Dermatosis Papulosa Nigra DPN
- Best Results1-2 months
- Treatment Recovery5 days
- Procedure Time15 to 30 minutes
- Skin SpecialistNurse
- Duration of ResultsYears
- Back to Work1-5 days
Dermatosis Papulosa Nigra DPN
DPN or dermatosis papulosa nigra is a common condition amongst ethnic & darker skin types. They are a form of age-related warts known as seborrheic keratosis. DPN increases with age. In many cases there is a genetic predisposition.
FactsFacts On Dermatosis Papulosa Nigra DPN
- DPN spots favours the face & neck area
- Up to one third of ethnic skin will have DPN
- Treatments include curettes, diathermy, lasers & chemical peels
- Precise treatments will reduce the incidence of post inflammatory hyperpigmentation
- One treatment will treat between 60 to 90% of lesions
- Lesions increase in adult life
What is Dermatosis Papulosa Nigra DPN?
Dermatosis papulosa nigra is termed Morgan Freeman’s Disease. It presents as spots of small, dark bumps that usually appear on the face & neck. While some people only develop a few bumps, others have many, numbering in the 100s. DPNs are asymptomatic, however can cause skin irritation & itch if clothing or jewellery causes friction.
Who gets dermatosis papulosa nigra?
DPNs are super common in darker skin types including ethnic Indians, Sri Lankans, Fijian, Pacific Islander & African Americans. There is often a family history of DPNs.
These spots & dots are common in the late 20s & increase with age.
What causes DPNs?
The short answer is genetics, ethnicity & age. These lesions are a variation of Seborrheic Keratosis, or Seb K—a non-cancerous skin growth that can occur in all skin types. Essentially, they are benign skin growths that are black or brown in colour and have a scaly texture.
How do dermatologists treat DPN?
Even though we have over 30 lasers, I teach my clinical team not to use lasers as the rate of collateral damage & resultant post inflammatory hyperpigmentation is too high. My nurses employ-
- Simple curettage without heat or desiccation
- Pinpoint electrodessication with a needle tip hyfrecator set to 1.2 to 1.8 watts
- Pinpoint RF devices
- TCA at 100% delivered precisely with a toothpick
I do not treat DPN, this is a simple condition to treat- if you are careful & meticulous.
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How many sessions are required?
Using the above protocols, my nurses can get up to 80-90% clearance of dermatosis papulosa nigra lesions in one sitting. Most patients will only require one session, if you want to get rid of the rest, book in for a second session.
Will DPN recur after treatment?
Yes, they will, as genetics play a role in the development of these spots. Most patients get 1-5 years of remission. Refer to the DIY section on how to manage recurrent or persistent lesions.
Can DPN be treated with cryotherapy?
Yes, but it requires some modifications to normal cryotherapy. If you spray DPN, you will cause collateral damage to the surrounding tissue, resulting in post inflammatory hyperpigmentation. Modification to this cryotherapy include-
- The use of a cryoprobe on a backing of a tongue depressor
- Use of a cotton tip dipped in liquid nitrogen
- Intermittent angled fine spray to the lesions
Are DPN contagious?
No, DPN is not contagious, even though it is frequently referred to as warts. DPN is a form of seborrheic, not viral warts.
Can DPN be treated with creams & skin care?
Skin care can potentially reduce the amount of skin tags & possibly prevent future DPN, however the evidence is limited. AHAs such as glycolic acid in concentrations ranging from 10 to 15 percent is a sensible starting point. Alternatively, salicylic acid from 3-7% in a lotion base.
What DIY treatments can be effective?
If you are going to go down this route, you must have a wee bit of common sense, otherwise you will end up with a chemical burn & post inflammatory hyperpigmentation. This is an old trick from the black book of dermatology DIY solutions-
- Use 35-70% TCA, undiluted. Apply the solution with a toothpick, only to the lesions. If you touch the skin below, you will have PIH.
- Tip: get someone with a steady hand & good eyesight to apply this
- Use Vaseline on the base of skin to protect from acid
- You can try this with Wart Kill
- Repeat 3 times a week if required
Disclaimer: DIY treatments require some sort of understanding & caution. If you are unsure, do not attempt it. You are far safer going to a skin care expert.
What are natural treatments for DPN?
Skin acids used carefully can get rid of DPN. These include AHAs such as lactic, & glycolic acid, as well as BHA including salicylic acid.
Another natural method is with atmospheric nitrogen concentration in a can & kept cold- otherwise known as liquid nitrogen.
There are many other DIY methods reported to treat DPN including vitamin C powder, garlic application, castor oil, & banana peels. Exert common sense when attempting to treat using DIY formulations. They don’t work. I will leave it up to you what you choose.
Who to see?
Your dermatologist will know what to do, & how to treat. If they are unsure, they will refer you to my clinical team for management. My nurses treat this condition. I do not treat DPN, seborrheic warts or skin tags as my work is theatre based.
How much are treatments?
Not much. It depends on the extent & complexity. A ballpark figure ranges from $290 to $690 (conducted by my nursing team). I do not treat DPN.
Davin’s Viewpoint on treating DPN
This common skin condition is seen frequently in darker skin patients. DPN are seborrheic warts & different from skin tags, however treated along the same lines.
This is one skin condition where simple is best, namely instruments such as curettes, paintbrushes & toothpicks can out do even the best lasers. The aim of treatment is to confine the injury of heat, chemicals, or trauma to the DPN itself, hence lasers in this context is one of my last options. Ablative lasers can however be very useful to treat extremely small DPN spots.
Plasma pen can also be used to treat DPN, skin tags & seborrheic warts. In fact, these are the only indications I endorse for plasma. Obviously, the success & side effects are dependent on the user or provider. If in doubt, conduct a test spot. If you use too much energy, post inflammatory hyperpigmentation ensures. This usually settles within 6-12 months. Hypopigmentation can be lifelong.
Prevention is hard as it is a genetic disorder. The use of sunscreen, as well as an exfoliating acid such as glycolic or lactic can be useful. As for DIY treatments? Yes, they can be super effective, however common sense & a steady hand is needed.
Disclaimer: I do not treat DPN, my procedural nurses are very experienced in treating this condition as I have taught them now to manage. My work focuses on treating complex skin conditions in an operating theatre.
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