DPN Dermatosis papulosa nigra

  • Best Results1-2 months
  • Treatment Recovery5 days
  • Procedure Time15 to 30 minutes
  • Skin SpecialistNurse
  • Duration of ResultsYears
  • AnaestheticNumbing
  • Back to Work1-5 days
  • Cost$$

DPN Dermatosis papulosa nigra

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 DPN/ Dermatosis Papulosa Nigra

  • 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 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.

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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