What is Seborrheic Keratosis?
A seborrheic keratosis is a type of harmless, benign skin growth. They usually arise in multiples in patients over the age of 40, and sometimes irritate because of their elevated, dry, and scaly nature. However, in some cases, a seborrheic keratosis can be challenging to distinguish from dangerous types of skin cancer. A seborrheic keratosis is easily identified using the following parameters.
Location
Growths can be found in many areas of the body, including the scalp, face, shoulders, chest, back, and abdomen. They can be found anywhere on the body except on the soles of the feet or the palms.
Shape
Usually round to oval in shape. Sometimes they follow the lines of skin tension, for example, on the back.
Color
Growths are usually brownish; they sometimes appear to be black, white, or yellow.
Texture
Small, rough areas initially (macular seborrheic keratosis). Over time, they develop a thick, wart-like surface with a raised, waxy, "stuck-on" appearance.
What is It Caused By?
Seborrheic keratoses are very common across all races. It has been estimated that over 9 in 10 adults above the age of sixty have one or more of them. They occur equally in both sexes and usually begin to erupt between the ages of thirty to forty years. They are not common under the age of twenty years.
Signs and Symptoms
A seborrheic keratosis usually looks like a waxy or wart-like growth with a stuck-on appearance. It typically appears on the face, chest, shoulders, or back. Though multiple growths are common, you might develop a single growth. The color varies from brown to light tan or black. It has a round or oval shape with a characteristic "stuck on" look.
It is usually flat but may be slightly raised with a scaly surface. It varies in size from very small to more than 1 inch across. A seborrheic keratosis could also be itchy. This may occur for several reasons: growth, irritation, or picking due to a new or irregular bump. The various fissures and grooves on the surface of the seborrheic keratosis may soak up pigment from spray tanning agents or hair color; they may then appear suddenly darker and concerning.
Dermoscopy is an effective method to diagnose seborrheic keratosis, particularly if there is a need to distinguish it from skin cancer. It is important to let the experts at PS Dermatology & Surgery diagnose and manage any skin lesions you have; we are experts in dermoscopy and non-invasive diagnosis.
Treatment Options
In most cases of seborrheic keratosis, there is no need for further treatment. The doctor may recommend removing the growth if the diagnosis is not certain (that is, if it is difficult to distinguish from skin cancer), if the patient does not want it for cosmetic purposes, or if it causes discomfort like itching or irritation with clothing or jewelry rubbing against it.
There are several methods of removing seborrheic keratosis.
A spray gun or cotton swab is used to apply liquid nitrogen to the growth. At -195°C, liquid nitrogen freezes the seborrheic keratosis and it falls off after a few days. A blister may appear when the growth falls off; this will dry into a crust, which will heal in with normal skin.
Electrocautery, Curettage, or Both
In electrocautery (electrosurgery), the surgeon uses an electric current to burn (cauterize) the growth, under local anesthesia. In curettage, a scoop-shaped surgical instrument is used to scrape off the burnt growth. Some patients may require just electrocautery, while others require curettage or both. Sometimes combined with shave removal of the lesion.
Ablation
Ablation involves vaporizing the growth with a laser to get rid of it.
Home Care
There are no proven home remedies for seborrheic keratosis. Lemon juice or vinegar may irritate and possibly cause the growth to dry and crumble, but there is no evidence this is safe or effective and it can cause substantial irritation and pain. Substances such as tea tree oil can trigger allergic contact dermatitis. The best thing is to visit your dermatologist where we can safely, easily, and painlessly remove lesions that are concerning or bothersome.