A DPN, or dermatosis papulosa nigra, is a small, harmless skin growth that appears as a dark or skin-colored bump, most commonly on the face and neck. These growths typically range from 1 to 5 millimeters in size and tend to first show up during adolescence, gradually increasing in number over time. Up to one-third of African American adults in the United States have DPN, and the condition is also common in people of Asian descent.
What DPNs Look and Feel Like
DPNs are smooth, round, slightly raised papules that can be either darker than surrounding skin or match your natural skin tone. They’re usually flat or barely raised, sometimes on a tiny stalk. Most appear on the cheeks, forehead, temples, and around the eyes, though they can also develop on the neck, chest, and upper back. Individual bumps are small, often compared to the size of a pinhead or a few grains of sand clustered together.
The bumps are painless and don’t itch. They don’t bleed, ooze, or change texture. A person might start with just a few in their teens or twenties, then gradually develop dozens or even hundreds over the following decades. Morgan Freeman’s prominent facial spots are a well-known example of DPNs. The condition carries zero risk of becoming cancerous.
Who Gets Them and Why
DPNs overwhelmingly affect people with darker skin tones. Reported incidence rates in African American individuals run as high as 70 percent, while roughly 40 percent of African individuals develop them. In broader study populations of people with darker pigmentation, rates range from 10 to 75 percent depending on the group studied. The condition also appears in people of South Asian, Southeast Asian, and East Asian backgrounds, though less frequently.
The exact cause isn’t fully understood, but genetics play a strong role. DPNs often run in families, and researchers have identified mutations in a growth-signaling gene (FGFR3) in many DPN samples. Cumulative sun exposure also appears to contribute, which helps explain why the bumps concentrate on sun-exposed areas like the face and why their numbers increase with age. Women tend to develop more lesions than men.
How DPNs Differ From Other Skin Growths
Under a microscope, DPNs look similar to seborrheic keratoses, those waxy, “stuck-on” growths common in older adults of all skin types. However, there are consistent structural differences. DPN tissue contains more prominent fibrous tissue within its growth structures, and it lacks the tiny cyst-like pockets commonly found in seborrheic keratoses. In practical terms, the distinction matters mostly to dermatologists confirming a diagnosis. For patients, the key point is that DPNs are entirely benign and don’t require monitoring for cancer.
Removal Options
Because DPNs are harmless, removal is purely cosmetic. Many people choose to leave them alone. For those who want them removed, the most common methods are electrodesiccation (using a small electrical current to destroy the growth), curettage (scraping it off with a small instrument), cryotherapy (freezing), and laser treatment. A comparison trial of 10 patients found all three tested methods performed similarly: curettage cleared 96 percent of treated lesions, electrodesiccation cleared 92.5 percent, and pulsed dye laser cleared 88 percent. Half the patients in that study preferred electrodesiccation. Interestingly, patients rated the laser as the most painful option.
Removal is typically done in a dermatologist’s office without general anesthesia. Most sessions take under 30 minutes depending on how many bumps are treated. The bumps that are successfully removed generally don’t return in the same spot, but new DPNs will continue to develop elsewhere over time, so some people return for periodic treatments.
The Biggest Risk of Treatment: Skin Darkening
For people with darker skin, post-inflammatory hyperpigmentation (temporary darkening at the treatment site) is the primary concern with any removal method. In a study of 137 patients with darker skin who underwent electrodesiccation, every single participant developed some degree of darkening at the one-month mark. On average, this discoloration took about five to six months to fully resolve, with some patients reporting it lasted closer to six months by their own assessment.
Scarring, by contrast, is rare. In that same study, only 2 out of 137 patients (about 1.5 percent) developed scars after one year, and both cases occurred on the neck or chest rather than the face. Still, the near-certainty of temporary darkening means you should discuss realistic expectations and timing with a dermatologist before treatment, especially if you’re considering removal before an event or specific date.
Living With DPNs
Since sun exposure contributes to the development of new DPNs, consistent sunscreen use and sun-protective habits may help slow the rate at which new bumps appear. This won’t eliminate existing ones or guarantee prevention, but it’s a reasonable step given what’s known about the condition’s triggers.
There are no effective over-the-counter creams or home remedies that safely remove DPNs. Products marketed for skin tag or wart removal can cause burns, scarring, or severe hyperpigmentation on darker skin and should be avoided. If DPNs bother you cosmetically, professional removal by a dermatologist experienced with skin of color is the safest path.