Dermatosis papulosa nigra (DPN) is a benign skin disorder that mostly affects individuals of color. It is characterized by tiny, black pimples that form on the face and neck. Some people just get a few bumps, while others get a lot.

Continue reading to find out more about the DPN, including what causes it and how to cure it.

Everything you should know about DPN

Dermatosis papulosa nigra is a benign disorder that typically affects the faces of black and Asian individuals. The etiology of dermatosis papulosa nigra is unknown, though around half of those affected have a family history of the condition.

Multiple, tiny, smooth, solid, black, or dark-brown papules with a diameter of 1–5 mm are observed on the malar area of the face and neck, as well as the upper back and chest. With age, the frequency, number, and size of the lesions increase. Many people find these lesions to be bothersome and seek medical advice on how to get rid of them. Pigmentary changes (hyperpigmentation or hypopigmentation), scarring, and keloid development have confounded locally damaging therapies such as curettage, freezing with liquid nitrogen (cryotherapy), and electrodesiccation followed by curettage.

Dermatosis papulosa nigra affects up to 35% of African-descent persons and an unknown number of Asian-descent people. Dermatosis papulosa nigra often begins in adolescence, and the number and size of lesions get larger with age. Dermatosis papulosa nigra patches do not go away. Females are more likely to be afflicted than males. DPN's pathophysiology is unknown. Favorable family history may indicate a genetic predisposition.

The price is determined by the type of therapy and the size of the treatment area. Your doctor will assist you in determining the best treatment choice based on the size of the bumps and the kind of skin you have. Scratching the treated area must be avoided at all costs to avoid infection.

Following the removal of the DPN, the skin is treated with an antibiotic ointment. For three days, use this ointment twice a day. The skin normally heals in 5 to 7 days, although it will most likely be sore for another two weeks.

A modest degree of redness and soreness are the only side effects. The pimples should disappear or shrink as a result of treatment. You may notice a lighter brown or tan flat patch in its stead after treatment. Pigmentary alterations and (occasionally) scarring in the treated regions are potential side effects of the therapy.

Dermatosis papulosa nigra (DPN) are flat or elevated papules, which range in size from 1 to 5 mm in diameter, mainly appear on the cheeks and forehead. They can also form all around eyes, the neck, the chest, and the upper back. The lumps may get harsher in appearance with time. Small flaps that resemble skin tags are sometimes linked to the lesions. These are referred to as peduncles. While the bumps are most commonly found on the face and neck, they can also appear on the upper back or chest.DPN often begins in adolescence. The bumps tend to be larger and more numerous as you get older.

The specific etiology of DPN is unknown to medical professionals. The darker your complexion, though, the more likely you are to have it. In many cases, it also appears to be inherited. It's thought to be a congenital cutaneous abnormality caused by a hair follicle maturation abnormality. Some doctors believe it's caused by photoaging, while others feel it's caused by a mix of sun exposure and genetics. Around half of all patients seeking therapy have a family history of the skin condition—for example, a parent or grandmother may have it. 2 Formation usually begins throughout the adolescent years, and as one grows older, the quantity and size of the formations may increase.

DPN does not need to be treated. While they are benign growths, if you aren't sure whether a lesion you've grown is dermatosis papulosa nigra, you should consult a dermatologist to ensure it isn't anything more severe or malignant. DPN seldom causes pain or discomfort unless the lesion is irritated (for example, by rubbing against or snagging on clothes) or inflamed. The lesions, on the other hand, do not go away on their own. Many doctors feel they should be left alone, but some people who are self-conscious about their looks seek therapy. Just keep in mind that skin removal might result in hyperpigmentation (darkening), hypopigmentation (lightening), scarring, or keloid development.

The pimples generated by DPN can be surgically removed in some situations using the following treatments, which are commonly performed under topical anesthesia:

  • Electrocautery 

Electrocautery is a kind of cautery. This entails burning away the bumps with a tiny probe and an electric current.

  • Curettage 

Curettage is the removal of bumps using a little scooping device.

  • Cryosurgery

Cryosurgery entails freezing the bumps with liquid nitrogen.

It is important to remember that these therapies may result in scarring. They will also not prevent additional bumps from emerging.

