Last Updated on November 17, 2020 by Dr Sanusi Umar MD


The  International Journal of Dermatology published a study called A clinical, dermoscopic, and histopathological study of Dermatosis Papulosa Nigra (DPN) – An Indian perspective. 100 patients diagnosed with Dermatosa Papulosa Nigra were observed using the methods of histopathology and dermascopy. The researchers were interested in noting common  epidemiological and clinical characteristics of these lesions. With their sample of participants, they observed a much earlier onset of the lesions during the age years of the 40’s versus the 60’s , which has been documented in other studies. They also found that DPN tends to occur in females with Fitzpatrick skin types IV to VI. Other characteristics they noted included a family history of lesions, a lifestyle where sun exposure is predominant and the development of DPN in the head and neck areas. The use of histopathology, which refers to the use of a microscope to examine tissue (i.e. biopsy) , revealed skin thickening as a prominent characteristic in the areas marked by lesions. Dermascopy (non-invasive evaluation of the outer epidermal skin layer in terms of colors as well as microstructures) was also used in this study. And through this approach, researchers noted the characteristics of “fissures and ridges of the cerebriform pattern followed by comedo-like openings.”

Dermatosis Papulosa Nigra DPN Treatment in Los Angeles:

DPN is a benign (not harmful) skin condition that appears as black or brown moles on the face with a diameter between 1-5mm. They appear flat and raised slightly from the surface of the skin. They sometimes protrude significantly and have the appearance of dark skin tags. Lesions first begin to appear during an individual’s teenage years and advance with age. Reasons for removal include that the lesions are aesthetically displeasing, itchy and irritating, and a cause for low self esteem. These lesions are not medically concerning or cancerous, but can be irritating, itchy, or aesthetically displeasing. While referred often as “moles,” by definition they aren’t true moles.

Patient before her DPN treatment

Photo of patient before her DPN removal healing.

DPN bumps tend to develop in these areas:

  • under the eyes
  • cheeks
  • forehead
  • neck
  • chest
  • upper back

As they are harmless, most people who choose removal do so for aesthetic reasons. A more uniform and clear complexion is the most often the result.

Who Is Affected By DPN?

DPN affects slightly more than one-third of the African American population, with the chances of fair-skinned African Americans developing DPN being lower than dark-skinned African Americans. However, this condition is also seen in Native American and Asian patients as well. Women also tend to develop DPN more than men.

An example of DPN skin causes

DPN Skin Causes: This patient was very susceptible to growing these DPN lesions.

DPN Skin Causes

The exact cause of DPN is unknown. A developmental abnormality in the pilosebaceous follicle may cause the lesions. There are studies that believe this disease is related to another medical condition named Seborrheic Keratoses because, the lesions are nearly identical when observed under a microscope. Other studies state that the most likely cause of DPN is genetic inheritance as a family history of it was reported in over half of people afflicted.

How DPN Differs From Regular Moles

DPN is not similar to regular skin moles since they are more aligned to skin follicles. Moles occur when skin cells known as melanocytes clump up. Melanocytes produce melanin which colors our skin. While normally evenly distributed, they will occasionally come together. A malignant growth tends to be an asymmetrical mole. DPN lesions where one side is a different shape from the other is quite common. DPN bumps both increase in size and grow in number over time.

DPN Moles’ Severity

Though benign, dermatologists classify DPN lesions according to severity.

  •         fewer than 10 papules: mild
  •         more than 10 papules: moderate
  •         greater than 50 papules: severe

DPN Removal Options

Patients who wish to be rid of DPN may choose to familiarize themselves with the types of treatment:

  •         Cryosurgery: Unwanted tissue is frozen with liquid nitrogen.
  •         Scraping or excision: Surgical tools can be used to scrape The raised tissue is scraped off with surgical tools. By cutting around the perimeter the lesion can also be excised . The resulting wound would need to be stitched closed.
  •         Electrocautery: To remove the tissue, an electric current is used to make the cuts. In one technique, the current is applied to seal off blood vessels that feed the DPN tissue as well. In another method (used by Dr U) the current is used to melt the DPN lesions instead of burning them.
  •         Nd:YAG laser: The Nd:YAG laser uses 1064nm wavelength which is safe for patients of all skin tones. The heat will seal off the blood vessels that cause DPN tissue to grow. It also causes the melanin to form a mass that is broken down to be carried away by the body. Minimal scarring results in this natural removal process.

