Dermatosis Papulosa Nigra

What is Dermatosis Papulosa Nigra?
Dermatosis papulosa nigra (DPN) is a harmless skin condition that tends to affect people with darker skin. It is often asymptomatic and involves the skin. It consists of small, black or dark brown bumps that usually appear on the face and neck (or upper back or chest). These bumps are usually smooth, round, and flat, and range from 1 to 5 millimeters. The number of bumps can vary from person to person. These bumps are benign or non-cancerous.

Over time, these bumps can become rougher. At times, they develop small flaps called peduncles which look like skin tags.

Who gets it?
The onset of DPN is typically during adolescence. Women are affected more often than men and people who have a family history of similar lesions are prone to get it. The number of lesions typically increases with age. 

It is important to note that around 25% of the patients with facial lesions will have lesions at other body locations. 

What triggers it?
Although the cause of DPN is uncertain, a strong genetic basis has been identified. Often, it can be seen in several members of the same family as it seems to be hereditary in many cases. Also, the darker the skin tone, more likely are the chances of developing DPN.

How is it diagnosed?
The appearance and distribution of DPN allows a dermatologist to easily recognize the condition by clinical examination. Dermoscopy is used to aid diagnosis. Rarely, a biopsy might be performed to confirm the diagnosis.

Is treatment necessary?
DPN is a cosmetic concern that does not require medical treatment. However, if the bumps bother you, you can consult your doctor. In certain circumstances, if they are symptomatic (painful, inflamed, itchy, or catch on clothing), a minor surgical procedure can be undertaken to manage them.

How is it treated?
Most treatment options rarely produce hypo or hyperpigmentation.

• Surgical removal: usually performed with topical anesthesia. These treatments may leave scarring. They also won’t stop new bumps from appearing.

  • Curettage: involves scraping away the bumps with a small scooping instrument.

  • Electrocautery: involves using a small probe with an electric current to burn away the bumps.

  • Cryosurgery: involves freezing off the bumps by using liquid nitrogen. It carries the risk of hypopigmentation, secondary to melanocyte damage and should be used with extreme caution.

• Laser treatment: uses different frequencies and levels of light to remove growth. Several types can be of use.

  • Carbon-dioxide laser

  • Long-pulsed neodymium-doped yttrium aluminum garnet lasers (Nd:YAG lasers)

  • Potassium titanyl phosphate (KTP) crystal-Nd:YAG laser
    At Dr Divya’s Skin and Hair Solutions Clinic we avoid lasers and opt for safer options.

• Electrodesiccation: is generally effective for smaller lesions. It is undertaken at a low setting after applying a topical anesthetic, and the patient is instructed to apply ointment to the desiccated crust daily until healed.

What is the cost of treatment?
The cost depends on the type of treatment and on the size of the area to be treated. Your doctor will help you determine the best treatment option for the size of bumps and skin type. Special care must be taken to prevent infection by avoiding scratching the treated area.

Dr Divya Sharma may prescribe you a topical antibiotic after the procedure to prevent infection.