Understanding Penile Seborrheic Keratosis

February 9, 2024

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Seborrheic keratosis occurring on the penis, also referred to as penile seborrheic keratosis, is a relatively rare skin condition that can cause concern due to its similar appearance to genital warts or other penile lesions. I aim to provide authoritative information on this topic to aid public understanding.

Overview of Seborrheic Keratosis

Seborrheic keratosis is a common noncancerous skin growth that tends to appear as people get older, usually after age 50. The lesions have a waxy, scaly, slightly elevated appearance and a “stuck-on” look. Though the growths are benign, they can sometimes be mistaken for skin cancer or genital warts.

While seborrheic keratoses most often occur on the face, back, chest, or arms, they can occasionally develop in the pubic or genital regions as well. Genital seborrheic keratosis located on or around the genitals is considered rare, estimated to account for just 3–5% of all seborrheic keratosis cases.

What is Penile Seborrheic Keratosis?

Seborrheic keratosis occurring specifically on the penis is even more uncommon than genital lesions. Very few documented cases of penile seborrheic keratosis exist in the medical literature.

Some key characteristics of penile seborrheic keratosis include:

  • Can take the appearance of a warty or scaly growth on penile skin
  • May resemble genital warts caused by HPV
  • Often pedunculated (on a stalk) when occurring on the penis
  • Size can range from a few millimeters to over a centimeter
  • Usually found on the penile shaft, glans (head), or foreskin
  • Peak incidence in middle age and older men
  • Considered benign but may be concerning to patients

Differential diagnosis through biopsy is important to rule out conditions like genital warts, penile cancer, or other penile lesions that could require different treatment.

Causes and Risk Factors

The underlying cause of seborrheic keratoses is not fully understood. They appear to be related to age, skin irritation, and sun exposure rather than any infection.

Research shows human papillomavirus (HPV) does not cause seborrheic keratosis growths, though their appearance can resemble HPV-induced warts. While friction and irritation may trigger lesions in some cases, seborrheic keratoses are considered genetic benign tumors of epidermal origin.

Risk factors for developing penile seborrheic keratosis can include:

  • Older age (>50 years old)
  • Personal or family history of seborrheic keratoses
  • Sun exposure
  • Skin irritation, friction, or trauma
  • Possibly obesity and cardiovascular disease
  • Genetic predisposition

Males who develop seborrheic keratoses in other body areas may also be more prone to getting them on the penis over time.

Signs and Symptoms

Signs of penile seborrheic keratosis are similar to lesions occurring elsewhere:

  • Flat or slightly raised growths
  • Varied size, often several millimeters to 1 cm
  • Warty, scaly, or crusted texture
  • Flesh, tan or brown coloring
  • Occasionally itchy or tender
  • Sometimes have a pedunculated stalk-like base

As seborrheic keratoses progress, they tend to grow slowly larger and more numerous over months or years. The growths are usually painless, but may become irritated by friction from clothing or during sexual activity in the genital area.

Patients may seek medical care due to concerns about cosmetic appearance, discomfort, or ruling out sexually transmitted infection or cancer.

Signs That Distinguish From Genital Warts

Telling penile seborrheic keratoses apart from genital warts clinically can be challenging. However, some characteristics that point to seborrheic keratosis include:

  • Occur in older men, unlike warts
  • Often less defined borders
  • Tend to be more waxy, less fleshy
  • Usually multiple, uniform growths
  • Can have a narrow stalk
  • No cauliflower-like projections

Still, biopsy is key for accurate differential diagnosis between seborrheic keratosis and HPV manifestations like genital warts.

