What Is Dermatosis Papulosa Nigra (DPN)?

Dermatosis papulosa nigra (DPN) is a common, benign skin condition that causes small, dark, raised bumps, usually on the face and neck. DPN is considered a variant of seborrheic keratosis. DPN is genetic, so if either of your parents have it you are more likely to develop it. DPN is benign, meaning it does not turn into cancer and treatment is elective or cosmetic. 

 

How Does Dr. Fix Treat DPN?

DPN can be treated several ways, including radiofrequency, electrosurgery, gentle curettage (scraping), snip removal, freezing, and laser. Because skin prone to DPN is also prone to pigment changes, the choice of method matters

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Dr. Fix treats DPN with radiofrequency. A fine-tipped instrument delivers a small, precisely controlled amount of radiofrequency energy to each bump, so the bump is treated while the surrounding skin is left largely undisturbed. This precision is well suited to the small, clustered bumps of DPN on the face and neck. Dr. Fix avoids freezing for DPN because freezing often leaves lighter spots on darker skin, called hypopigmentation.

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What to Expect During Treatment

• Numbing: A topical numbing cream is applied before treatment.

• Sensation: Most people feel brief warmth or a light sting with each treated bump.

• Time: A typical session takes about 15-30 minutes, depending on how many bumps are treated.

• Most people require 1 test treatment followed by 1-2 treatment sessions, a test area is recommended as results can be more variable on darker skin tones 

• Right after treatment: Treated areas create small wounds in the skin. A medical grade cellulose powder is applied to protect the treated areas and speed healing. Small scabs will form within 48 hours. 
   

Healing and Aftercare

• Each treated bump forms a tiny dark crust that flakes off on its own in about 7-14 days, leaving smoother healed skin underneath.

• Avoid moisture on the treated areas for 48 hours, and keep the area clean while healing

• Let crusts fall off naturally. Picking increases the chance of dark marks.

• Protect treated skin with a mineral sunscreen (SPF 30+). Sun exposure can darken healing skin.

• Makeup can be resumed once the scabs fall off

• Most people return to work and normal activity the same day.
   

Will Treatment Affect My Skin Tone or Leave a Scar?

Any procedure that removes skin tissue carries some risk of scarring or pigment change. With DPN, the main concern is temporary darkening (post-inflammatory hyperpigmentation) or, less often, lightening of the treated spot. Darkening usually fades over weeks to months. People with a history of keloids should tell Dr. Fix before treatment.

Dr. Fix evaluates your skin tone, the location and thickness of each bump, and your healing history before treatment, and talks through expected healing and realistic results with you. Because results can be more variable on darker skin tones, Dr. Fix often recommends starting with a test area to see how the skin heals. 

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What Does DPN Look Like?

DPN typically appears as:

• Small bumps or streaks, usually 1 to 5 millimeters across

• Dark brown to black in color

• Smooth and dome-shaped

• Clustered on the cheeks, around the eyes, on the forehead, or on the neck

• Usually painless, though they can occasionally itch or catch on clothing, jewelry, or a razor

Most people notice a few bumps in their teens or twenties, and the number and size tend to increase over time.
 

DPN vs. Skin Tags, Moles, and Seborrheic Keratosis

These growths can look alike, which is why a professional evaluation matters before any treatment.

• DPN: small, dark, smooth bumps, often many, on the cheeks, around the eyes, and on the neck. Most common in darker skin tones, starting in the teens to adulthood.

• Skin tags: soft, skin-colored flaps on a thin stalk, usually on the neck, underarms, eyelids, and skin folds.

• Moles: flat or raised spots, brown or skin-colored, that can appear anywhere and usually develop in childhood or young adulthood.

• Seborrheic keratosis: waxy, "stuck-on," rough or crusty growths on the chest, back, face, or scalp, most common after age 40.
   

Who Gets DPN?

DPN is most common in people with medium to dark skin tones. It is more common in women and often runs in families. DPN can occur in lighter skin as well, where it is usually less noticeable.
 

Is DPN Dangerous?

No. DPN is benign and does not require treatment. Removal is a personal, cosmetic choice.

Some skin cancers and other conditions can look similar to a benign DPN growth. A spot that is changing quickly, bleeding without a clear reason, painful, irregular in shape or color, or different from your other bumps should be evaluated before any cosmetic treatment.
 

How Is DPN Evaluated?

Dr. Erin Fix examines each growth before cosmetic treatment using dermoscopy, a magnified, lighted exam that shows details not visible to the naked eye. If a growth has uncertain or concerning features, she may recommend additional evaluation or a biopsy before cosmetic treatment.
 

Why Remove DPN?

Common reasons include:

• Wanting a smoother, more even appearance on the face or neck

• Bumps that make makeup application uneven

• Bumps that catch on razors, clothing, necklaces, or glasses

• Self-consciousness about bumps that have grown in number over the years

 

Can DPN Come Back?

Treated bumps usually do not return in the same spot. Removal does not prevent new bumps from developing over time, so some people choose periodic maintenance visits.
 

Cost, Insurance, and Consultations

DPN removal is a cosmetic/elective procedure and is generally not covered by insurance. Cost depends on the number and size of bumps treated. A typical session costs $500-$800. Every patient starts with a free consultation. Dr. Fix examines your skin, determines if you are a candidate for treatment, explains the options, and gives you a clear price before treatment is scheduled. 

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Appointments: Wednesdays and Fridays, 9 a.m. to 4 p.m.
Location: 15962 Boones Ferry Rd #102, Lake Oswego, OR 97035
Phone: 503-245-6516

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Frequently Asked Questions About DPN
 

Q: Are DPN and skin tags the same thing?

A: No, though they can look alike. Skin tags are soft, skin-colored flaps on a thin stalk. DPN bumps are usually darker, smaller, and clustered on the face. Dr. Fix treats both and can tell you which you have.
 

Q: Can I remove DPN at home?

A: At-home removal products, cutting, or freezing kits can cause burns, infection, scarring, and dark marks, especially on darker skin. They can also delay evaluation of a spot that needs a closer look. Professional removal is safer.
 

Q: Does DPN removal hurt?

Most people feel only brief, mild discomfort. Numbing is used to keep treatment comfortable.

 

Q: How many bumps can be treated in one visit?

Many bumps can often be treated in one session. Dr. Fix will recommend a plan based on the number, size, and location. Most patients need 1-2 sessions. 
 

Q: Is DPN removal safe for dark skin?

A: DPN removal can be done safely in darker skin with a conservative technique and good aftercare.There is risk of pigment changes, and Dr. Fix discusses it at your consultation along with the option for treating a test area to assess healing on your individual skin.
 

Q: Can bumps near my eyes be treated?

A: DPN is common around the eyes. Whether a specific bump can be treated depends on its exact location, which Dr. Fix evaluates at your consultation.
 

Q: Will my insurance cover DPN removal?

A: Generally no, since removal is cosmetic.
 

Q: How long until my skin looks normal?

A:Crusts usually fall off within about two weeks. Any temporary darkening can take several weeks to a few months to fade.
 

Q: What is the best time of year for treatment?

A: Many people prefer fall and winter, when sun protection during healing is easier. Treatment is available year-round.
 

Ready for Smoother Skin?

Schedule a free consultation with Dr. Erin Fix to find out whether your bumps are DPN and whether they are appropriate for cosmetic removal.

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