Seborrheic Keratoses

Seborrheic keratoses are oval-shaped growths on the skin’s surface characterized by crusty, scaly brown, black, or tan wart-like lesions that generally look like dripped candle wax. These skin lesions are very common, with as many as three million new cases every year in the United States. While Seborrheic keratoses are noncancerous and, therefore, benign, the scaly texture of the skin growths can sometimes catch on clothing, causing irritation, itching, and bleeding, leading many patients to wonder if there is a way to remove the growths. Even if the dark brown spots do not cause skin irritation, some patients may still find they wish to remove the lesions for cosmetic reasons. Luckily, several treatment options for removing seborrheic keratoses are available at expert board-certified dermatologist Dr. Michele Green’s Upper East Side dermatology office.

Whenever patients experience new skin growth, it is recommended to seek a diagnosis from an expert dermatologist, such as Dr. Geen, to ensure that the lesion is not a form of skin cancer, like melanoma or basal cell carcinoma. Dr. Green will begin treatment by examining the skin pigmentation and possibly performing a biopsy to diagnose the skin condition. For patients experiencing seborrheic keratoses, many treatment options are available at Dr. Green’s office, including laser therapy, prescription hydrogen peroxide solution, curettage, and electrocautery. Depending on whether the seborrheic keratosis lesion is raised or flat, Dr. Green may use one or a combination of treatments to achieve the best results. To find out which treatment option is best for you, schedule your initial consultation with Dr. Michele Green.

Dr. Green is an internationally renowned board-certified cosmetic dermatologist with over 25 years of experience providing some of the most discerning men and women worldwide with the best non-invasive cosmetic treatment options, including chemical peels, laser treatment, and prescription topical treatments. For her dedication to her patients and expertise, she is consistently voted as one of the best dermatologists in NYC by Castle Connolly, the New York Times, Super Doctors, and New York Magazine. When you consult with Dr. Green for your facial rejuvenation treatment, she will work with you to create a customized approach that includes a unique combination of in-office cosmetic procedures and specially formulated topical products best suited to your specific needs and goals.

What are Seborrheic Keratoses?

Seborrheic keratosis is a common skin condition characterized by oval-shaped, waxy skin lesions that appear over time. Most commonly affecting patients over the age of 50, seborrheic keratoses are benign skin growths, meaning that they are noncancerous and do not pose a danger to the patients. Typically, seborrheic keratoses are light tan, brown, or black, and they tend to appear most frequently on the face, neck, chest, or back. While seborrheic keratoses can look warty, they are different, as a virus or bacteria cause warts but not seborrheic keratoses. Seborrheic keratoses are a common skin condition, with nearly 30% of the population developing at least one skin growth by the time they are 40 years old and 75% of the population developing at least one skin growth by the age of 70. The growths defined as seborrheic keratoses are less common in patients with darker skin. However, a sub-type of seborrheic keratoses called “dermatosis papulosa nigra” appears frequently on patients with darker skin tones. While seborrheic keratoses are not dangerous, it is always best to consult a dermatologist when you notice new or changing skin lesions.

Do Seborrhoeic Keratoses grow?

Seborrhoeic keratoses tend to grow gradually and typically begin to appear in middle age – after the age of 40. The skin growths can vary in size, ranging from having a diameter of a couple of millimeters to one inch across. Sometimes, a single seborrheic keratosis will grow, and in other circumstances, a whole cluster will appear, which is called a leser-trélat sign. At this time, researchers do not know for sure what triggers the growth. What is known is that patients are at a higher risk of developing seborrhoeic keratoses if they have a family history of the condition.

Do Seborrheic Keratoses grow quickly?

Seborrheic keratoses are characterized by slow, gradual growth of light tan, brown, or black skin lesions. Often, the waxy, scaly, wart-like texture will change over time, and the growth may stay flat or become raised. If you notice a growth that grows very quickly, it is best to consult with a healthcare provider as soon as possible, as fast growths with irregular borders may be a sign of skin cancer. Some research has demonstrated that rapid growths of seborrheic keratoses in a cluster can also indicate a form of internal cancer. While the causation has not yet been fully demonstrated, it is still best to have any rapid growths examined by a dermatologist.

Is Seborrheic Keratosis a wart?

While the seborrheic keratoses growths are often considered “wart-like” in appearance, they are not warts. Warts form due to a virus, such as the human papillomavirus (HPV), and may be contagious. Seborrheic keratoses, on the other hand, are not caused by a virus or bacteria and are not contagious. For that reason, seborrheic keratoses and warts should be treated differently.

Is a Seborrheic Keratosis scaly?

Seborrheic keratoses are skin lesions that can commonly appear scaly or “stuck on” as if a candle has dripped wax on the skin. Seborrheic keratoses can be flat or raised, but either way, they have a rough texture that can be felt when you rub them with your finger. This texture is due to the build-up of keratin on the skin’s surface, which is the same fibrous protein that creates our fingernails.

Are Seborrheic Keratoses itchy?

