Treatment of PPPs and Fordyce Spots

Mr Gault uses several types of laser to remove Pearly Penile Papules.  Each laser has a long and safe history as a skin laser and is very effective in ablating both superficial and deeper lesions.  Treatment requires anaesthesia to avoid pain - a general anaesthetic is most popular, but many patients choose local anaesthesia. Below the age of 16, parental or guardian consent is required.  

The local anaesthetic cream and, later, injections, cause the tissues to swell and some very small lesions can be masked by this.  The number of papules involved is often quite considerable, and although it cannot be guaranteed, every effort is made to remove each one in one surgical sitting, leaving the area smooth. Complete clearance of all lesions is more likely under general anaesthesia. The recovery period is 7-10 days. There should be no alteration of sensitivity, scarring or patches left afterwards. 

Fordyce spots are sebaceous patches which may be situated on the shaft of the penis or sometimes on the lips or face. They can be treated with a variety of techniques but are more difficult than PPP's to remove reliably. The preferred treatments use the CO² laser only, or alternatively, the laser is used to remove the outer skin layer followed by manual, surgical removal of the sebaceous material within the spots. The best technique varies between individuals and even between lesions. It is possible to undergo a trial of both techniques at a similar cost to PPP treatment.

 

Treatment

You would need to see Mr Gault for consultation first so that you are able to understand what the procedure involves and give informed consent. 

Please use the appointments page on the website to book.  The choice of location for consultation does not limit your choice of hospital for surgery. A see and treat is not normally possible, not least because it is generally recommended that you allow a “cooling off” period of at least a day to allow to time to think about all the information and options.

A layer of ointment is applied post treatment. For PPP's If you are uncircumcised, then the foreskin acts as a protective dressing.  If you are circumcised, then a dressing may be applied. The recovery period is 7-10 days.  The general complications of any surgery (bleeding, infection and scarring, hyperpigmentation or hypo pigmentation) would apply but adverse results are rare.   

 

Typical fees

The typical surgical fee is £1145. If you have a general anaesthetic, then there is an additional fee of £325 for the anaesthetist. If you have injectable local anaesthetic, the additional anaesthetic fee is £150. We recommend, instead, that you arrive with EMLA cream applied (we send a prescription for the cream which you purchase at a pharmacy).

 

The hospital’s fee depends on which one you choose, and an out-patient procedure (Walk-in, walk-out WIWO) is cheaper than a day case stay. You would need to stay in hospital as a day case (DC) if you chose to have a general anaesthetic, but it would be unusual to require a night’s stay in hospital. 

For a GA day case at the Wellington South building, you add together the surgical, anaesthetic and hospital fees, as follows: £1145 + £325 + £2380 approximately

For an LA stay as a day case at the Wellington South building, you add together the surgical, anaesthetic and hospital fees, as follows: £1145 + £2380 approximately

For an LA WIWO at the Cadogan Clinic using the CO2 laser, you add together the surgical, anaesthetic and hospital fees, as follows: £1145  + £1012.50 approximately 

For an LA WIWO at the Lister Hospital using the Diolite laser, you add together the surgical, anaesthetic and hospital fees, as follows: £1145 + £480 approximately

Follow up fee: for additional appointments, if necessary £240

We have no sway over hospital fees and any increases they choose to impose periodically.  Hospital fees should be paid direct to the hospital, usually shortly before or on the day of surgery. Payment of surgical and anaesthetic fees is due on booking. 

Hospital fees do not include painkillers to take home, but you would be much better advised to buy these over-the-counter because Paracetamol from the hospital is extremely expensive.