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DERMATOSIS PAPULOSA NIGRA

Clear skin and hair

DPN 

What is Dermatosis Papulosa Nigra (DPN)? 

Dermatosis Papulosa Nigra (DPN) commonly known as DPN; predominantly found in darker skin. They are smooth round black or dark brown, flat or papular lesion, occur prominently on the cheek and around eyes; also found over the lower part of the face, neck, chest, abdomen, and back. 

What causes it?

The cause of DPN is unknown. The darker skin is at high risk usually at puberty. The genetic predisposition and ultraviolet exposure (photoaging) have been proposed. 

Signs and Symptoms: 

· DPN is mostly characterized by black or dark brown, flat, or small bumps, occur prominently on the cheek and around eyes; also found over the lower part of face, neck, chest, abdomen, and back.

· They measure from 1-5 mm in diameter.

· They usually start during adolescence and over time they tend to grow bigger and increase in number.

· DPN may be itchy or irritating and cosmetically undesired.

Treatment

DPN is harmless and doesn’t require treatment. However, if the bumps become itchy or irritating or increase in number and size will make you cosmetically undesired due to their appearance. 

There are many treatment options for dermatosa papulosa nigra as mentioned below; which are usually done with topical anesthesia.

Surgical procedures:

Curettage: This involves scraping the lesions with a small scooping instrument.

Electrocautery: This is using a small probe with an electric current to cauterize the skin tissue..

Cryosurgery: This involves freezing off the bumps using liquid nitrogen.

Laser treatments:

Laser therapy uses different lasers to remove the bumps. Lasers have promising results and can help to remove or reduce the appearance.

Carbon-dioxide laser: This produces a specific wavelength of light in the mid-infrared spectrum (10600 nm) and its energy is an effective option for DPN. 

Erbium Yag laser: is a solid-state laser and emits a wavelength of 2940nm and its wavelength is closer to top layers of skin or peak spectrum of water. It is the best, most effective, and almost painless option to remove DPN.

KTP laser: This method uses a potassium titanyl phosphate (KTP) crystal along with an Nd: YAG laser.

However, there are many treatment options for dermatosa papulosa nigra, but some have a risk of pigmentation changes in skin color and causing scar formation. The treatment will not stop from getting new lesions. It better to consult a reputed dermatology clinic with advanced laser technology, understands the unique properties and treatment outcomes of ethnic skin.

What causes it?

The cause of DPN is unknown. The darker skin is at high risk usually at puberty. The genetic predisposition and ultraviolet exposure (photoaging) have been proposed. 

Signs and Symptoms: 

· DPN is mostly characterized by black or dark brown, flat, or small bumps, occur prominently on the cheek and around eyes; also found over the lower part of face, neck, chest, abdomen, and back.

· They measure from 1-5 mm in diameter.

· They usually start during adolescence and over time they tend to grow bigger and increase in number.

· DPN may be itchy or irritating and cosmetically undesired.

Treatment                                                                                                  

DPN is harmless and doesn’t require treatment. However, if the bumps become itchy or irritating or increase in number and size will make you cosmetically undesired due to their appearance. 

There are many treatment options for dermatosa papulosa nigra as mentioned below; which are usually done with topical anesthesia.

Surgical procedures:

Curettage. This involves scraping the lesions with a small scooping instrument.

Electrocautery. This is using a small probe with an electric current to cauterize the skin tissue..

Cryosurgery. This involves freezing off the bumps using liquid nitrogen.

Laser treatments:

Laser therapy uses different lasers to remove the bumps. Lasers have promising results and can help to remove or reduce the appearance.

Carbon-dioxide laser. This produces a specific wavelength of light in the mid-infrared spectrum (10600 nm) and its energy is an effective option for DPN. 

Erbium Yag laser: is a solid-state laser and emits a wavelength of 2940nm and its wavelength is closer to top layers of skin or peak spectrum of water. It is the best, most effective, and almost painless option to remove DPN.

KTP laser. This method uses a potassium titanyl phosphate (KTP) crystal along with an Nd: YAG laser.

However, there are many treatment options for dermatosa papulosa nigra, but some have a risk of pigmentation changes in skin color and causing scar formation. The treatment will not stop from getting new lesions. It better to consult a reputed dermatology clinic with advanced laser technology, understands the unique properties and treatment outcomes of ethnic skin.

Although dermatosis papulosa nigra is not a dangerous condition, some patients choose to have the spots removed for cosmetic reasons. The condition generally worsens with age, and the size and number of spots do not decrease without treatment.

People who are considering treatment for dermatosis papulosa nigra should carefully consider their expectations and goals of treatment. Because treatment may not be able to completely remove spots, the goal of treatment should be to minimize the appearance of spots rather than to remove them completely.

Treatment for dermatosis papulosa nigra is complicated by the fact that the condition occurs mostly in skin of color patients, who are at a higher risk of developing pigmentation defects (lightening or darkening of the skin) and scarring following treatment. The resultant blotchy or scarred appearance of the skin may be as cosmetically undesired as the original dermatosis papulosa nigra spots.

Treatment options for dermatosis papulosa nigra include scissor excision, shave excision,cryosurgery, electrodessication, curettage, dermabrasion, and laser removal. The cost of treatment depends on the type of treatment and on the size of the area to be treated. Since treatment is usually performed for cosmetic reasons, removal of these benign lesions is not covered by insurance and is an out-of-pocket expense. 

