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Are These Moles? Understanding Dermatosis Papulosa Nigra

Expert advice on treating unwanted dark marks.

dermatosis papulosa nigra

When I was younger my mother once told me, “You’re going to be freckly just like your aunt.” Fast-forward to now, years later, and her prediction has decidedly come true. I’ve started to notice a few dark, mole-like dots appear on my facesimilar to those of Morgan Freeman, for reference. But since Im trying to be a cautious twentysomething who practices preventative skin care, I refuse to accept the fact that Id have to live with these spots for the rest of my life.

I did some digging to figure out what exactly these types of dark spots are, actively looking up Black people freckles or tiny black moles for answers. What I found is that both my mom and I were wrong—the marks arent freckles at all, but something called Dermatosis Papulosa Nigra, or DPN, a condition common in people of African, Latin American, and Asian descent, wherein hyperpigmented epidermal growths appear on the face and neck beginning in adolescence. But simply putting a name to the condition wasnt enough—I needed to know more. Thats why I spoke with Chicago-based, board-certified dermatologist and founder of Tone Dermatology Dr. Caroline Robinson, MD, FAAD, to learn the ins and outs of DPN and the best ways to treat it. Keep reading to find out for yourself.

What Exactly Is DPN?

While we dont know the direct cause of DPN, Dr. Robinson explains that it is a variation of Seborrheic Keratosis, or SK—a non-cancerous skin growth that can occur in all skin types. Essentially, they are benign skin growths that are black or brown in color and have a scaly texture. “There are growth-factor genes that we know tend to be present more often than in Seborrheic Keratosis, and that makes them a little bit thicker. You can think of them as like a little bit of overgrowth on the top layer of the skin,” says Dr. Robinson.

She explains that DPN usually occurs at an earlier age than SK, but can exhibit similar symptoms when they first appear. “Itching and irritation are the most common symptoms—[more so] if theres a lot of friction in that area, [which can be] painful. Theyre usually prominent on the cheeks and temples [and develop] as we age. Genetics seem to have the biggest influence on the amount of DPN you might experience and where it will appear on your body. In my experience, some patients tend to create more DPN than others. If you look back at maybe Mom, Dad, or Grandma, they have a lot of DPNs as well.” She also explains that because they are benign, there is no amount of growths that can qualify as excessive by scientific standards. They are not dangerous to your overall health, and the choice to remove them is mainly cosmetic.

How to Treat DPN?

Because your likelihood of developing DPN is determined by genetics, as opposed to environmental factors, there sadly aren’t any preventative measures to stop its growth. Luckily, there are various forms of treatments to remove them. Electrodesiccation is one of the more common options, during which a medical professional uses a needle-shaped electrode to deliver an electric current to burn off the growths. While this treatment can be a bit more painful, Dr. Robinson explains that there are options to use “numbing creams, injectable numbing medication, ice, et cetera” beforehand to help make the patient more comfortable. “After treatment you can expect redness and some scabbing, almost as if the DPNs are still there, but once these areas of treatment heal, patients are typically very happy with the results and notice smother skin as soon as one week following treatment.”

Cryotherapy is another common treatment to remove skin growths. By applying liquid nitrogen, the procedure essentially freezes off the growth instead of using heat. For people of color who have DPNs, Dr. Robinson cautions against this procedure due to the risk of developing hypopigmentation—a lightening of the skin. “This procedure, while effective, can damage the pigment-producing cells in that area, causing a white spot.” Dr. Robinson advises her patients to avoid trying at-home treatments as well. “You could get scarring or more irritation that can expose you to infections. It’s just not worth it.” When in doubt, visit your doctor or dermatologist for proper treatment.

As for recovery, Dr. Robinson stresses the importance of moisturizing as well as protecting your skin with sunscreen. Due to (totally normal) scabbing during the healing process, a lack of sun protection can allow damaging UVA/UVB rays to penetrate your skin and cause unwanted hyperpigmentation or dark marks. And because DPNs can reappear and continue to form over time, you may need to receive multiple procedures or a “tune up” every few years to keep your skin free of the growths. Consider it yet another reason for you to visit your dermatologist for a yearly checkup. 

[Editor’s Note: As ever, we are not doctors or medical know-it-alls. And everybody is different, so make sure to check with a doctor about all of your options.] 

Photo: Shot on site at 6 Columbus, a Sixty Hotel; On Jonelle: Dress, Jonathan Simkhai; Sunglasses, Dior; Earrings, Paige Novick; Hair, Angela Soto; Makeup, Andriani

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