If you have dark brown or black lumps, tiny in size and multiple in number, sitting on the cheekbones and under the eyes, it’s likely you have dermatosis papulosa nigra. Despite the grand title, these are completely harmless. These usually feel smooth and soft and are each only 1 to 5mm wide, and you may have a few or many, of differing sizes. They appear from the teenage years onwards and don't usually cause any symptoms, but some find them unsightly, especially with their prominence on the face.
There isn't any treatment per se, but a private dermatologist may choose to treat them surgically. This condition is more common in those of Afro-Caribbean descent and women get them more often than men. They often run in families. These are thought to be similar to seborrhoeic keratoses, harmless brownish spots that appear anywhere on the body, but dermatosis papulosa nigra tend to appear much earlier in life. They are not contagious, and can't be passed on.
There are some treatments that can be used to reduce the appearance of hyperpigmentation associated with dermatosis papulosa nigra. Aside from using make-up that contains sun protection, you can use creams such as Fade Out or similar that are available from pharmacies and popular health and beauty retailers. Fade Out cream can be applied daily, and is formulated with SPF 25 for UVB protection plus UVA protection to prevent the ageing and skin darkening effects of the sun. It contains extracts of mulberry and liquorice that penetrate deep into the skin's outer layers, working together to help reduce the production of melanin, our natural pigment. It also contains niacinamide (Vitamin B3) to help to inhibit the transfer of melanin to the upper layers, where it would become visible on the skin’s surface. Other products such as Bio-Oil can also be used since it is formulated especially to help improve the appearance of scars, stretch marks and uneven skin tone through regular use.
If you are unsure of your diagnosis, you should book a routine appointment with your doctor, who will consider your symptoms and examine you. If one of the spots has changed or looks different to the others, you should book an urgent appointment in case this needs a specialist opinion. You should seek a private dermatologist if you wish to discuss any treatment options, as the NHS does not offer treatment for this condition.