Yahoo Lifestyle Everything you need to know about dermatosis papulosa nigra (DPN)
When it comes to new marks appearing anywhere on your skin, it can feel a bit disconcerting, right? Is it a wart? Is it a freckle? Perhaps, but it could also be dermatosis papulosa nigra (DPN), which is a common skin condition where small, fleshy bumps develop on the surface of your skin. The most common reference is Morgan Freeman's noticeable moles that pepper his face. They're often called ‘Black beauty spots’ because they arise mainly on Black skin and while they are completely different, the condition is also sometimes mistakenly thought of as moles or blackheads because of the similarity of their appearance.
The confusion can lead to frustration but the most important thing to note is that DPN is harmless, and not something to fret about. But that being said, it's always good to seek medical attention for any new marks or growths on your skin. If you have confirmed you have DPN and want to understand what it is and what your options are available, we spoke to four expert dermatologists to clear up any misconceptions and answer the most common questions - from what it is to the ways to get them removed if you so wish.
What is dermatosis papulosa nigra?
“Dermatosis papulosa nigra (DPN) are harmless small, dark bumps that feel soft to firm and range from less than 1mm to several millimetres wide,” explains consultant dermatologist Dr Mary Sommerlad. For some of us, one or two brown or black bumps may appear, whereas others contend with hundreds as a cluster, “DPN can appear anywhere on the body but are particularly noticeable on the cheeks, neck and between and under the breasts,” adds Dr Sommerlad.
Thankfully, DPN is benign and does not require medical intervention. However, these bumps can be incredibly irritating, especially if they are situated in awkward places, such as rubbing against your bra or glasses.
Is DPN dangerous?
While dermatosis papulosa nigra growths are benign and not harmful to our physical health, the presence of these ‘blemishes’ can affect confidence levels. “Many clients express feeling self-conscious about DPN, which can impact their mental health. It can affect self-esteem and how people feel about their appearance,” says skin expert and medical director of Adonia Medical Clinic Dr Ifeoma Ejikeme.
What causes DPN?
While the cause remains unknown, dermatologists agree that the skin tag-like condition is genetic. “Higher rates in those of African descent stem from genetic factors and are linked to how our skin produces melanin,” explains Dr Ejikeme. Whilst the DPN club isn’t exclusively for Black people and can occur on all skin types, these bumps are most commonly seen on people with Black, Asian heritage and darker skin - Fitzpatrick skin type scale IIII to VI - if you want to get technical. And yes ladies, the condition is twice as likely to affect women than men.
If your mum, auntie, granny or grandad have these bumps, it’s highly likely that you’ll inherit them too as the condition often runs through the family line, says consultant dermatologist Dr Derrick Phillips. There’s no way to prevent the skin growth, it is hereditary and many of us are simply predisposed to developing DPN.
Is DPN a sign of ageing skin?
Essentially, yes. Although first signs of DPN can occur as early as your late teens, the condition grows as you do; “DPN is associated with the natural ageing process and becomes more prominent and widespread as you get older. The lesions increase in number and size with age,” explains dermatologist and medical director of EUDELO Dermatology & Skin Wellbeing Dr Stefanie Williams. However, avoid slathering on retinol to tackle this, anti-ageing ingredients do not prevent or reduce the appearance of DPN but Dr Ejikeme recommends using an antioxidant and sunscreen to slow its progression.
Should you remove DPN or not?
So now we know that these bumps aren’t dangerous, if these bumps are bothersome, you’re fed up with trying to conceal them under heavy makeup or you just want to cut them out of your life (literally), don’t you worry, we’ve asked the best in the business for the DL on the most common ways to remove them.
First things first, as each person and skin is different, it is essential to speak with a dermatologist to determine the best course of action for your specific DPN case and realistic outcomes. There are no recommended at-home solutions, so keep your scissors in the drawer to avoid infection and scarring. Also, it’s ideal to do your research and find a practitioner that is experienced working with Black skin.
The good news is that there are several professional, in-clinic options to say goodbye to DPN. However, be mindful that for melanin-rich skin especially, no matter the method of treatment, there is always a risk of the arrival of uninvited guests, such as post-inflammatory hyperpigmentation aka PIH (darkening of the skin) and scarring in place of the DPN.
Curettage
Using a surgical blade, the lesions are scraped off your skin. This technique is often reserved for larger bumps and you’ll be pleased to know that this is performed with local anaesthetic, so pain levels are kept to a minimum. Heal time is usually around one to two weeks, similar to a graze healing.
Laser
Targeted laser energy is used to vaporise each bump says Dr Williams, with minimal scarring, but there is still a risk of PIH. Dr Sommerlad recommends nd: Yag or Erbium Yag lasers - types of non-ablative (minimally invasive) lasers whose wavelengths are safe for Black skin - rather than any other forms. There is mild discomfort, and minimal downtime and your skin may feel a bit sensitive post-treatment, like the other treatments, scabs fall off in the following days.
Cryotherapy
Using liquid nitrogen to freeze DPN clusters, beware that there is an increased risk of post-inflammatory hyperpigmentation, discolouration, and scarring which might not be your go-to option, especially if your area of concern is on your face. Dr Sommerlad stresses that she is not a fan of this treatment for Black skin as the risk of irreversible hypopigmentation (the lightening of the area of skin) is high.
Advanced Electrolysis
Also known as diathermy (high-frequency electric heating), this specialised procedure uses a precise electric probe to cauterise (burn away) the skin growths, says Dr Williams. There is a level of discomfort, the treatment feels like a pinprick and post-procedure, expect some redness and scabbing as the area heals.
Here, content creator Lesley Buckle speaks about her experience of removal.
Scarring after DPN removal
As for scarring, “removal leaves a risk of scarring including textural changes such as a keloid, hypertrophic (thick and raised) or dipped (atrophic) scar,” explains Dr Sommerlad. So deciding if the excision of your clusters outweighs the potential risks is essential and whether the potential scarring could actually be worse than the original DPN bumps.
Now, there is one other downside. As well as the risk of discolouration, hyperpigmentation and scarring, even after successful removal treatments, DPN can reoccur in new places. So take into consideration if removal is the right course of action for you and be prepared that you may need to invest in further treatment in future years.
Removal aftercare rules
If you have said bye to your bumps, we asked Dr Ejikeme for her top aftercare routine to stick to. Keep the area clean and moisturised, and use sunscreen daily to protect it (SPF50 in summer and SPF30 for the rest of the year). Although tempting, don’t pick it and steer clear of using harsh products until it’s fully healed, she says. So keep your actives, retinoids, and physical and chemical exfoliants to the side for the moment.
Needless to say, if you have a new spot or patch of skin that has changed shape, colour or size, or you’re just concerned about it, please consult your doctor to quash any fears.
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