All educational content on this website is medically reviewed and overseen by Dr Joshua Berkowitz (MB ChB, FRCOG), a UK GMC-registered physician with over 18 years of experience helping men with Pearly Penile Papules and related concerns.
Cold Plasma for PPP & Fordyce Spots: What Does the Evidence Show?
Cold plasma is increasingly discussed in aesthetic medicine as a way to treat unwanted skin lesions. But can it safely remove Pearly Penile Papules (PPP) and Fordyce spots? We examine the technology, clinical evidence, potential risks and what men should understand before considering treatment.
Primary Information Category: Professional Removal Methods – Emerging Plasma Treatments. This page explains how cold plasma and plasma-based devices work, whether they can remove PPP and Fordyce spots, what medical research demonstrates, and the potential benefits and risks.
Quick Answer:
Cold plasma and plasma-based devices are different technologies. Although plasma exeresis has been investigated for certain benign skin lesions, there is currently insufficient published clinical evidence to establish its safety and effectiveness specifically for removing Pearly Penile Papules (PPP) or Fordyce spots. Research involving cold atmospheric plasma largely concerns wound healing, inflammation and skin conditions rather than the selective removal of these genital lesions. Men considering treatment should establish exactly which technology is being offered and whether the practitioner has relevant experience treating genital skin.
Quick Clinical Information & Reassurance from Dr Josh:
“PPP and Fordyce spots are different benign skin conditions, and neither needs removing for medical reasons. I understand that their appearance can nevertheless affect confidence and intimacy. Before considering any treatment, it is important to understand precisely how the technology works and what evidence supports its use on genital skin.”
What does the evidence show about cold plasma for PPP and Fordyce spots?
Cold plasma is an emerging technology in dermatology and aesthetic medicine.
It is sometimes promoted as a treatment for unwanted skin growths, pigmentation, wrinkles and other cosmetic concerns. Some practitioners also advertise plasma-based treatments for Pearly Penile Papules (PPP) and Fordyce spots.
However, there is an important distinction between a technology being used in aesthetic medicine and having sufficient clinical evidence to establish that it is safe and effective for a particular condition.
At present, there is insufficient published clinical evidence to establish cold plasma or plasma exeresis as an effective, established treatment for either PPP or Fordyce spots.
To understand why, it is necessary to look at what plasma treatment actually involves.
What is cold plasma treatment?
Plasma is sometimes described as the fourth state of matter, alongside solids, liquids and gases. It is produced when energy is applied to a gas, causing some of its particles to become electrically charged.
In medicine, different forms of plasma technology are being investigated for their potential effects on living tissue.
One important area is cold atmospheric plasma (CAP). This technology produces a partially ionised gas at or near room temperature, containing reactive oxygen and nitrogen species, charged particles and other active components.
Source: Cold atmospheric plasma (CAP): a revolutionary approach in dermatology and skincare
Researchers have investigated CAP for several potential applications, including:
- Supporting wound healing.
- Reducing microbial contamination.
- Influencing inflammatory processes.
- Modifying skin barrier function.
- Supporting tissue repair.
These applications are not the same as physically removing an individual skin papule.
Source: Plasma Dermatology: Skin Therapy Using Cold Atmospheric Plasma
Cold atmospheric plasma versus plasma exeresis
This distinction is particularly important when considering treatments advertised for PPP and Fordyce spots.
Cold atmospheric plasma and plasma exeresis are not interchangeable.
Cold atmospheric plasma is generally investigated for its biological effects on tissue, including wound healing, inflammation and microbial activity.
Plasma exeresis, sometimes marketed as plasma pen treatment or plasma energy treatment, uses an electrical discharge between the device and the skin. This produces a localised tissue effect, which can create superficial tissue injury and controlled ablation.
Although both technologies involve plasma, their mechanisms and intended clinical applications differ.
A device marketed as a cold plasma treatment should therefore not automatically be assumed to use the same technology as a plasma exeresis device.
This matters because research demonstrating that cold atmospheric plasma can influence wound healing does not establish that a plasma-based device can selectively remove PPP or Fordyce spots.
Can cold plasma remove Pearly Penile Papules?
PPP are small, benign angiofibromas that typically appear in one or more rows around the corona of the glans penis.
They are not an infection, are not sexually transmitted and do not require medical treatment.
Nevertheless, some men find their appearance distressing and may choose professional removal.
There is published research investigating several methods of PPP removal, including carbon dioxide laser, Er:YAG laser, cryotherapy and electrocoagulation.
A systematic review published in 2025 examined 17 publications involving 142 patients. It identified several treatment approaches, with ablative laser procedures being the most frequently reported.
Source: Pearly Penile Papules: A Systematic Review of Treatment Modalities
However, plasma treatment was not identified as an established PPP removal method in that review.