        Research shows that an effective DPN treatment is using the ND:YAG laser system.


Laser energy is non-invasive and able to make highly precise tissue changes ensuring very low risk of complications like keloid development or pigmentation.


Dr U’s Los Angeles Patient DPN Removal Before and After

Photo showing lack of DPN skin prevention

Although DPN skin prevention is almost unavoidable in certain patients, safe removal is now a very viable option: Before Photo


What happens after DPN removal healing

Although DPN skin prevention is almost unavoidable in certain patients, safe removal is now a very viable option: After Photo*


DPN Removal Healing

DPN skin causes show a less severe diagnosis.

Before DPN removal healing.


DPN removal before and after with this being the after.

After DPN removal healing.*


DPN removal before treatment with Dr. Umar.

Lesions on forehead before DPN removal healing.


DPN removal healing shows remarkable clearer skin: dpn removal before and after

After DPN removal healing in Los Angeles.*


DPN Skin Prevention

It’s vital that the affected individual stays indoors and avoids sun as much as possible as exposure to the sun may cause the lesions to become more prominent. If one has to go out, it is advisable to protect the affected areas of the skin by using appropriate lotions so the lesions are not exposed to the sun.  

Video: Dermatosis Papulosa Nigra – DPN Removal – DPN Removal by Dr. U for Los Angeles Patient

This Los Angeles patient consulted Dr. U about the tiny black dots on her face. These dots are actually pigmented lesions known as Dema Papulosa Nigra, or DPN for short.


Consult with Dr. Umar

If you are interested in DPN treatment services, sign up for a free consultation at Dr. U Skin Clinic. You will be able to have your questions answered and learn which cosmetic procedure would be best for achieving your goals. You may fill out our consultation form at the top of the page. To get started, fill out our consultation form or call us at 1800-499-DRUCLINIC (3782) to schedule an appointment.



DPN Treatment in Los Angeles FAQ’s

Do the procedures for DPN treatment hurt?

Topical anesthesia can be used to maximize the patient’s comfort level during their removal procedure. This includes:

  • EMLA which is a combination of topical lidocaine and prilocaine cream
  • LMX which is a topical lidocaine cream
  • BLT Betacaine, Lidocaine and Tetracaine

In addition to the aforementioned topical anesthetics, Dr Umar favors adding a drop of injectable lidocaine into the base of each DPN lesion before removal. This is because often it is necessary to use electrocautery either for removal or for stoppage of bleeds. The use of topical anesthetics alone may not assuage the pain that accompanies electrocautery.

Are there natural DPN skin prevention treatments or any other ways to treat DPN?

There are some natural options. Some of these treatments have been used in an attempt to get rid of the lesions due to DPN include:

  • Garlic: Squeeze a garlic clove and apply over affected area. Cover with a bandage.
  • Vitamin Tablets: Crush vitamin C tablets and apply powder to affected areas. Place a bandage over area.
  • Castor Oil: Take castor oil and gently massage over affected areas couple of times a day.
  • Banana: Use the inside of a banana peel and place over affected area that the peel covers the lesions. Cover area with bandage and keep bandage on for two to three hours.

While these are enticing options, their effectiveness has not been studied. The only treatments that are 100% effective for DPN are those medical level “DPN Removal Options” listed in this article

How do I know if I have DPN?

A dermatologist is easily able to recognize the appearance and distribution of DPN during a clinical examination. In rare instances a dermatologist may perform a biopsy to confirm the diagnosis.

What are some of the risks with DPN treatment?

Some potential complications of surgery include postoperative scarring, skin discoloration, or formation of keloids. It is advisable that conservative treatment be tried first.


DPN is a condition afflicting many. The good news: if you struggle with Dermatosis Papulosa Nigra, you’ve got plenty of options. Click the button below to ask Dr. U any questions you may have regarding your condition:




Further Reading:

Learn about the different ways to remove a mole. 

Learn what to look for when choosing a dermatologist.