What Are Those Dark Spots On My Cheeks? How to Know When to be Concerned

As people of color, like everyone else, grow older, our skin begins to show signs and symptoms such as dark spots, wrinkles, dryness, oiliness – and everything in between. Sometimes we know these signs are innocent, but other times they can be a bit worrying. How do you know if that weird mole that sprouted up is benign, or something more?

Well, what's better than getting the rundown on skin spots from a doctor? Today, we have Dr. J taking over the Alpha Blog to give everyone an in-depth look into dark spots.

Small brown or black spots on your cheekbones or around your eyes are probably Dermatosis Papulosa Nigra. These spots are not medically concerning and are not cancerous. Dermatosis Papulosa Nigra affects 35% of African Americans. It is more common in dark-skinned African Americans. Dark-skinned Asians and Polynesians are also affected but, unfortunately, the frequency of Papulos Nigra in Asians and Polynesians is unknown. You may develop more spots as you age.

What Causes Dermatosis Papulosa Nigra?

Unfortunately, no one knows what causes these types of dark spots – yet. The science is inconclusive though studies have suggested a potential association with cumulative ultraviolet (UV) exposure. Women are twice as likely to be affected as men. 77-93% of patients with Dermatosis Papulosa Nigra report positive family histories.

How Can I Treat My Dermatosis Papulosa Nigra?

Currently, the only treatment options involve a procedure which involves the removal of the spots with cutting, shaving, freezing, burning, scraping, peeling, or lasering. The problem with these procedures is that you can develop scarring and discoloration where you receive treatment. Further, even if you have insurance, it may not cover the procedures that you need and you will have to pay out of pocket. These procedures can be quite expensive!

Identifying Dermatosis Papulosa Nigra – How Do You Know You Have It?

If you suspect that you have Dermatosis Papulosa Nigra, it's a good idea to get a doctor to take a quick look at it so they can confirm your suspicions. Remember, with any new spots on the skin, it's a good idea to have a trained physician examine your skin for signs of something more dangerous, like skin cancer.

That said, to identify whether your spots are just Dermatosis Papulosa Nigra, you can tally your signs and symptoms against the following:

  • The brown or black spots of Dermatosis Papulosa Nigra most commonly occur on the cheeks and around the eyes.
  • You may also notice them on your neck, chest, and back, too.
  • They may be flat or look like a skin tag and are less than ¼ inch in diameter.
  • The spots are round with smooth edges. Scaling, crusting, and ulceration do not occur.

When to See a Doctor – Dermatosis Papulosa or Something More?

When it comes to skin spots, what you don't want to miss is a skin cancer – and yes, people of color get skin cancer, too! Skin cancer represents 4‐5% of all cancers in Hispanics and 1‐4% of all cancers in Asians, Asian Indians and African‐Americans. Although skin cancer is more common in populations with lighter skin, people of color are more likely to die from skin cancer than Caucasians and other light skinned populations . The reason for this is that skin cancer is usually diagnosed later in people of color than in Caucasians.

When it comes to skin cancer, it's also good to note that there are different types of skin cancer, with some being more dangerous than others. The scariest type of skin cancer is melanoma. Melanoma are dark brown to black lesions that can be flat, raised or ulcerated (form a vesicle or blister and easily bleed). Edges of these lesions are irregular. Melanoma can be on the found feet, palms, fingernails, toenails, and inside of the mouth. The lesions can be painless or painful. They can also travel to other parts of the body (metastasize).

Other types of skin cancer can be flat or raised, shiny, red, pink or brown. They can be painless or painful.They can bleed, scab, grow, and change shape and color. These skin cancers occur anywhere on the body.

So, if you find that you're having any type of skin spots or lesions that bleed, scab, grow, or change shape and color, you know it's time to see a doctor.

Can Skin Cancer be Treated If Caught Early?

Basal cell and squamous cell carcinomas are the two most common forms of skin cancer. These types of skin cancer are highly curable if detected early and treated properly.

Outcomes of patients diagnosed with melanoma is measured in five-year survival rates and vary based on spread of the disease. If melanoma is detected and treated before it spreads to the lymph nodes, then the five-year survival rate is 99 percent. Five-year survival rates for patients with melanoma that has spread into nearby tissues is 64%. Five-year survival rates for distant stage melanomas are 23 percent.

But I Never Sunburn! Do I Still Need to Worry?

Remember, even if you have darker skin that doesn't burn easily, you still need to be wary of the effects of the sun. Skin of color does not burn easily, but the sun's rays still cause skin cancer. On a lesser, but still concerning note, the sun's rays also cause acceleration of the aging process and changes in skin pigmentation.

People of color, like everyone else, need to use sunscreen that is SPF30 SPF, or greater, everyday. Reapply sunscreen every 2 hours while in the sun; wear broad-brimmed hats, long sleeves and pants; never use a tanning bed, and eat a healthy diet to get an adequate amount of Vitamin D.

Dark Spot Takeaways

Now you know – dark spots on your skin can be completely harmless, but can also be signs that you need to see a doctor. Luckily for us, it's pretty clear when you need to see a doctor. As long as your spots are not changing in shape or color or bleeding, you're basically in the clear. Just remember to wear your SPF!

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