What are Seborrheic Keratoses? 

Seborrheic Keratoses (singular: Seborrheic Keratosis) are harmless common skin growths.  They occur during adult life, and may gradually increase in number.  Some persons have very large numbers of them.  While the cause is unknown, most experts believe they are not caused by sun exposure.  Under clothing and around the neck they may be due to irritation of the skin.

They should not be confused with Actinic Keratosis which is cancerous or age spots. If you are not sure which type you have, ask your Dermatologist who can usually recognize the difference without a biopsy.  In unusual cases, a shave or punch biopsy may be necessary to distinguish the two types.

What do they look like?

Seborrheic keratoses begin as slightly raised light brown or pink spots.  Gradually they thicken and take on a rough, warty appearance, slowly darken and can turn black.  Typically they appear as if they are stuck on top of the skin.  If scratched or rubbed they can bleed and sometimes even fall off by themselves.  They may be itchy if the skin is dry and soap is used routinely.

Look closely at the spots that your dermatologist says are Seborrheic Keratoses.  If you develop more spots just like these, there is probably no need for concern.  Many people have hundreds located on trunk, neck, face, scalp, arms and legs.

However, if you notice or develop spots that look different from the Seborrheic Keratoses you now have, you should see your Dermatologist.  These could be skin cancers.  Melanoma usually is flat or slightly raised and has a mostly smooth surface, but these can bleed also, so anytime you're not sure, get the spot checked out by an expert in skin diseases. 

How are they removed?

Removal of Seborrheic Keratosis is entirely optional if the doctor is certain of the diagnosis. Some insurance companies may consider the treatment to be "cosmetic" and therefore treatment may not be covered.  However, sometimes they itch, rub against clothing, or are cosmetically unpleasant.  In these circumstances, they are often removed.  This is very easy to do and does not usually leave a scar if performed by a skilled dermatologist.  Liquid nitrogen is used most often to remove these lesions.  After liquid nitrogen cryotherapy, the skin underneath the Seborrheic Keratosis may be pink for some months, gradually returning to normal or slightly lighter, but in most cases, the appearance after treatment is better that before.

Many people desire removal of all their Seborrheic Keratoses because of itching.  In some cases, there are so many, this is virtually impossible.  Most of the time, the itching is due to dry skin and can be improved or alleviated with avoidance of soaps, body washes and abrasives like loofahs or brushes.  Use of Cetaphil or Aquanil Soap Free Cleanser or Pureblend Cleanser for bathing followed by gentle drying with a soft towel and immediate application of Eucerin lotion after bathing can improve symptoms in a few days.

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They should not be confused with Actinic Keratoses (also called Solar Keratoses).  Actinic Keratoses are pre-cancerous.

Seborrheic Keratoses are harmless.  They begin as slightly raised light brown spots.  Gradually, they thicken and take on a rough, wart-like surface.  They slowly darken and may turn black.  They typically look as if they were stuck on top of the skin.

What if I develop spots that look different? 

Look closely at the spots that your doctor says are Seborrheic Keratoses.  If you develop more spots just like these, it is probable that there is no need to be concerned.

However, it you develop spots that look different from the Seborrheic Keratoses you now have, you should see your dermatologist.  These could be skin cancers.  If any future spot has any of the following features, be sure to have your doctor look at it: the overall shape of the growth is asymmetric, the borders are irregular in outline, or the spot is not the same color throughout.

Treatment 

Removal of Seborrheic Keratosis is entirely optional if the doctor is certain of the diagnosis.  Some insurance companies may consider the treatment to be “cosmetic” and therefore it may not be covered.  However, sometimes they itch, rub against clothes, or are cosmetically unpleasant.  In these circumstances, they are often removed.  This is very easy to do and does not leave a scar.   However, the skin underneath may be lighter in color than the surrounding normal skin in some cases.  The color difference may resolve with time.  In almost all cases, the appearance after removal is better than before removal.