From your pictures, it appears that you have Fordyce spots and not pearly penile papules.
Pearly Penile Papules quite common, found in up to 50% men. They consist of small, pink, round bumps and are found lining the area just above the corona, the groove between the shaft and head of the penis. Rarely they can be found on the head ( glans) penis and shaft. They can be misdiagnosed as warts or Fordyce spots ( or Tyson's glands, which are the same thing on the head of the penis) by the unwary physician. These are actually angiofibromas, similar to the fibrous papule of the nose ( where they are often mis-diagnosed as a basal cell carcinoma, again by the unwary physician).
What you appear to have are Fordyce spots which are ectopic sebaceous glands. They are also found in the border of the lips and sometimes in the mouth.
Laser, the pulsed dye laser is the most commonly used, and cryotherpy, are the treatment of choice. Of course, since these are both benign conditions, no treatment is really needed.
Insurance and Tricare do not cover either of these procedures since they are regarded as cosmetic.
Pearly penile papules treatment
Pearly penile papules are fairly common and can be treated effectively and safely treated by experienced dermatologist. We have vast expertise treating these at our practive - feel free to come in for a consultation. Some insurance plan may cover the treatment.
Anatoli Freiman, MD, FRCPC
Pearly penile papules are on the glans, not shaft of penis
The lesions you appear to be showing are Fordyce glands, benign and normal structures commonly found on the shaft of the penis and not easy nor satisfactory to treat. This is in contrast to pearly penile papules (PPP) found at the base of the glans (tip of penis) ; these lesions are easily treated by your dermatologist. We regularly treat pearly penile papules with great success, fast healing, and no scarring. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.
Treatment of pearly penile papules with the CO2 Laser
The photos that you have demonstrate Fordyce spots. These are different and more difficult to treat than pearly penile papules. I have treated over 600 patients with PPP and the treatment is painless, and usually requires just one treatment. Fordyce spots can be treated with the Co2 as well, but could leave tiny scars.
Take care, Dr. Groff