A decade spent covering skin care and interviewing dermatologists created a false sense of confidence. After years of reporting on treatments and talking to experts, a beauty editor believed she could diagnose her own skin concerns. That confidence crumbled during a casual dinner conversation at the American Academy of Dermatology's annual meeting in Denver.
The culprit: a cluster of spots on her cheekbones. When they first appeared years earlier, she assumed acne scarring, despite having no major breakouts in that area. Later, she wondered if they were sun damage from years living in Miami. Dr. Victoria Humphrey, a New York-based dermatologist, quickly identified them as something neither of those guesses.
The diagnosis was dermatosis papulosa nigra, or DPN, a common benign skin condition sometimes called "Black girl freckles." For a mixed-race woman of Japanese and Puerto Rican heritage, the label felt unexpected. While DPN shows up most often on Black skin, it also affects people of Asian, Hispanic, and other ethnicities. Her spots appeared as a lighter brown, clustered in a characteristic pattern, slightly raised, and stubbornly unresponsive to every brightening serum she'd tried, including her beloved SkinCeuticals C E Ferulic.
DPN typically starts appearing in the late 20s or early 30s as small, raised spots that cluster together. While the cheeks, eyelids, and temples are the most common locations, DPN can also appear on the neck, chest, shoulders, and upper back. The condition is recognizable enough that people often search for it online as "Morgan Freeman moles," a nod to the actor's visible DPN.
The confusion between DPN and other skin concerns is easy to understand. Skin tags are soft and fleshy, usually found in body folds like the neck or underarms. Warts have a rough, cauliflower-like texture and can appear anywhere from the face to the feet. Moles can be flat or raised, grow from deeper skin layers, and typically appear singly or scattered randomly. DPN spots, by contrast, are consistently dark and pigmented, sit on the skin's surface, and follow a distinctive clustered pattern on the face.
Genetics plays the biggest role in whether someone develops DPN. If parents or grandparents have it, there's a high likelihood their children will too. Sun exposure likely influences how many spots develop and how quickly they appear, but it doesn't cause DPN on its own. For someone who spent years in sunny Florida, the timing of her spots may or may not have been influenced by UV exposure, a reminder of the importance of consistent sun protection regardless.
The bad news for anyone hoping to fade DPN with topical treatments: they don't work. Vitamin C serums, exfoliating acids, and retinoids won't touch them. In-office procedures are the only effective option for removal. Electrodesiccation uses a tiny electric needle to zap each spot. Curettage gently scrapes them away. Laser treatments and cryotherapy, which freezes spots with liquid nitrogen, are also options. Some providers use surgical scissors for simple snip removal.
For darker skin tones, the electric needle method and certain lasers tend to work best because they allow the most precision with minimal trauma to surrounding skin. Treatment doesn't come cheap. Expect to pay anywhere from $250 to $1,000 per session, depending on the number of spots and the provider. Since DPN removal is considered cosmetic, insurance typically doesn't cover it.
Post-inflammatory hyperpigmentation is the most common complication, where the skin produces extra pigment and leaves a dark mark where the spot was removed. The opposite can also happen, with treated areas losing pigment and appearing lighter than surrounding skin. People with deeper skin tones face a higher risk of scarring or keloids, the raised, thickened scar tissue that sometimes forms at treatment sites.
A skilled provider who regularly treats patients with melanated skin knows how to minimize these risks. None of this should discourage anyone from seeking treatment if they want to, though there's an important catch: treatment removes existing spots, but new ones can develop over time. It's not a sign something went wrong. It's just how DPN works. Think of it less as a one-time fix and more as ongoing maintenance, similar to managing other skin concerns across a lifetime.
Any changes in shape, size, or color warrant a dermatologist appointment. DPN is completely harmless from a medical standpoint, but spots that bleed without being scratched or irritated, or spots that look noticeably different from others on the body, should always be checked by a board-certified dermatologist.
Learning what DPN actually was shifted how the editor saw her skin. What once felt mysterious, or like a stubborn game of whack-a-mole, turned out to be simply a common condition in skin of color like hers. The decision to treat it ultimately comes down to personal preference, not medical necessity.
Author Jessica Williams: "Even beauty editors need dermatologists to set the record straight, and frankly, that's exactly how it should be."
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