lumps or bumps, or if you have other symptoms like itching and burning, ask a doctor to check it out or go to a genitourinary medicine clinic.

If you've never had sex, those little bumps on your penis or testicles may be pimples, sebaceous cysts, Fordyce spots, ingrown hairs, or pearly penile papules. They are all harmless and normal and are absolutely nothing to worry about. However, if you were sexually active, there is a chance that those pimples and bumps on your penis could be a sign of a sexually transmitted disease — herpes, genital warts, syphilis, or molluscum contagiosum. In this case, you should visit your doctor and get treatment as soon as possible.

There are many types of penis pimples and bumps, but they all have one thing in common: they should not be popped or squeezed. [2]   

Your first line of defense when you notice a pimple on your penis is “do not squeeze it”. Really, do not be tempted to pop that bump. Squeezing your skin will cause additional stress and inflammation and will very probably worsen an infection that is already present on the spot. In the long run, this type of skin trauma may lead to scarring.

So, when you notice a pimple on your penis, you shouldn’t try to pop it and you should keep a penis pimple and the surrounding area clean and dry [2]:

  • Be gentle and avoid scrubbing or forceful cleaning or you could cause additional skin problems such as irritation or even a rash.
  • Use a gentle soap: no harsh cleansers that can cause irritation, no anti-acne cream, no powders. A simple cleaning with a gentle soap is the best thing you can do at this moment.

One thing is for sure though, if a pimple doesn’t go away or if the spots on your penis look like:

  • Warts
  • Blisters
  • Are raised
  • Show signs of being infected
  • Or are accompanied by other symptoms
you should see your doctor or dermatologist for an exam.

Spots on a penis that are normal

Skin in the genital area often resembles chicken skin, It is normal that the skin on testicles looks similar to the skin of a plucked chicken.  

  • Sebaceous cysts: they are swollen, blocked grease glands that look like yellowish pimples. They occur in dozens or more. Usually, they don’t need medical attention, but if they become infected, they can be treated. [3]    
  • Angiokeratoma of Fordyce spots: tiny, white or yellowish spots to bright-red or purple papules or blisters. If your skin is brown or black, they may look more prominent. They are normal. They can be itchy but are otherwise harmless. Fordyce spots are small (1-5mm) spots that can appear on the penis or testicles. They usually affect younger men and appear in crops. They are painless but can be embarrassing because of their appearance. Fordyce spots can also appear elsewhere on the body, in both men and women: many people also have them around their lips. Fordyce spots are sebaceous glands and are just part of the natural structure of many penises. They are not sexually transmitted, they don’t do any harm, so don’t require any medical attention at all. [4]
  • After masturbation or sexual intercourse, hard swelling might appear near the foreskin, in the shaft of the head of the penis. This swelling is called lymphocele and is caused by temporary blockage of the lymphatic channels at the area described. This condition is also normal and goes away on its own without any after-effects. Lymphoceles often occur in relation to surgery in a wide variety of other areas including the mediastinum, axilla, neck, aorta and peripheral vasculature, not just in association with urological pelvic surgery and renal transplantation. [5
  • Pearly penile papules or Hirsutoid papillomas are perfectly normal and often called (and look like) pimples, but they don’t require any medical attention. [6] Pearly penile papules are flesh-coloured papules that are small in size (approximately 1-2 mm) and they look just like pimples but are not pimples. They are very small bumps, the same color as your skin, but with a pearly appearance. They occur around the margin of the penis head, in a ring around the head of the penis just above the shaft, they can be better seen when the foreskin is pulled back. They are normal and they usually develop during the teenage years but may occur up to the age of 40. They are visible in some men, while less noticeable in other men. Around 10% of men are affected by pearly penile papules. Pearly penile papules are harmless, and don’t disappear, but are not the result of an STD or contagious. They do not need medical attention.
  • Virtually all men have quite a few hairs growing around the base of the penis. And often, particularly in people of Middle Eastern background, the hairs extend some distance up the underside of the organ. Human hairs grow out of a tiny 'pit', which is called a 'follicle'. And very frequently, the follicles on the penis may be quite prominent. This is nothing to worry about and no treatment is needed. [7] However, folliculitis is a condition caused when hair follicles become infected, resulting in inflamed pimples. Folliculitis may look like tiny pimples around individual hairs, with skin slightly reddened and raised. Folliculitis is typically an infection that does not require any treatment — as long as you don’t create additional stress to the infected area with squeezing, the body is capable of clearing the infection on its own. If you don’t pick on them, they typically go away on their own without medical care. Folliculitis is not as deep as a boil, but it still is a way for staph bacteria to enter and blow into an infection.
  • Staph is a contagious infection but is not necessarily transmitted by sexual contact, so it is not an STD. Many healthy people normally have staph on their skin, in their noses, or other body areas and most of the time, the germ does not cause an infection or symptoms. While more than one-fourth of people carry the staph bacteria, a genital staph infection is a rare occurrence, but it is possible. The usual cause of infection is not sexual, but tiny cuts caused by razors, also known as razor burns. They are the ones that allow the bacteria to enter the body, which causes a pus-filled boil to form. If you notice pus-filled blisters, skin an area of red, irritated or painful skin or even fever, you should visit your doctor and start a simple treatment with antibiotics as Staph can spread and cause serious health problems. [8]

Spots on a penis that are not normal

  • Ulcers

If an ulcer develops, you must immediately visit your doctor. Ulcers appear as craters on the skin and represent a full-thickness loss of skin (epidermis). Typical of ulcers is a crust, clear liquid (serum) or pus in the crater. Ulcers may occur due to genital herpes, infection, virus or may even be a form of skin cancer.  

