Dermatosis Papulosa Nigra: What It Is And How To Treat It

I don’t know how many mole-like spots have appeared on my face in the middle of my life. All I knew was that these beauty marks, scattered across my cheeks and forehead, were a perfect match between my mother and father, who also had them. They made me feel like there was something I received equally from both of them, so I accepted the spots but never thought much about them. It wasn’t until I was an adult that I realized there was a medical term for this, and that other Black women had varying experiences with dermatosis papulosa nigra.

DPN is a common skin condition that primarily affects people with melanated skin color, including black women of African, Afro Caribbean, or African American descent. This disease is characterized by small, benign papules that are dark brown to black in color and usually appear on the face and neck. These papules are often confused with moles, freckles, or warts, even though the two are slightly different.

A Movement Toward Embracing DPN

As part of a broader shift in redefining beauty standards, DPN is now increasingly accepted — but it wasn’t always that way. For Black women who grew up with skin types that don’t have the smooth texture idealized by mainstream beauty standards, things like DPN can be a trigger — especially considering how often products like Proactiv are slathered on our faces. There is an idea that DPN must be “fixed,” reinforcing the message that anything other than flawless skin is abnormal, and therefore not beautiful or even visually acceptable.

In recent years, Black women have taken the lead in challenging outdated norms and pushing for a more inclusive and empowering definition of beauty. Many are now more open with their natural bodies and skin, and don’t always cover them with makeup or remove traces of DPN beauty. As the conversation around this condition continues to gain momentum, it’s clear that the future of beauty is incredibly diverse, celebrating the uniqueness of every individual and every skin type.

After speaking with Black women with DPN, I increasingly feel that as we age, we accept ourselves, our bodies, and our beauty.

Does DPN Have Health Risks?

Jannah Abdul-Rahman, a mother of four, was often teased in middle and high school because of her DPN. Children find ways to internalize the idea that DPN is what makes them different. She recalled that kids would try to “wipe off her black girl freckles,” questioning whether they were real, or turning their faces away in displeasure and asking, “What’s on your face?”

The author shows his beautiful DPN.The author shows his beautiful DPN.

“I never wanted to get rid of it until someone mentioned the potential for cancer,” Abdul-Rahman told Talk News. But fortunately, this assumption is misguided.

Adeline Kikam, board-certified dermatologist and founder of Brown Skin Derm and Skinclusive Dermatology in Houston, DPN is not associated with any health risks, including skin cancer. However, Kikam emphasized that even though the lesion is benign, it is important to see a dermatologist if there are symptoms such as swelling, pain or bleeding. Some women find that after pregnancy or getting older, their DPN becomes more obvious, causing prominent lesions on the skin.

Can (And Should) DPN Be Removed?

Kikam notes that some black women choose to remove their DPN for cosmetic purposes. He said that “DPN can be removed via several methods,” such as snip excision, light curettage with or without anesthesia, light electrodessication, or cryotherapy. “But in darker skinned individuals, this should always be weighed against the risk of hyperpigmentation or hypopigmentation and scarring which can be more unsightly than the lesion itself, if not done correctly,” he adds.

In talking to more Black women with DPN, I found that few of us cared about the health implications. Kendra Jeel is an influencer whose focus is empowering women and is very transparent on TikTok, so I DMed her to ask how she felt about her DPN.

Jeel said that his DPN gradually became more pronounced as he got older. “Because my skin becomes more visible as I age, it reminds me of my mother’s beauty,” she says. “It never took away from its beauty, even though I used to view it as something scary (wishing I didn’t get it). But I have seen that with them, I changed my perspective on aging and beauty changed too.”

Is There a Way to Prevent or Treat DPN?

“DPN cannot be prevented,” explained Kikam. “We don’t know the cause, but we do know there is a genetic predisposition to DPN.”

However, it may have something to do with sun exposure, which is often the biggest concern dermatologists warn patients about, even black and melanated people.

“DPN tends to occur mainly in areas of the body that are exposed to sunlight, such as the head, neck and upper body,” said Kikam. “So although we don’t know the primary cause of the lesions, we think there is a potential association with cumulative sun exposure that cannot be excluded.”

According to the DPN medical review, previous research showed that “dark-skinned patients using topical treatments for artificial depigmentation experienced exacerbation of DPN, possibly due to decreased UV (ultraviolet) protection from skin pigment loss.” The general overview states that exposure to UV light may play a role in the development of DPN, but Kikam said that this could not be said with certainty as the cause.

Caring for skin with DPN includes two main requirements: keeping the skin protected from sunlight, and maintaining moisture so it doesn’t dry out.

Kikam emphasized that it is important for black people to protect their skin from the sun. “I strongly and frequently emphasize the use of sun protection in the form of sunscreen, wide-brimmed hats and scarves to minimize exposure to UV rays,” said Kikam.

She also recommends these products, none of which will leave a white cast on dark skin: TIZO Photoceutical AM Replenish Lightly Tinted SPF 40 broad spectrum mineral sunscreen with antioxidants, Venus Williams’ Eleven broad spectrum 100% mineral Unrivaled Sun Serum 35 SPF, and EltaMD UV Elements Broad Spectrum SPF 44 Tinted.

Like many other women with DPN, my features became more apparent later in life. And as a 37-year-old millennial, I’ve developed my own skincare routine that makes me feel beautiful. I never viewed my DPN as anything unfavorable, as I always found it beautiful and enjoyed compliments from people, even from those who asked, “Are your ‘freckles’ real?” For me, I often say that it’s the chocolate chips that make my face so much cuter.

Leave a comment