Have you ever spotted tiny bumps on the skin beneath your eyes? Or maybe you've felt small lumps on your forehead, cheeks, or nose? Depending on the colour of the bumps, you may have either milia or dermatosis papulosa nigra (DPN).
Milia are formed by dead skin cells trapped beneath the skin at the base of hair follicles or sweat glands. The cause of DPN is unknown, but it does tend to run in families. Both types of skin bumps feel firm yet smooth to the touch. And both are harmless and quite common. One risk of either type of skin bump is that they may be mistaken for a different skin conditions. Milia, for instance, may be confused for acne, and DPN spots may mask potentially cancerous moles and should be watched for changes.
Milia tend to be 1 to 2 millimetres in size, with white or yellowish domes. The spots characteristic of DPN are dark brown or black in colour and may be a bit larger - from 1 to 5 millimetres.
Milia can occur on the skin of people of all ages and races, affecting women and men equally as often. Milia occur on the skin of nearly half of all newborn babies, affecting their eyes, cheeks, nose, and forehead. DPN occurs on the faces of about one-third of people of African descent and some people of Asian descent. Women tend to be more affected than men. While milia may fade, DPN spots may increase in size and number as a person ages.
Though harmless and not predictive of disease, both types of skin bumps can be removed by a dermatologist for cosmetic reasons. A dermatologist can extract milia bumps one at a time, using a tool called a comedon extractor (commonly used to remove blackheads). Milia may also be treated with chemical peels or with topical retinoid cream. DPN spots may be removed by scalpel or by being frozen or burned off of the skin. Laser therapy has been used successfully in some cases. Any procedure must be approached with caution due to risk of scarring or loss of skin pigmentation.
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