The Ins and Outs of Dermatosis Papulosa Nigra: Causes and Treatments
- Dermatosis papulosa nigra is a skin condition that most often affects individuals with darker skin tones.
- It involves dark skin growths on the face and neck that are similar in appearance to skin tags.
- While the condition itself is harmless, there are several treatments used for removing these skin lesions.
- Some homeopathic remedies may also reduce the size and appearance of resulting skin growths.
What is Dermatosis Papulosa Nigra?
Dermatosis papulosa nigra (DPN), a benign, cutaneous condition that often affects black adults, involves the appearance of soft brown papules on the skin, particularly around the cheekbones and eyes. These papules are harmless, benign growths, but they can be itchy and scratching or scraping the affected area just irritates them further.
Individual lesions most often appear on the face and neck but also show up on the upper chest and back. This skin condition is considered fairly common, affecting up to 35% of black adults, and typically arising in females more often than males.
While those with lighter or fairer skin are less likely to experience DPN’s than people with dark skin, anyone of African, Latino, or Asian descent can experience the condition. DPN’s are similar to seborrheic keratosis in appearance, and are not considered cancerous or symptomatic of any other underlying disease or condition. Some research suggests it may stem from genetics while other studies have found that sun exposure is a contributing factor.
Regardless, DPN’s are considered a sign of aging in people of color. If you have DPN’s, expect to see the number and size of hyperpigmented papules increase as you age. Consequently, many individuals who experience DPN don’t like the way it affects their appearance and choose to undergo treatment for cosmetic reasons. It is possible to remove the lesions, with several treatment options available depending on what works best for you personally.
While it’s fairly easy to diagnose the condition, if you’re not sure you have it you should definitely visit your doctor to confirm that you don’t have skin cancer. It’s possible he or she may want to conduct a biopsy, but this is unlikely. While it’s not medically necessary to remove papules caused by DPN’s, you can always opt for a cosmetic procedure if you’re unhappy with how they affect your appearance. Your doctor will be able to help you make the best decision about the available treatment options.
There are several methods of removal and treatment: curettage, electrocautery, electrosurgery, cryotherapy, and electrodessication. Each treatment presents the risk of permanent scarring, decreased pigmentation, and keloid formation. Keloid formation occurs when scar tissue forms and grows excessively.
In other words, the scar tissue doesn’t know when to stop growing. This creates a hard, benign growth, similar to the papules caused by DPN’s. While keloids aren’t harmful, they can be irritating and itchy and undesirable from a cosmetic perspective. Similar to DPN’s, keloids are also more common in individuals of African, Asian, and Latino descent.
Before you schedule a treatment, make sure you’ve considered the potential outcomes and side effects of each treatment. Further, nothing will prevent new papules from appearing in the future, so you may want to seek additional treatment if new skin lesions continue to show up on your skin.
Curettage involves applying a local anesthesia to the affected area and surgically scraping growths from the body with a device known as a curette. Curettage is typically used when the lesion being removed is softer than the surrounding tissue. It’s a common method to remove skin cancer, viral warts, and skin tags. After the procedure, you will notice some scarring. You can expect it to take about 2-3 weeks for the wound to heal, and while the initial scarring may appear red and raised, it will fade and shrink over time.
Electrocautery involves burning off skin growths. For larger papules, your doctor will first apply a local anesthetic. Next, using tweezers, he or she will lift and hold the lesion away from where it is attached to the skin, and use a cautery to burn off the growth and cauterize the wound. As a final step, a topical antibiotic ointment is applied to encourage healing while also protecting the wound from infection. It is then covered with a bandage. This process is repeated for as many growths as desired. It’s absolutely critical to have a doctor perform this procedure; otherwise you risk serious burns or injuries.
Electrosurgery is useful for removing skin lesions of all types. According to American Family Physician, “modern, high-frequency electrosurgical devices transfer electrical energy to human tissue via a treatment electrode that remains cool.” These devices operate at the lowest frequencies and convert electrical energy into molecular energy in order to excise tissue.
Electrosurgery differs from electrocautery in that the tip of the device is cool and the electrical resistance comes from the human tissue as opposed to the device itself. With electrocautery, the tip of the device must be hot in order to burn off and remove tissue.
Cryotherapy works much like electrocautery, only you’re freezing off skin growths with liquid nitrogen instead of burning them off. Your dermatologist will insert a pair of forceps into liquid nitrogen for approximately 15 seconds. Then he or she will use forceps to grab the skin tag, taking extra precaution to avoid damaging any surrounding skin with the liquid nitrogen.
Because the procedure is relatively painless, producing only a mild stinging feeling, local anesthesia typically isn’t required; however, your doctor will decide if this is necessary. No bandages are required after the procedure, and the growths should fall off within 7 to 10 days.
According to Pisco Med Publishing, electrodessication is a surgical procedure that involves the use of a high-frequency electric current to remove superficial skin growths.
The patient is first given local anesthesia before an electric current is applied to the tissue, which dehydrates the lesions.
The procedure is generally considered relatively effective, affordable, and easy for patients to tolerate. There are minimal side effects involved with the procedure. ED is commonly used as a treatment for conditions such as skin tags. Around 85% of patients who undergo electrodessication experience significant improvement when it comes to the appearance and presence of skin growths in the affected area.
The most notable side effect is the loss of pigmentation in areas that have been treated with the electric current. Patients with a darker skin tone may notice a more drastic contrast as a result of scarring from the procedure. However, it’s worth noting that in a study published in the Journal of Surgical Dermatology, post-inflammatory hyperpigmentation was observed in only a small number of patients and subsided within 8 to 12 weeks with additional treatment and therapy.
Other treatments for DNP involve KTP and YAG lasers. When KTP laser light is absorbed by the skin it is converted to heat energy, which destroys the targeted cells. However, given the wavelength of laser light in this procedure targets melanin, it’s not typically used on individuals with darker skin.
In addition to professional treatments, some homeopathic remedies may help reduce the appearance of skin growths from DPN. First, try squeezing a clove of garlic onto an area of skin with a high concentration of growths. Then, cover the area with a bandage.
Similarly, to reduce spot size you can try crushing up vitamin C tablets, putting the powder on your skin and covering it with a bandage. Castor oil is also known to have positive effects on both hair and skin. Try massaging some into the skin of the affected area 2-3 times a day to reduce the appearance of skin growths arising from DPN.
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