Patients often wonder, “Why does seborrheic keratosis itch?” Seborrheic keratosis lesions have a rough, scaly texture that is often slightly raised. This means that the lesions can catch on clothing and rub uncomfortably. The friction against your clothing can cause skin lesions to itch and may make you feel very uncomfortable. While seborrheic keratosis is not dangerous, patients experiencing this itching and irritation may opt to have the lesions removed.

Can Seborrheic Keratoses be flat?

Seborrheic keratosis skin lesions can be flat or slightly raised when they grow gradually on the skin’s surface. Typically, seborrheic keratoses have a rough, scaly texture that can be felt with your finger and are often described as appearing “stuck on.” Other types of growths can resemble seborrheic keratoses, including actinic keratosis, melanoma, and basal cell carcinoma, which is why it is essential to consult with a dermatologist when you see any new lesions developing on the skin.

Are Seborrheic keratoses precancerous?

Patients often ask, “Are seborrheic keratoses cancerous?” Seborrheic keratoses are benign skin lesions, meaning that they are not precancerous or cancerous. Seborrheic keratoses differ from melanoma in several ways, including the number of lesions that appear, the texture, the shape, and the rate of growth and change. While seborrheic keratoses often appear in clusters, melanoma usually forms as a single lesion. Seborrheic keratoses tend to have a rough, scaly texture with a well-defined border, compared to melanoma, which is typically smooth with an irregular border. Where seborrheic keratosis lesions grow gradually, melanoma lesions tend to grow rapidly and change quickly. However, seborrheic keratosis lesions can be very similar to other types of precancerous growths, such as actinic keratosis. Actinic keratoses are pigmented precancerous growths that form due to sun exposure and are often crusty and scaly like seborrheic keratoses. For that reason, it is always best to consult with a dermatologist about new skin growth.

Are seborrheic keratoses hereditary?

Patients often wonder, “How does Seborrheic Keratosis start?” While the exact cause of seborrheic keratosis is not known, research has linked family history as a primary risk factor for developing the skin condition. Certain genetic mutations may be responsible for the development of seborrheic keratoses in some patients. Additionally, patients with one seborrheic keratosis growth are at a higher risk of developing additional lesions. This is likely also due to family history, as 50% of multiple seborrheic keratosis cases occur within families.

What causes a seborrheic keratosis on the breast?

Seborrheic keratoses do not commonly form on the breasts. Rather, the most common areas of the body for seborrheic keratosis development include the back, face, neck, and chest. If you are experiencing a pigmented growth on the breast, it is best to schedule an examination as soon as possible. Any pigmentation on the breast may be a sign of invasive breast carcinoma. When you have your appointment with Dr. Green, she will take a biopsy of the lesion, meaning that she will use a scalpel to shave off a part of the growth for further tests.

Is Seborrheic Keratosis the same as seborrheic dermatitis?

Seborrheic keratosis is not the same as seborrheic dermatitis—they are two different skin conditions that should be diagnosed and treated differently. While seborrheic keratoses are characterized by small, scaly wart-like lesions most commonly found on the face, neck, back, and chest, seborrheic dermatitis typically affects the scalp or other greasy areas of the face like the eyebrows, beard, armpits, or mustache. Characterized by scaly patches, irritated skin, and dandruff, seborrheic dermatitis can also cause itchiness, flaking, and irritation. The condition is not contagious but can be distressing, causing many patients to seek treatment. If you are experiencing seborrheic dermatitis, the best first step is to schedule a consultation appointment with an expert board-certified dermatologist, such as Dr. Green, who can prescribe shampoo or other topical treatments.

Where does Seborrheic Dermatitis come from?

At this time, healthcare professionals are not entirely certain of the root cause of seborrheic dermatitis. Researchers hypothesize that the condition may occur due to excess oil in the skin, the presence of the yeast Malassezia, or a weakened immune system. Several other risk factors that can trigger the onset of seborrheic dermatitis symptoms include stress, changes in the weather, fatigue, depression, immune system disorders, or sudden traumatic medical conditions.

Where does Seborrheic Dermatitis occur?

Patients often ask, “Where is seborrheic dermatitis commonly seen?” Seborrheic dermatitis most often affects areas of the face and body with excess oil, including the scalp, beard, eyebrows, mustache, armpits, ears, eyelids, side of the nose, and chest. The areas of the body where seborrheic dermatitis occurs are highly visible, meaning that the skin condition can leave many patients self-conscious. Luckily, several treatment options are available at Dr. Green’s dermatology office, including prescription topical creams and shampoos.

Are Seborrheic Keratoses contagious?

While seborrheic keratoses are a very common skin condition, with as many as 3 million new cases in the United States every year, it is not contagious. Unlike warts, which form due to viruses like human papillomavirus (HPV), seborrheic keratosis does not arise due to a bacterial, viral, or fungal infection. While the exact cause of seborrheic keratosis is not known, there is a strong connection to family history, meaning the condition is likely hereditary. Additionally, seborrheic keratosis lesions will not spread on the body. New growths are likely to occur after one seborrheic keratosis lesion has formed but not due to any spread of virus or bacteria.

