I had no idea what the multitude of molelike freckles were that had appeared on my face partway through life. All I knew was that these beauty marks, spread across my cheeks and forehead, were a perfect blend of my mother and father, who also have them. They made me feel like there was something I received equally from both of them, so I embraced the freckles but never thought too much of them. It wasn’t until I became an adult that I realised there’s a medical term for this, and that other Black women have a diverse range of experiences with dermatosis papulosa nigra.
DPN is a common skin condition that primarily affects people with melanated skin tones, including Black women of African, Afro Caribbean or African American descent. It’s characterised by small, benign papules that are dark brown to black in colour and typically appear on the face and neck. These papules are often mistaken for moles, freckles or warts, but they are a little different.
A Movement Toward Embracing DPN
As part of a broader shift in redefining beauty standards, DPN is becoming more accepted these days — but it hasn’t always been this way. For Black women who grew up with a skin type that wasn’t the smooth texture idealised by typical beauty standards, something like DPN can be triggering — especially when remembering how often products like Proactiv were shoved in our faces. There was an idea that DPN had to be “fixed,” reinforcing the messaging that anything other than smooth skin was not normal, and therefore not beautiful or even visually acceptable.
In recent years, Black women have led the way in challenging outdated norms and fostering a more inclusive and empowering definition of beauty. Many are now more open with their natural bodies and skin, and not always covering it up with makeup or ridding themselves of their DPN beauty marks. As the conversation around the condition continues to gain momentum, it’s clear that the future of beauty is diverse, celebrating the uniqueness of every individual and every skin type.
Having spoken to Black women with DPN, I got a greater sense that as we age, we are accepting ourselves, our bodies and our beauty.
Are There Health Risks To DPN?
Jannah Abdul-Rahman, a mother of four, found herself being teased in her middle and high school years because of her DPN. Children found a way to instill the idea that her DPN made her different. She recalled that kids would attempt to “rub her Black girl freckles off,” question if they were real, or turn their faces in displeasure and ask, “What’s all that on your face?”
“I never wanted to get them removed until someone mentioned the potential for cancer,” Abdul-Rahman told HuffPost. But fortunately, that notion is misguided.
According to Dr. Adeline Kikam, a board-certified dermatologist and the founder of Brown Skin Derm and Skinclusive Dermatology in Houston, DPN is not associated with any health risks, including skin cancer. However, Kikam affirmed that while the lesions are benign, it’s important to get an examination by a dermatologist if there are symptoms such as swelling, pain or bleeding. Some women find that after pregnancy or simply getting older, their DPN becomes more pronounced, causing the lesions to protrude on the skin.
Can (And Should) DPNs Be Removed?
Kikam noted that some Black women opt to get their DPN removed for beautification purposes. She said that “DPNs can be removed through several methods,” like snip excision, light curettage with or without anaesthesia, light electrodesiccation or cryotherapy. “But in darker-skinned individuals, this should always be weighed against the risk of hyperpigmentation or hypopigmentation and scarring that can end up being more unsightly than the lesions themselves, if not properly done,” she added.
In speaking to more Black women with DPN, I found that few of us are concerned with the health implications. Kendra Jeel is an influencer whose focus is empowering women and being very transparent on TikTok, so I slid in her DMs to ask how she felt about her DPN.
Jeel said that her DPNs have gradually become more pronounced as she’s gotten older. “Since they’ve become more apparent as my skin ages, it reminds me of my mother’s beauty,” she said. “It never took away from her beauty, even though I used to look at them as something to fear [hoping that I wouldn’t get them]. But I’ve seen that with them, I’m reframing how my perspective on aging and beauty is changing as well.”
Are There Ways To Prevent Or Treat DPN?
“DPNs cannot be prevented,” Kikam explained. “We don’t know the cause, but we know there is a genetic predisposition to DPN.”
However, there may be a link with sun exposure, which is often the biggest concern that dermatologists warn patients about, even for Black and melanated people.
“DPNs tend to occur mostly in sun-exposed areas of the body, like the head, neck and upper trunk,” Kikam said. “So while we do not know the underlying cause of the lesions, we think there is potential association with cumulative sun exposure that cannot be ignored.”
According to one medical overview of DPN, a prior study showed that “darker-skinned patients who used topical treatments for artificial depigmentation had an exacerbation of DPNs, possibly due to decreased UV [ultraviolet] protection from loss of skin pigment.” The overview said that UV exposure may have a role in the development of DPN, but Kikam said that it can’t be stated definitively as a cause.
Treating skin with DPN includes two key requirements: keeping the skin protected from the sun, and keeping it moisturised so it doesn’t dry out.
Kikam stressed that it’s important for Black people to protect their skin from the sun. “I strongly and often emphasise the use of sun protection in the form of sunscreen, wide-brim hats and scarves to minimise UV exposure,” Kikam said.
She also recommended these products, none of which will leave a white cast on dark skin: TIZO Photoceutical AM Replenish Lightly Tinted SPF 40 broad-spectrum mineral sunscreen with antioxidants, Venus Williams’ Eleven broad-spectrum 100% mineral Unrivaled Sun Serum 35 SPF, and EltaMD UV Elements Broad Spectrum SPF 44 Tinted.
Like many other women with DPN, my features have become more apparent later in my life. And as a 37-year-old millennial, I have developed my own skin care routine that makes me feel beautiful. I never looked at my DPNs as something to frown upon, because I have always found them to be beautiful and enjoyed the compliments from people, even those who ask, “Are your ‘freckles’ real?” For me, I often say that they’re chocolate chips that make my face just that much sweeter.