Pearly Penile Papules (PPP) and the NHS
Pearly Penile Papules (PPP) are widely recognised by the NHS as a harmless anatomical variation that ‘does not usually’ require medical treatment.
As a result, routine removal of PPP is not ‘normally’ funded by the NHS.
However, in exceptional circumstances, NHS treatment may be possible through a formal process known as an Individual Funding Request (IFR).
This page explains the NHS position clearly, how IFRs work, and what options are available if removal is being considered.
What Are Pearly Penile Papules? (NHS Position)
According to NHS guidance, Pearly Penile Papules are:
- A normal anatomical variant
- Small, smooth, dome-shaped papules
- Typically found around the rim of the glans
- Not sexually transmitted
- Not infectious
- Not linked to cancer or disease
For most patients, the NHS advises reassurance only.
Does the NHS Treat Pearly Penile Papules?
Routine treatment
In the vast majority of cases, PPP removal is not routinely offered by the NHS, because:
- PPP are medically harmless
- They are classed as a cosmetic condition
- There is no physical health risk
GPs and NHS sexual health clinics will usually confirm the diagnosis and provide reassurance.
Can PPP Ever Be Treated on the NHS?
Yes — in exceptional circumstances via an Individual Funding Request (IFR)
NHS England guidance allows for treatment to be funded on a case-by-case basis where a clinician believes a patient’s circumstances are clinically exceptional.
This is done through an Individual Funding Request (IFR).
What Is an Individual Funding Request (IFR)?
In NHS England’s own words:
“Individual funding requests (or IFRs) are made to NHS England by clinicians when they believe that a patient’s clinical circumstances are exceptional and because of this, they would benefit from a treatment that isn’t usually available on the NHS.”
[Emphasis added]
Important points to understand:
- An IFR must be submitted by your NHS doctor, not the patient
- Approval is not automatic
- Each case is assessed individually
- Evidence of exceptionality is required
When Might an IFR Be Considered for PPP?
An NHS clinician may consider an IFR where PPP are associated with significant psychological or functional impact, such as:
- Severe or persistent social anxiety
- Significant sexual anxiety or avoidance
- Psychological distress that is greater than would normally be expected for someone with the same condition
- Where treating the physical condition is believed to directly reduce or resolve the psychological harm
In such cases, a doctor may argue that early treatment of the PPP, even if delivered by an external private clinic, would provide measurable clinical benefit.
Why a Doctor Might Recommend External Treatment
In some situations, an NHS clinician may believe that:
- Treating the underlying physical condition promptly
- Would reduce or eliminate associated anxiety
- And prevent further psychological harm
In this context, permanent removal of PPP could be viewed as a therapeutic intervention, rather than a purely cosmetic one.
Important: You Must Ask Your Doctor About an IFR
An IFR is not automatic and is not initiated by the clinic.
If you believe your PPP are causing significant distress:
- You must raise this with your GP or NHS clinician
- You must ask whether an IFR is appropriate
- The decision to apply rests solely with your doctor
If an IFR Grant Is Not Approved
Patients may be informed that:
- Their PPP are acknowledged as benign
- NHS funding is not approved
- No further NHS treatment is available
Frequently Asked Questions
Private PPP Removal as an Alternative
Private treatment allows:
- No NHS waiting times
- Same-day consultation and treatment
- Local anaesthetic
- Permanent cosmetic removal
- Discreet, one-to-one care
Electrosurgery (Hyfrecator) is commonly used for PPP removal, with CO₂ laser available in selected cases.
Further Information for Patients and Doctors
NHS England provides guidance on Individual Funding Requests for clinicians considering exceptional cases.
If you or your doctor wish to explore this route, they should consult NHS England’s IFR documentation.