Treatments using lasers

To eradicate growths, laser treatment employs a variety of light frequencies and intensities. Several varieties may assist to eradicate or minimize the appearance of DPN growths including:

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

Nd: YAG laser treatment reduced the number of bumps and their diameters by 75% in a 2015 research involving 60 persons with DPN. The same study discovered that conducting two sessions yielded the best outcomes.

  • carbon-dioxide lasers

According to Trusted Source based on a 2016 research, this sort of laser therapy is a safe and effective treatment option for DPN with minimal risk of recurrence.

  • KTP laser

A potassium titanyl phosphate (KTP) crystal and an Nd: YAG laser is used in this procedure.

Consult your doctor to decide the best treatment choice for the size of your bumps and your skin type.

There are a few natural therapies available on the internet. One method is to apply the juice of a garlic clove to the afflicted region and cover it with a bandage. Some claim that the sulfur in garlic helps to strengthen skin fibers and cells and minimize wrinkles, however, this is mostly through dietary sources. Garlic is also a home cure for healing acne and acne scars, however, in some people, it can cause skin damage comparable to a burn. If you're going to burn your skin, leave it to the specialists.

Another natural remedy is to apply vitamin C powder to the afflicted regions and then wrap with a bandage. While vitamin C can help revitalise ageing and photodamaged skin as well as promote healthy collagen formation, there is no proof that it can eradicate DPN.

Some people feel that massaging castor oil into the afflicted regions two to three times a day would help to lessen the appearance of lesions. It's also a popular recommendation for psoriasis.

When it comes to home cures, it's better to exercise common sense to avoid causing more skin harm. If you don't already have a dermatologist, ask around for recommendations from doctors who are familiar with skin of colour and have expertise treating skin disorders.

How doctor diagnose DPN ?

DPN is diagnosed by a clinician who examines the skin and notices the characteristic appearance of elevated patches. A skin biopsy may be required to confirm the diagnosis in rare cases. These procedures are frequently not covered by health insurance since they are cosmetic.

Electrocautery and electrodesiccation are two procedures that employ electric current to degrade and remove DPN. Electric current is sent through a tiny probe with a thin needle electrode tip to cauterise (burn or destroy) skin tissue during electrocautery (or thermal cautery). The tip of the needle becomes heated during electrocautery, but the electricity does not flow through the body.

The most expensive treatment is laser therapy, which results in a scab that peels off after a few days. The wavelength of the Nd:YAG laser (1064nm) is safe for dark skin. It causes melanin in black spots to coagulate, as well as blood supply to the growths. There is some discomfort, but there are few negative effects. One week is all it takes for the skin to recover. Skin discoloration is possible, although it will disappear with time.



Treatments with therapies and lasers

Laser therapy targets damaged skin with pulses of concentrated, strong light. Lasers are available in a range of forms and sizes. The 1064 Q-Switched Nd YAG laser is effective for treating freckles, according to 2015 research. According to the results of the study, 62 percent of individuals had their freckles lightened by more than 50 percent after treatment with this laser.

The use of lasers is generally considered to be safe. Scarring is unlikely to occur. Other side effects, however, may occur, including:

  • itching
  • swelling
  • redness
  • crustiness
  • peeling
  • infection
  • skin color changes

Other drugs or creams may be prescribed by your Dermatologist before treatment. They may also advise against taking certain drugs or using specific items before the surgery. Any drugs or lotions you're utilizing should be disclosed to your doctor.

Radio Wave Surgery

Radiowave surgery is a minimally invasive treatment that is done with topical and local anesthesia. Each elevated DPN is treated separately and depending on the overall number of lesions to be treated, the doctor will address around 10 lesions in a single session. The thermal damage caused by radio wave surgery is minimal. Some light brown spots may remain, but they will seem considerably better than the initial DPN and may ultimately merge completely with the patient's skin tone.

The operation is often carried out using topical gel and local anesthetic. The technique is completed rapidly, with the amount of time determined by the number of DPNs that must be removed. Following the removal of the DPN, the skin is treated with an antibiotic ointment. For three days, use this ointment twice a day. The skin normally heals in 5 to 7 days, although it will likely be uncomfortable for another two weeks. When the skin has completely healed and reverted to its natural color (or near to it), it is often difficult to determine the location of the mole or skin tag.

Topical medications

Topical treatments containing hydroquinone are perhaps the most common treatment for skin whitening on a spot-by-spot basis. Despite being certified safe for use in cosmetics, the concentration of hydroquinone is restricted since larger quantities offer more dangers. 

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