dermatosis papulosa nigra on dark skin

Dermatosis Papulosa Nigra

Dermatosis Papulosa Nigra (DPN) is a harmless skin condition that is common in individuals with darker skin type. Although it is commonly seen in Afro-Caribbeans, we encounter many Asians with similar condition as well.  It usually appears during the adolescent period, and increases in size and number with age. Females appear to have a greater prevalence of dermatosis papulosa nigra compared to men. 

What Causes Dermatosis Papulosa Nigra?

The exact cause of DPN is unknown. In about 50% of cases, we find that it runs in families, suggesting some genetic factors involced.

What Does It Look Like?

Dermatosis Papulosa Nigra starts as small brown bumps over the face and neck region. Multiple in number, DPN affects the face, neck and chest regions. Over time, you may notice an increase in size and number of this skin lesion. It is often confused as skin tags and viral warts.

Does It Cause Harm?

No, it does not. Dermatosis Papulosa Nigra does not develop into skin cancer nor does it signify any underlying medical illness.

How is Dermatosis Papulosa Nigra Diagnosed?

Most cases of DPN are diagnosed based on their appearance. It shares some features as seborrhoeic keratoses under the microscopic and may be a subset of it. Rarely, is a skin biopsy needed to make a diagnosis.

Dermatosis Papulosa Nigra Treatments

Being a benign and harmless condition, it is not necessary to treat dermatosis papulosa nigra.

We understand that many individuals with DPN may find the appearance of it undesirable, and therefore prefer its removal. There are a variety of methods to remove dermatosis papulosa nigra skin lesions. The selection of the treatment modality takes into account the downtime, potential side effects of the treatments and costs.

Treatment methods to remove Dermatosis Papulosa Nigrans include electrodessication, cryotherapy (liquid nitrogen) and laser surgery. The Nd:YAG Laser, CO2 (Carbon Dioxide) Laser and Pulsed Dye Laser systems have been used to treat DPN. In one study, CO2 Laser surgery for dermatosis papulosa nigra has been shown to have low complication rates with a high degree of patient satisfaction. The healing time takes about a week, and side effects such as skin hyperpigmentation, hypopigmentaion and scarring are minimal in our clinical experience. 

Laser Removal of Dermatosis Papulosa Nigra

dermatosis papulosa nigra removal

Although DPN may be cosmetically unpleasant, it may be cause skin irritation when rubbbed or scratched. These may prompt many individuals to seek treatment.

Carbon dioxide laser removal of dermatosis papulosa nigra is safe, effective and many patients are found to be satisfied after the procedure.

As most individuals that present with DPN have a darker skin phototype, Dr Ng believes that a procedure that causes minimal collateral damage but maximal effectiveness will lead to better results.

 

A numbing cream or local anaesthetic is used prior to your treatment to ensure youe comfort. During the laser procedure, it is virtually painless.

Small dermatosis papulosa nigra lesions usually heal between 5-7 days, whereas larger ones may take 7-10 days for healing to occcur.

You would need to keep the wound clean with regular cleansing. An antibiotic ointment is prescribed to reduce infection. Keeping your hands clean with regular hand washing is essential. Sun avoidance and protection about 4 weeks after your treatment helps reduce the risk of post-inflammatory hyperpigmentation,

As with any surgical procedure, there is a risk of infection, hyperpigmentation, hypopigmentation, scarring and recurrence. From Dr Ng’s experience, these side effects are uncommon and mostly temporary in nature.

Dermatosis papulosa nigra is known to increase in number with age. Treatment is only meant to improve the cosmetic appearance but does not prevent recurrence given the natural history of the condition.

The cost of dermatosis papulosa nigra removal is from $350-$650 onwards.

More Information:

Skin Of Color Society – Dermatosis Papulosa Nigra

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References:

  1. Dunwell P, Rose A. Study of the skin disease spectrum occurring in an Afro-Caribbean population. Int J Dermatol. 2003 Apr. 42(4):287-9.
  2. Schweiger ES, Kwasniak L, Aires DJ. Treatment of dermatosis papulosa nigra with a 1064 nm Nd:YAG laser: report of two cases. J Cosmet Laser Ther. 2008 Jun. 10(2):120-2.
  3. Ali FR, Bakkour W, Ferguson JE, Madan V. Carbon dioxide laser ablation of dermatosis papulosa nigra: high satisfaction and few complications in patients with pigmented skin. Lasers Med Sci. 2016 Apr. 31 (3):593-5.
  4. Lupo MP. Dermatosis papulosis nigra: treatment options. J Drugs Dermatol. 2007 Jan;6(1):29-30. PMID: 17373158.