Dermatosis papulosa nigra (DPN) is a skin condition that typically appears as small, dark, or skin-colored bumps on the face, neck, and upper torso. Some people only develop a few bumps, while others have many bumps covering large parts of their skin. DPN mostly affects peoples of African and Asian descent and tends to run in families.
Similar growths can happen on lighter skin tones, too, but they’re less visible because of lower pigmentation.
Is Dermatosis Papulosa Nigra Harmful?
DPN papules (bumps) are harmless and don’t cause any ulcerations (breaks in the skin), scaling, or crusting. The bumps are about 1-5 millimeters in diameter and 1-3 millimeters high. They start in adolescence as smooth, freckle-like bumps and gradually become rougher with time. They may also grow in size and number with age.
DPN usually shows up on the face and neck, but you may also notice them on your upper back and chest. About 1 in 4 people with DPN papules on their face will also have them on their body.
DPN lesions do not go away on their own.
What Causes Dermatosis Papulosa Nigra?
DPN shares some similarities with a common noncancerous skin growth (seborrheic keratoses), which may explain why DPN appears to be hereditary. However, the exact causes of DPN remain unclear.
Since the DPN lesions appear mainly on the head, neck, and upper trunk — areas more exposed to sunlight — there may be a possible link between UV exposure and DPN. A study found that people with darker skin who used skin-lightening creams had a large amount of DPN bumps. This is possibly due to reduced UV protection from loss of protective skin pigment.
Who’s most affected by DPN?
You’re more likely to have DPN if:
- You have darker skin. Almost one third of American adults of African descent have DPN. DPN also shows up in people of European, Filipino, Mexican, and Vietnamese backgrounds with highly pigmented skin.
- You were assigned female at birth. Women are twice as likely to have DPN as men.
- You have a family history of DPN. In about 75%-95% of reported cases, people with DPN say it runs in their families.
- You’ve been exposed to the sun a lot. DPN tends to be more common in regions that get more sun.
- You use skin lighteners. Darker skin shields you more from UV rays than lighter skin. So if you use lighteners, you might not be getting enough UV protection.
What Are the Symptoms of DPN?
If you have DPN, you’ll likely have small, black, or brown spots on the upper part of your face, usually sprinkled near your eyes and cheekbones. These areas can show up on other parts of your face or neck (the most common places) or on your back or chest.
DPN spots can range from few to many. They can be tag-like, raised, or lie flat on your skin. The spots can feel uncomfortable or itchy. They won’t progress to ulcers, scales, or crust over, though.
How to Diagnose DPN
DPN can be diagnosed clinically and usually doesn’t require any tests. However, if there are doubts, a dermoscopy may be used. A dermoscopy is a noninvasive and inexpensive tool used to differentiate DPN from similar skin lesions.
DPN mostly appears as ridges in a cerebriform (brain-like) pattern. If the growth is believed to be cancerous, a skin biopsy (sample) can be taken and sent for closer examination.
What Is the Treatment for Dermatosis Papulosa Nigra?
DPN doesn’t usually require treatment; but you may want bumps removed if they become itchy or you don’t like their appearance.
“DPN can be removed using procedures like curettage (gentle scraping it off), cryotherapy (freezing with liquid nitrogen), or superficial laser treatments,” says Bruce Brod, MD, MHCI, FAAD. He’s a clinical professor of dermatology and director of contact dermatitis and occupational dermatology, University of Pennsylvania Perelman School of Medicine in Philadelphia.
“However, recurrence is possible, and treatments may carry risks like scarring or pigmentation changes where the skin may heal darker or lighter than the surrounding skin. Over time, patients continue to develop new spots of DPN.”
Treatment typically falls under two broad categories — surgery and laser treatments — with varying degrees of success. The following are all possible treatment options for DPN:
Cryotherapy. One of the most affordable and effective treatment options available. Liquid nitrogen is used to freeze off the bumps.
Electrodesiccation. This involves zapping the bumps with an electric current from a probe.
Curettage. This procedure involves scraping off the bumps with a small surgical instrument.
Nd:YAG laser treatment. This treatment uses laser energy to heat and destroy DPN lesions.
Other treatment options include snipping the bumps off, a carbon-dioxide laser treatment, and potassium titanyl phosphate (KTP) laser therapy. While effective, treatment methods for DPN may leave some scarring. There's also no guarantee that DPN bumps won’t make a comeback.
Treatment for DPN is often out of cosmetic concern. Laser therapy has proven to be effective in reducing the appearance of DPN. It leaves little or no scarring. Talk to your dermatologist to determine the best treatment option for your skin.
Risks and Considerations of DPN Removal
If you’re considering getting your DPN spots removed, it’s helpful to think about what you want the treatment to do for you. For example, while treatment can make the spots less visible, it doesn’t always remove them completely.
Also, depending on the treatment you get, it’s possible to have scars or for your skin color to change. Also, weigh the potential results against the cost, as most insurance plans don’t cover DPN treatment. A dermatologist can give you solid answers.
You might wonder if there are treatments you can do yourself. However, “There are no widely recommended at-home treatments for DPN due to the risk of scarring or pigmentation issues, especially in darker skin,” Brod says. “It's best to consult a dermatologist for safe and effective options.”
How to Prevent DPN
There isn’t a way to prevent spots from happening, especially because they might have a genetic cause. Also, if you get treatment for spots, it doesn’t keep new ones from appearing.
Good skin habits always help, though. “While prevention isn’t guaranteed, avoiding skin trauma and maintaining good skin care may help reduce irritation that could worsen lesions,” says Brod.
When to See a Dermatologist
DPN doesn’t need medical treatment. If you’re uncomfortable with DPN spots, visit a dermatologist to go over options to remove or minimize them.
Living With DPN
A study into the quality of life (QoL) of people with DPN found most participants were comfortable in social settings. However, the study also found DPN affects QoL moderately, showing the potential of DPN to trigger concerns about appearance and social comfort.
Many people in the study were concerned about DPN treatments and spot removal.
As DPN is a harmless condition, it’s a personal choice about whether to get treatment for it or not.
Takeaways
DPN most often shows up on the face and neck and can affect all skin types. It’s more common and noticeable in people with darker skin especially those of African and Asian descent. Genetics play a part, too.
Lighter skin tones may develop similar growths, but they’re less visible because of lower pigmentation.
Though DPN is a harmless condition, some people opt to get the spots removed or have treatments to minimize them. Surgery and laser treatments are the most common approaches.
FAQs About Dermatosis Papulosa Nigra
How do you get rid of dermatosis papulosa nigra?
There are numerous treatments to temporarily remove or minimize the appearance of DPN.
Can DPN be removed permanently?
No, DPN spots can always return over time. Taking good care of your skin and protecting it from harmful UV rays always helps, though.
What age does DPN start?
It usually starts in adolescence and grows more in number and spot size as you get older.
Is DPN cancerous?
No, DPN isn’t cancerous. It’s considered a benign condition — meaning it’s harmless.