Diagnosis of Penile Seborrheic Keratosis

Due to their rareness and similarity to concerning penile lesions, seborrheic keratoses on the penis should be carefully evaluated. Diagnostic steps may include:

  • Medical history to assess risk factors and symptoms
  • Physical exam noting growth characteristics
  • Biopsy for histological analysis
  • Other testing like a vinegary acetic acid wash to rule out HPV

Features that help distinguish seborrheic keratosis from precancerous or cancerous penile lesions on biopsy include:

  • Presence of basaloid cells
  • Papillomatosis
  • Hyperkeratosis
  • No cellular atypia or malignant characteristics

Treatments for Penile Seborrheic Keratosis

Though penile seborrheic keratoses are harmless, treatment is sometimes preferred for cosmetic reasons or symptom relief. Various options may include:


Freezing with liquid nitrogen to destroy abnormal skin cells. May require several applications.


Using a special surgical instrument to scrape lesions off the surface layer of skin.


Burning tissue away with electrical current while numbing the area with local anesthesia.

Laser Therapy

Using precision laser energy to vaporize and eliminate lesions.

Medicated Creams

Topicals like retinoids, fluorouracil, or imiquimod to break down warty skin growths over time.

In most cases, penile seborrheic keratosis does not recur after removal. However, new lesions may continue to gradually develop elsewhere with aging skin.

Expert Tips on Coping With Penile Seborrheic Keratosis

  • Consult your healthcare provider about any new penile lesions or changes for proper diagnosis.
  • Biopsy first before attempting removals at home to ensure what you have is benign.
  • Avoid repeatedly handling or picking at genital growths, which can cause more irritation.
  • Use barrier methods during sex to minimize friction on lesions.
  • Apply moisturizer daily to reduce rough, flaky skin that can snag on clothes or during intimacy.
  • If self-conscious about appearance, discuss discretion and technique with your doctor so any scarring from treatment is minimal.
  • Remain patient and understanding with partners about the condition.

FAQs on Penile Seborrheic Keratosis

What causes penile seborrheic keratosis?

The exact triggers are unknown, but penile seborrheic keratosis develops from noncancerous overgrowth of epithelial skin cells. Factors like aging, genetics, and skin irritation may contribute to lesions developing on the penis and elsewhere over 50 years old. HPV does not appear to play a role.

Are seborrheic keratoses contagious or sexually transmitted?

No, fortunately seborrheic keratoses are not contagious sexually or transmittable between partners. They result from benign skin cell changes. However, their appearance can resemble contagious genital warts, making diagnosis important.

How can I tell a seborrheic keratosis from penile cancer?

There is unfortunately no reliable way to distinguish noncancerous seborrheic keratosis on the penile shaft from potential penile carcinoma based on visible traits alone. Your doctor should perform a biopsy to examine cells microscopically before confirming diagnosis and appropriate treatment.

Will using creams treat penile seborrheic keratoses effectively?

Medicated creams like imiquimod or fluorouracil often help eliminate common warts and some kinds of precancerous penile lesions. However research is limited on their efficacy for seborrheic keratoses specifically in the genital area. Most experts recommend biopsy first, then possible excision or cryotherapy for penile seborrheic keratosis.

Can seborrheic keratoses return after surgical removal from the penis?

Yes, new seborrheic keratosis lesions may gradually develop on the genitals and other areas over time after treatment. Some men are just prone to getting more with age. But recurrent growths should not appear in the exact spot that was excised or destroyed. Follow up with your doctor about any new bumps or changes detected.

Conclusion and Key Takeaways

  • Penile seborrheic keratosis is a rare, benign form of skin lesion that can appear on the penis most often after middle age.
  • Signs involve warty-looking, scaly growths that may cause symptoms like irritation.
  • While not cancerous, penile seborrheic keratoses can resemble concerning conditions like genital warts or penile cancer.
  • Biopsy is advised for accurate diagnosis instead of just visual assessment alone.
  • If treatment is preferred, cryosurgery, curettage, laser removal, or other methods typically eliminate lesions successfully.
  • New seborrheic keratoses may continue developing gradually elsewhere over time.
  • Getting educated, following up promptly with providers about changes detected, and practicing good penile skin care are important for coping with this manageable condition.
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