  • Plaques

Plaques are raised, flat-topped lesions, greater than 1cm in diameter. Usually, they do not have a serious cause, but some are infectious and others may develop into more serious conditions, such as Erythroplasia of Queyrat, lichen sclerosis and balanitis xerotica obliterans, which may lead to the development of penile cancer.

Erythroplasia of Queyrat appears as a sharply demarcated bright red plaque with a velvety surface. The disease is not infectious but needs prompt medical attention since it represents an early manifestation of penile cancer. Treatment usually involves excision of the affected area. [9]   

Lichen sclerosis looks like white plaques on the glans, foreskin or shaft of the penis. The severe form of lichen sclerosis is balanitis xerotica obliterans, and it occurs on the opening of the foreskin, which becomes white and firm. Both conditions may lead to penile cancer, but rarely. Medical care is necessary. [10]   

  • Papules

Papules are small lumps (less than 1 cm), raised above the skin surface. Most penile papules do not have a serious cause (pearly penile papules for example), but some, such as genital warts are infectious and may lead to more serious conditions. 

Types of papules: 

Molluscum contagiosum is a form of papules, which is very common but must be supervised by a doctor. They are pinkish-white round lumps, each about 1–5 mm in diameter, and are caused by a virus. 

Hair follicles are a normal and are usually found on the underside of the penile shaft. They may be visible or only felt as small lumps in the skin. They are recognized by having a hair arising from them.

Fordyce spots are small (1-5mm) bright red or purple papules that can appear on the penis or testicles. They usually affect younger men and appear in crops. They are painless and not itchy but are embarrassing because of their appearance. Fordyce spots can appear also elsewhere on the body, in both men and women. They don’t require medical attention and should be left alone.      

Genital warts are very common and are caused by a virus: certain strains of HPV, human papillomavirus, can cause genital warts in the groin area. These warts are often first thought to be pimples by many patients. In the case of genital warts seek medical help. 

  • Herpes Simplex

Herpes is caused by a virus and can be transmitted during sex, including oral sex. Genital herpes outbreaks cause cluster-like patches of blisters, rather than actual spots, and sometimes these blisters can be confused for pimples or acne. Herpes can occur on penis head of shaft, testicles, buttocks, and at any other point of sexual contact. The first symptom is usually a reddish or brownish discoloration on the area where the outbreak will take place. This soon breaks down into a number of small blisters, filled with straw-colored fluid. Blisters caused by herpes simplex are usually very painful and cause itching and may last up to 7 days before they break and turn into tiny wounds. The skin usually completely heals within 14 days.

Unfortunately, that doesn't mean you are cured: herpes is a virus that you can’t get rid of. You will always carry antibodies in your blood and you might get future herpes outbreaks. Herpes is a sexually transmitted disease you will have to learn to deal with. If you think that you might have caught herpes, go to a GUM clinic and you will be given treatment with an anti-viral agent. During a herpes outbreak, you must abstain from sex. [11]

  • Syphilis

Syphilis is a very serious sexually transmitted disease. It’s one of the least prevalent STDs — there are “only” 10 million new cases each year, compared to chlamydia with 100 million new cases — but it is very dangerous if it’s not treated in its early stages. Syphilis has been known as "the great imitator" as it may cause symptoms similar to many other diseases, especially in later stages. [12]   

Syphilis is transmitted by bacteria and is very easily treated if caught in its primary stage: after an incubation period of up to 3 months, syphilis announces its arrival when a single or multiple chancre sores form: for some painful for others painless, non-itchy lesion, sore or skin ulceration. A lesion is about the size of a coin and can appear on a penis or in rare cases on any other site of sexual contact, even the upper legs. The sore can be dull red or brown or black, and the color of the sore varies with the color of your skin. In this first stage, syphilis is easily treatable with antibiotics. The sore breaks down into a raw painless ulcer, and after three to six weeks disappears even without treatment. In secondary syphilis, which can occur years later, a diffuse rash occurs and frequently involves the palms of the hands and soles of the feet and sores in the mouth or vagina. In the last stage of syphilis, there are serious neurological and cardiovascular symptoms. [13]

  • Tropical sexually transmitted infections

If you've recently had sex in a tropical country or had sex with someone who's come from a tropical country you could be at risk for tropical venereal infections [14]:

  • Lymphogranuloma venereum (LGV);
  • Chancroid (soft sore);
  • Granuluma inguinale.

All of the tropical sex infections listed above cause a little brownish or pinkish bump on the penis, which looks very similar to the lump that syphilis causes. Another common symptom of tropical sex infections is swollen glands in your groin area. 

If you’re in doubt, it is best to go to a GUM clinic for expert diagnosis and tests.

Spots that are not normal on testicles

  • Genital warts are a sexually transmitted disease that is caused by the human papillomavirus (HPV). Genital warts are soft to the touch and moist. They are usually pink or flesh-coloured bumps. In men, genital warts are less common but might occur on the tip of the penis, and there can be one or many of bumps. [15]
  • Varicoceles, which are caused by the swelling of veins; are more noticeable when standing. Approximately 15% men have this condition and usually occurs on left side.[16
  • Lump(s) in the testicles, which usually aren't visible, but can be felt through the skin. In most cases, these lumps are harmless cysts, but they may develop into testis cancer. Consult your doctor if you find a lump in your testicle.

In conclusion

Men are understandably concerned when they notice spots on the penis. So, what is best to do in this case? 

First of all, do not make the situation worse! For that reason do not try to squeeze anything! Squeezing might cause an additional inflammation, which can spread the bacteria that caused the pimple and lead to spreading pimples and possible scarring. Clean your skin several times daily with pH neutral soap, but do not exaggerate, since this could lead to other problems. If you suffer from swelling, apply an ice pack, which should reduce swelling, redness and pain. 

However, if you feel your condition isn't just pimples, it is highly recommended to see doctor or dermatologist as soon as possible.