Anxious young man with PPP’sSection of letter to GP;…..He has significant pearly penile papules which were noted at APH and although they tried to reassure him about these, he is concerned; particularly as a partner commented on them once and this has left him with a significant amount of self-consciousness regarding these. I have showed him pictures of other pearly penile papules and reassured him that these are absolutely necessary as they secrete oily substances which keep the foreskin healthy. They are also exquisitely tender which should contribute to the pleasure of intercourse. If he is determined to do something he would have to have them removed privately by a plastic surgeon, which I estimate would cost between £800-1,000 and this would really only be skirting the issue.I have tried to explain to A…. that it’s his reaction to this normal variation which needs addressing rather than the normal variation itself. This anxiety might simply be replaced by a different type of worry. There is a very good book I recommend to patients by Dale Carnegie called ‘How to stop worrying and start living’ (ISBN: 978-0-74-930723-3) and would suggest he has a read of it. It contains good techniques on how to avoid intrusive, useless thoughts.

Fordyce spotsWarts