moles or freckles

I get that question every other day as i see quite a number of patients with these growths at my place of practice daily.

moles or freckles

These black colored, fleshy, small multiple growths are called “DERMATOSIS PAPULOSA NIGRA (DPN)”.  It is a big, long name for a relatively harmless condition, with mostly cosmetic concern for those that have them.

Histologically/ Microscopically they are similar to Seborrheic keratosis which are seen worldwide in older people and are just abnormal but harmless growths from some cells on the outermost layer of the skin (keratinocytes). So in summary DPN is the ethnic variant of Seborrheic Keratosis.

DPN presents mainly in dark skin and lighter ethnic skin types have less of them. They are extremely common with up to 30% of all Black Americans having them(1), they are even called the “Morgan Freeman moles”.

There are no Nigerian statistics but they are extremely common. They are hereditary, seen more in females than males and increase in quantity and size with age. This increase can also be seen during pregnancy and following the use of certain creams especially the steriod containing lightening creams that age the skin as a side effect. Infact, the most profuse variants of DPN I have seen in practice have been in patients that have a long history of using all types of bleaching creams and had invariably used steroid containing types.

There is really no way to stop DPN from coming up once one has inherited the potential to have them, however they can be minimized by avoiding the use of the bleaching creams mentioned above.

Thankfully, there are many ways of treating DPN presently with great results.  At my place of practice we use the fine tipped electrocautery/electrodessication or KTP laser with a very small spot size. We apply a numbing cream before the procedure to minimise discomfort and use an antibiotic cream for 5 days afterwards to reduce chances of infection. After the procedure patients may experience a little discomfort after the numbing cream wears out, mild swelling and redness on the treated areas which goes down in at most 72 hours (all things being equal). Usually there are no long lasting side effects but very few patients experience prolonged pigment change in the treated areas and the risk of keloids is always there when treating ethnic skin.

Other methods of removing DPN worth mentioning which we don’t use at our Clinic though because of the higher risk of scarring are currettage and cryosurgery. With currettage a fine instrument is used to scrape off the DPN lesions while extreme cold is used to destroy the DPN lesions in cryosurgery.

DPN is completely benign, non-cancerous and removable if they bother you cosmetically. To the best of my knowledge there are no creams or pills that can satisfactorily remove or stop the proliferation of DPN.

Thank you for reading!

  1. May 31, 2018

    Thank you for this write up, it has widen my knowledge. But may I know the price range of such treatment and consultation if inclusive.

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