DPN May Be Causing Your New "Moles"—Here's What You Need to Know

These freckle-like bumps are actually pretty common.

woman in green trousers with moles on abdomen

Stocksy

When a new mole appears on your skin, it's normal to get suspicious. Sometimes new skin formations can be signs of an underlying illness. But other times, thankfully, they're benign. Dermatosis papulosa nigra—aka DPN— is one of those non-threatening formations.

Often mistaken for freckles, DPN manifests as raised dark brown bumps on areas including the face, neck, and chest. (A good example of someone with DPN would be Morgan Freeman.) While DPN is completely benign, it's important to get all the facts so you can live with it confidently. Also, should you want to remove it for cosmetic reasons, it's great to know what does and doesn't work—and what experts recommend.

So, we spoke to board-certified dermatologists Michelle Henry, MD, and Cameron Rokhsar, MD, to get answers to all our questions about DPN. From what it is and its prevalence to five popular removal methods (should you wish to go the route), keep reading for what they had to say.

Meet the Expert

  • Michelle Henry, MD, is a board-certified dermatologist and founder of Skin Aesthetics Surgery in New York City.
  • Cameron Rokhsar, MD, is a board-certified dermatologist and founder of the New York Cosmetic, Skin, and Laser Surgery Center.

What Is Dermatosis Papulosis Nigra (DPN)?

"DPN is a common skin condition characterized by the presence of small, benign (non-cancerous) dark brown to black papules (bumps) on the face, particularly on the cheeks and temples," explains Rokhsar, who adds that they typically range from one to five millimeters in diameter. "They have a smooth or slightly rough surface and are often mistaken for moles or freckles," he says.

What Causes DPN?

"The exact cause of DPN is not fully understood, but it is believed to have a genetic predisposition as it tends to run in families," says Henry. In fact, around 50 percent of patients seeking treatment have a family history of the skin condition—a parent or grandparent, for example, might have them. Another commonly speculated cause is sun exposure, and Rokhsar says DPN typically begins to appear in adolescence or early adulthood and becomes more pronounced with age.

As previously mentioned, DPN is common among those of African descent and affects many Black people in the United States. Henry says up to 70 percent of people of African descent will develop DPN at some point. "However, it's worth noting that the presence and severity of DPN can vary among individuals, and not everyone with darker skin will develop these lesions," adds Rokhsar.

DPN also occurs among Asians, Polynesians, and Latin and Native Americans with darker skin tones. While DPN is less common among those with lighter skin, it does occur. "In these cases, the papules may appear lighter in color," says Rokhsar. The condition more commonly manifests in women.

When to See a Doctor

DPN are benign growths; however, if you are not sure whether a lesion is, in fact, dermatosis papulosa nigra, you should check with a dermatologist. They can rule out any serious conditions, including cancerous growths. DPN doesn't usually cause pain or discomfort unless the lesion becomes irritated (by rubbing against or catching on clothing, for example) or inflamed. So if you experience any pain, contact a dermatologist right away.

DPN Removal Methods

Although DPN doesn't require treatment and many medical professionals believe they are best left alone, you can opt to have them removed if you want. (Note: The lesions don't go away on their own). There are safe and effective cosmetic procedures for getting rid of DPN. Just keep in mind that these treatments are cosmetic and, as such, are usually not covered by health insurance.

Curettage (Scraping)

Curettage (scraping) uses an instrument called a curette to scrape away growths. According to Henry, this method is typically reserved for very large or atypical-appearing lesions. Note that this procedure carries a risk of pigmentation problems for darker skin. 

Electrocautery

Two methods use electric currents to destroy and remove DPN, the first of which is electrocautery. With electrocautery (or thermal cautery), an electric current runs through a small probe with a fine needle electrode tip to cauterize (burn or destroy) skin tissue. In electrocautery, the lesion becomes hot, but the current doesn't pass through the patient. "It typically provides immediate results. However, there is a small risk of scarring or hyperpigmentation," says Rokhsar.

Electrodesiccation

Electrodesiccation is the second DPN removal method that uses an electric current. A specific type of electrosurgery. Electrodesiccation dehydrates and destroys superficial tissue. The electrode remains cool, and the electrical current passes through the tissue. Without touching the surrounding skin, the lesions are desiccated using an instrument with an electrical needle-like tip until the lesions turn a grayish color. A topical anesthetic applied before the procedure will make it more comfortable.

Depending on the size of the lesion, electrodesiccation treatments might be followed with curettage, or some raised lesions may need to be snipped with special scissors. At low settings, these are considered safe and effective procedures with minimal to no scarring.

Post-treatment, lesions will be red and swollen (like an insect bite) for about an hour or so. Petroleum jelly will be applied to soothe the skin. The treated skin will scab and fall off within seven to 10 days. Lesions don't grow back, but new ones may develop.

Cryotherapy

DPN can also be treated with cryotherapy (freezing) using liquid nitrogen, but there is a possibility of discoloration and scarring and a risk of post-inflammatory hyperpigmentation (as well as hypopigmentation), which makes it a potentially less appealing option. For this reason, Rokhsar says it's his least preferred method. 

Laser Treatments

Lasers are the most expensive treatment, but Henry says they allow for precision and the ability to treat multiple lesions. With this treatment, small scabs will form but will fall off a few days post-treatment. The Nd:YAG laser has a wavelength (1064nm) that is safe for dark skin. It coagulates melanin in the dark spots and the blood vessel that supply the growths. There is a little pain but minimal side effects, and the skin heals within one week. Skin discoloration is possible, but if it happens, it will fade.

DPN Removal Aftercare

After any treatment, refrain from picking at lesions and avoid sun exposure. Do not use anti-aging products, alpha hydroxy acids, or any other products with abrasive ingredients that can potentially cause irritation, skin sensitivity, or photosensitivity. Apply sunscreen whenever you will be exposed to sunlight. If the face and cheeks have been treated, do not apply makeup, including blush, to the area for three to four days after treatment.

FAQ
  • Are there any natural or at-home treatments for DPN?

    No creams or ointments have been developed to safely treat and remove DPN. 

    And while you may find natural treatments on the internet, it's best to consult a doctor before trying any home remedies. If you don't already see a dermatologist, check around and get referrals from medical professionals that are experienced with darker skin tones and specifically skilled in treating skin conditions.

  • Are there any risks or side effects to DPN removal?

    Depending on the treatment, DPN removal can lead to hyperpigmentation (darkening of the skin), hypopigmentation (lightening of the skin), scarring, or keloid formation.

  • When does DPN typically form?

    DPN most commonly begins to form during the teen years and may increase in number and size as one gets older.

Article Sources
Byrdie takes every opportunity to use high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial guidelines to learn more about how we keep our content accurate, reliable and trustworthy.
  1. Uwakwe LN, Souza B, Subash J, McMichael AJ. Dermatosis Papulosa Nigra: A Quality of Life Survey Study. J Clin Aesthet Dermatol. 2020 Feb;13(2):17-19

  2. Vashi NA, Kundu RV. Facial hyperpigmentation: causes and treatmentBr J Dermatol. 2013;169 Suppl 3:41-56. doi:10.1111/bjd.12536

  3. Tran M, Richer V. Elective treatment of dermatosis papulosa nigra: a review of treatment modalities. Skin Therapy Lett. 2020;25(4):1-5.

  4. Uwakwe LN, Souza B, Subash J, McMichael AJ. Dermatosis papulosa nigra: a quality of life survey studyJ Clin Aesthet Dermatol. 2020;13(2):17-19.

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