This does not prove that plasma-based technology cannot affect PPP tissue. It means that there is not currently sufficient published clinical evidence to establish its effectiveness, appropriate treatment settings, recurrence rates or safety profile specifically for PPP.
The distinction is important because the skin around the glans is a sensitive anatomical area. Removing individual papules requires careful control of the depth and extent of tissue treatment.
Potential complications of any destructive treatment include:
- Scarring or textural changes.
- Changes in pigmentation.
- Uneven removal or residual papules.
- Delayed healing.
- Infection.
- Persistent sensitivity or discomfort.
These are potential risks of tissue-destructive procedures, not established complication rates for plasma treatment of PPP.
Can cold plasma remove Fordyce spots?
Fordyce spots are visible sebaceous glands that commonly appear as small yellowish or white spots on the penis or other areas of the body.
Unlike PPP, which are angiofibromas, Fordyce spots are associated with sebaceous glands.
They are also harmless and do not require treatment.
Some professional removal methods have been investigated or used for Fordyce spots, including electrosurgery and carbon dioxide laser treatment.
However, the clinical evidence specifically supporting plasma-based removal of Fordyce spots is currently insufficient.
It is also important to consider that Fordyce spots can be numerous and may extend across a relatively broad area. A technique that produces a satisfactory cosmetic result on an isolated skin lesion cannot automatically be assumed to produce an equally satisfactory result when treating numerous visible glands.
The depth of treatment, preservation of surrounding tissue, healing response and potential for scarring or pigment changes all matter.
What does the wider medical research tell us?
There is legitimate scientific research into plasma technologies.
For example, a 2024 review published in the European Journal of Medical Research, titled Cold atmospheric plasma (CAP): a revolutionary approach in dermatology and skincare, discusses the potential applications of CAP in dermatology.
The research considers wound healing, inflammatory skin conditions, microbial control and other dermatological applications.
However, it does not establish CAP as a clinically validated method for removing PPP or Fordyce spots.
There is also research into plasma exeresis for benign skin lesions.
A 2023 randomised controlled trial compared plasma exeresis with cryotherapy for seborrhoeic keratoses. The study found that plasma exeresis achieved greater lesion clearance at the six-week assessment, although the research involved a different type of skin lesion and does not establish effectiveness on genital skin.
This is a useful distinction: research into plasma-based lesion removal exists, but evidence from one type of lesion cannot simply be transferred to another.
Is cold plasma better than hyfrecation, laser or cryotherapy?
There is currently no adequate head-to-head clinical research comparing plasma-based treatment with hyfrecation, laser or cryotherapy specifically for PPP and Fordyce spots.
Consequently, it would be premature to describe plasma as safer, more effective, less painful or quicker to heal than established removal methods.
The relevant considerations include:
- How precisely the treatment targets the unwanted tissue.
- How much surrounding healthy tissue is affected.
- The practitioner’s understanding of genital anatomy.
- The depth and extent of tissue injury.
- The likelihood of complete removal.
- The potential for scarring and pigmentation changes.
- The expected recovery period.
The technology’s name alone does not establish its suitability.
What should men understand before considering plasma treatment?
Before agreeing to treatment, men should ask the practitioner:
- Is the device using cold atmospheric plasma, plasma exeresis or another form of plasma energy?
- What is the exact make and model of the device?
- Is there published clinical research involving PPP or Fordyce spots specifically?
- Has the practitioner treated these particular genital conditions using this device?
- What are the risks of scarring, pigmentation changes and uneven removal?
- What recovery period should be expected?
- What happens if the result is incomplete or complications occur?
A practitioner should be able to explain the technology, its limitations and the evidence supporting its use without relying solely on manufacturer information or before-and-after photographs.
The bottom line: Plasma technology is an interesting area of medical development, and some plasma-based devices have demonstrated applications in treating other skin lesions. However, there is not yet sufficient published clinical evidence to recommend cold plasma or plasma exeresis as an established removal method for PPP or Fordyce spots. Men should understand the distinction between promising technology and demonstrated clinical outcomes before making a treatment decision.
Reassurance
Having PPP or Fordyce spots does not mean that anything is medically wrong. Both are benign findings, and neither needs removing to protect your health. However, feeling uncomfortable about their appearance is also valid. If you are considering removal, you deserve clear information about the available methods, their evidence and their potential risks. An emerging technology should never be presented as proven simply because it is being commercially offered.
Knowledge gained from 18 years of clinically helping Men with Penile Papules
Dr Josh’s Direct Answer for Evidence on Cold Plasma technology for PPP & Fordyce Spots
I want men to feel informed, not pressured. You do not need to remove PPP, but you should feel confident about any treatment you choose.
“After 18 years treating men with PPP, I believe the important question is not whether a device is new, but whether it can deliver predictable results while protecting healthy genital skin. Plasma treatment needs condition-specific clinical evidence before its suitability can be established.”
