Celeb Derm-Mystery:


What's Up With Bill Cosby's Spots?


Comedian Bill Cosby has been an entertainment icon for decades.  Via standup, movies, albums and his groundbreaking sitcom, “The Cosby Show,” Cosby has not only made audiences laugh, but has acted as a role model as well. As Dr. Cliff Huxtable, Cosby played a respected physician, a loving husband and a caring, if stern, parent.  More recently, Cosby has taken upon himself the role of advisor to parents and young people, promoting responsibility, accountability and self-reliance.


Yet for the last several years, there has been a visible flaw on this public façade.  Cosby’s projected perfection has been marred by a dermatological distraction. People say don’t sweat the small stuff.  Yet occasionally, an icicle may really be the tip of an all encompassing iceberg.  Just ask The Titanic.

 


The dark lesions that dot Cosby’s face are called dermatosis papulosa nigra (DPN’s), essentially “dark skin bumps.” Despite looking like contagious warts, they are not caused by a virus or any sexually transmitted disease.   Though they are black and gradually grow in size and number, their presence does not portend cancer or suggest systemic health problems.

 

Questionable dietary choices, like over-consumption of jello pudding, or potentially risky behaviors, such as cigar smoking, play no role in their development. Found more commonly in people of color, DPN’s simply arise with advancing age.  Cosby, African-American and in his late 70’s, is in the routine DPN demographic. No dermatologist would be surprised or concerned to diagnose these lesions on someone the same age and race as Cosby.


When patients elect to have DPN’s treated, the driving force is typically cosmetic, a desire for skin that is smooth and bump-free. Treatment can be performed safely and painlessly with a topical anesthetic.  Low strength electric zapping, called hyfrecation, works well, some doctors also treat with lasers.  Treatment is not wildly expensive.  The results tend to be remarkably good, usually healing without scarring or discoloration. 


This begs the question:  Wouldn’t a high profile, wealthy entertainer want to consider a treatment that should be affordable, relatively painless and scar-free?  Wouldn’t a face without warty looking spots best reflect an individual self-appointed to be a role model? Why wouldn’t someone in Bill Cosby’s position keep these distracting lesions at bay?


Is it possible that there is something lurking in the past, unknown acts that may never be admitted, that are creating subconscious feelings of shame? Could these benign bumps actually represent a strange, self-imposed modern day scarlet letter?



Runner up:  Celeb Derm-Mystery:

What is Cindy Crawford going to do about her beauty mark?


Former supermodel Cindy Crawford single-handedly put the beauty mark back on the media map. 
The small dark mole provided the perfect accent to her full lips and separated her from the pack of other aspiring models. 
Over time, however, facial moles tend become lumpy, raised and lose their dark color. This is current appearance of Crawford's mole.

These are not dangerous changes, except on an aesthetic level.  Shall she let the lesion continue to grow and potentially droop?  Have it entirely removed, like fellow fashionista Sarah Jessica Parker?

 Or possibly undergo a shave procedure, flattening the lesion and restoring its dark, alluring hue? The mystery deepens...



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