The type of treatment that is best for dermatosis papulosa nigra depends on the individual patient. For example, a physician may prefer different treatments for patients with a small number of spots versus patients with many spots. Special care must be taken when treating skin of color patients with dermatosis papulosa nigra because of the increased likelihood of developing scarring and coloration problems.

In conclusion, there are many treatment options for dermatosa papulosa nigra, but some carry a higher risk of causing scar formation and pigmentation changes in skin of color patients. Because of this, skin of color patients who are considering treatment for dermatosa papulosa nigra should consult a dermatologist who understands the unique properties and treatment outcomes of ethnic skin.

Surgical removal : In some cases, the bumps caused by DPN can be surgically removed through the following techniques, which are usually done with topical anesthesia:

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

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

•Cryosurgery. This involves freezing off the bumps using liquid nitrogen.

Keep in mind that these treatments may leave scarring. They also won’t stop new bumps from appearing.

Laser treatments

Laser therapy uses different frequencies and levels of light to remove growths. Several types can help to remove or reduce the appearance of DPN growths, including:

•Carbon-dioxide laser. A 2016 studyTrusted Source found that this type of laser therapy was a safe and effective option for DPN with a low chance of recurrence.

•Long-pulsed neodymium-doped yttrium aluminum garnet lasers (Nd:YAG lasers). In a 2015 study involving 60 people with DPN, Nd:YAG laser therapy provided a 75 percent improvement in the number of bumps and their sizes. The same study also found that results were best after doing two sessions.

•KTP laser. This method uses a potassium titanyl phosphate (KTP) crystal along with a Nd:YAG laser.

·The treatment usually depends on the patient’s compliance. It is always better to minimize the appearance of spots rather than removing them completely.

·Some natural methods are- using garlic, castor oil, vitamin C tablets or banana.

·An imperative step is to avoid sun exposure.

·Cosmetic removal is a matter of grave discussion preceding the surgery as it increases the chances of pigmented scars in the darker skin types.

·Curettage that is scraping of the growth, electrocautery that is using the current to cauterize skin tissue and electrodesiccation which dehydrates and destroys the superficial tissue is the most effective treatment procedures.         

How do I know if I have dermatosis papulosa nigra?

The appearance and distribution of dermatosis papulosa nigra allow a dermatologist to easily recognize the condition by clinical examination. Rarely, a dermatologist may perform a biopsy, a procedure in which a small skin sample is taken from the affected area and looked at under a microscope to confirm the diagnosis.

How is Dermatosis Papulosa Nigra treated?

Although dermatosis papulosa nigra is not a dangerous condition, some patients choose to have the spots removed for cosmetic reasons. The condition generally worsens with age, and the size and number of spots do not decrease without treatment.

People who are considering treatment for dermatosis papulosa nigra should carefully consider their expectations and goals of treatment. Because treatment may not be able to completely remove spots, the goal of treatment should be to minimize the appearance of spots rather than to remove them completely.

Treatment for dermatosis papulosa nigra is complicated by the fact that the condition occurs mostly in skin of color patients, who are at a higher risk of developing pigmentation defects (lightening or darkening of the skin) and scarring following treatment. The resultant blotchy or scarred appearance of the skin may be as cosmetically undesired as the original dermatosis papulosa nigra spots.

Treatment options for dermatosis papulosa nigra include scissor excision, shave excision, cryosurgery, electrodessication, curettage, dermabrasion, and laser removal. The cost of treatment depends on the type of treatment and on the size of the area to be treated. Since treatment is usually performed for cosmetic reasons, removal of these benign lesions is not covered by insurance and is an out-of-pocket expense. The type of treatment that is best for dermatosis papulosa nigra depends on the individual patient.  

For example, a physician may prefer different treatments for patients with a small number of spots versus patients with many spots. Special care must be taken when treating skin of color patients with dermatosis papulosa nigra because of the increased likelihood of developing scarring and coloration problems.

In conclusion, there are many treatment options for dermatosa papulosa nigra, but some carry a higher risk of causing scar formation and pigmentation changes in skin of color patients. Because of this, skin of color patients who are considering treatment for dermatosa papulosa nigra should consult a dermatologist who understands the unique properties and treatment outcomes of ethnic skin.

What does it look like?

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What causes it?

Healthcare providers aren’t sure about the exact cause of DPN. However, the darker your skin is, the more likely you are to develop it. It also seems to be hereditary in many cases.

How is it treated?

DPN is harmless and doesn’t require treatment. However, if the bumps become itchy or you don’t like their appearance, there are a few options for removing them.

Surgical removal :In some cases, the bumps caused by DPN can be surgically removed through the following techniques, which are usually done with topical anesthesia:

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

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

•Cryosurgery. This involves freezing off the bumps using liquid nitrogen.

Keep in mind that these treatments may leave scarring. They also won’t stop new bumps from appearing.

Laser treatments

Laser therapy uses different frequencies and levels of light to remove growths. Several types can help to remove or reduce the appearance of DPN growths, including:

•Carbon-dioxide laser. A 2016 studyTrusted Source found that this type of laser therapy was a safe and effective option for DPN with a low chance of recurrence.

•Long-pulsed neodymium-doped yttrium aluminum garnet lasers (Nd:YAG lasers). In a 2015 study involving 60 people with DPN, Nd:YAG laser therapy provided a 75 percent improvement in the number of bumps and their sizes. The same study also found that results were best after doing two sessions.

•KTP laser. This method uses a potassium titanyl phosphate (KTP) crystal along with a Nd:YAG laser.

 

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