Skin Challenge: DPN

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Dermatosis papulosa nigra (DPN) is characterized by small brown or black spots found on the skin around the cheekbones and eyes. It can also be found on other areas of the face, neck, chest, and back. Some people with dermatosis papulosa nigra have a few, isolated spots while others have hundreds of spots. The spots may be flat or hang off the skin like a skin tag. Scaling, crusting, and ulceration do not occur.

The spots are neither cancerous nor medically concerning, but they may be itchy, irritating, or cosmetically undesired. DPN spots are usually present as multiple small, 1–5 mm diameter, smooth, firm, black or dark brown papules that are deemed another type of seborrheic keratosis.

The papules are symptomless but may be regarded as unsightly. They are common in people with skin of color, with Fitzpatrick skin types 4, 5, or 6. This condition affects up to 35 percent of African Americans, yet has a lower frequency in same group with a fairer complexion. Dermatosis papulosa nigra also occurs among dark-skinned Asians and Polynesians, but the exact frequency is unknown. Females are more frequently affected than males. Dermatosis papulosa nigra usually begins in adolescence. The incidence, number and size of lesions increases with age.

SPA MANAGEMENT

What is the cause of Dermatosis Papulosa Nigra in your client?

Dermatosis papulosa nigra is likely to be genetically determined with 40–50 percent of patients having a family history. It is believed to be due to a naevoid developmental defect of the hair follicle; otherwise, cause is unknown.

Determine any medications, contraindications, and cautions before proceeding with any spa treatment.

Treatments that can be offered:

Electrodessication
Cryotherapy
Laser therapy

Estheticians: Treatment for DPN is complicated as it occurs mostly in people of color who are at a higher risk of developing pigmentation defects (lightening or darkening of the skin) and scarring following treatment. The result can be a blotchy or scarred appearance on the skin, which could be worse than the original dermatosis papulosa nigra spots.

DISCLAIMER: Work within the scope of your license/certification.

About the Author

Mórag Currin is a highly sought-after esthetic educator with more than 27 years of spa industry experience and more than twelve years of training and training management experience. She travels around the globe with her training and expertise, helping to raise the bar in the spa industry and to open the door to all people, regardless of skin type or health condition. To learn more about this topic and many other skin challenges, diseases, and symptoms, check out Mórag’s book, Health Challenged Skin: The Estheticians’ Desk Reference.