Will Seborrheic Keratoses go away?

Seborrheic keratoses typically do not go away on their own. However, seborrheic keratosis is noncancerous, meaning it is not dangerous and does not have to be removed. Some patients may find that the texture of seborrheic keratosis causes the lesions to rub against their clothing uncomfortably. Sometimes, this friction can lead to itchiness, skin irritation, and bleeding. For these patients, removing the lesion can help to eliminate these symptoms.

What is the treatment for seborrheic keratoses?

If you experience any new skin lesions, it is best to schedule an appointment with a board-certified dermatologist, such as Dr. Green, who can diagnose the skin condition so you know it is not dangerous. Patients experiencing seborrheic keratosis may want the lesions removed for cosmetic reasons or because the texture of the lesions is causing itchiness, irritation, or bleeding. Depending on the shape and texture of the seborrheic keratosis, Dr. Green will choose from several treatment options, including electrocautery, which uses an electric current to destroy the growth; laser therapy; scraping, which uses a curette blade to remove the growth; shave excision to shave the growth off; prescription hydrogen peroxide to dissolve the growth; or freezing the growth with cryotherapy/cryosurgery.

Who removes Seborrheic Keratoses?

When looking to diagnose and remove your skin growth, it is best to seek out an expert, board-certified dermatologist, such as New York City-based Dr. Michele Green. Dr. Green will start by examining the growth to ensure it is not dangerous. Typically, just looking at the growth will be enough to tell if it is seborrheic keratosis, but in some cases, Dr. Green may take a biopsy to test for skin cancer. A biopsy involves the removal of some or all of the lesion for examination in the lab. Seborrheic keratosis can look like other skin conditions like actinic keratosis, which can be precancerous. Skin cancer can be fairly easily treated as long as it is caught early.

How do dermatologists remove seborrheic keratosis?

Dermatologists have several methods for removing seborrheic keratosis lesions, including:

Laser Treatment: Laser therapy to remove seborrheic keratosis lesions can be ablative, meaning that some of the outer layer of skin is removed, or non-ablative, meaning that an energy source like light is used to burn the lesion away. Laser treatments are highly effective at removing seborrheic keratosis lesions, particularly ablative laser therapies. Ablative lasers are associated with some downtime.

Prescription Hydrogen Peroxide: Recently, the FDA approved the use of prescription-strength 40% hydrogen peroxide on seborrheic keratosis lesions. Patients will receive an applicator pen to use for the application of the medication at home. Some patients experience skin irritation around the site as a common side effect of the treatment.

Curettage: Curettage, sometimes more simply referred to as “scraping,” involves the use of a scalpel blade to scrape off the growth. Depending on the shape and size of the seborrheic keratosis, Dr. Green may pair curettage with electrocautery or cryosurgery.

Electrocautery: Electrocautery uses an electric current to burn the lesion, effectively destroying it. When a seborrheic keratosis lesion has thicker growth and rougher texture, electrocautery can be paired with curettage for improved results.

Cryotherapy: Cryotherapy is a treatment option that uses liquid nitrogen to essentially freeze off the seborrheic keratoses. Typically, Dr. Green does not turn to liquid nitrogen, as there is a risk of loss of skin pigmentation in the treatment area for patients with darker skin tones. Additionally, cryotherapy is not associated with the best results.

What dissolves seborrheic keratosis?

The best treatment option for dissolving seborrheic keratoses is the recently FDA-approved 40% hydrogen peroxide. Due to the high concentration of hydrogen peroxide used in the topical treatment, 40% hydrogen peroxide is only available when prescribed by a dermatologist, such as Dr. Green. The solution is applied using an applicator pen to avoid additional contact with the skin. Prescription hydrogen peroxide is associated with skin irritation at the application site, but this side effect is typically mild and well tolerated.

Will fluorouracil remove seborrheic keratoses?

Fluorouracil is a topical treatment option available to treat seborrheic keratosis. Studies have demonstrated that while fluorouracil can decrease the appearance of seborrheic keratosis lesions over time, it is not nearly as effective as in-office treatments like laser therapies, electrocautery, curettage, or cryotherapy. If you are looking for a topical solution to treat seborrheic keratosis, Dr. Green recommends a prescription of 40% hydrogen peroxide for the best results.

How to treat seborrheic keratoses at home

The best treatment option for seborrheic keratosis is to schedule an appointment with a board-certified dermatologist, who can properly diagnose the condition and prescribe a topical solution or in-office treatment. Some topical treatments are available over the counter, including alpha-hydroxy acid products like glycolic acid and salicylic acid, over-the-counter 1% hydrogen peroxide, and 0.1% tazarotene cream. At-home treatments can reduce the appearance of seborrheic keratoses but are not nearly as effective as in-office treatment options.

Are seborrheic keratoses dangerous?

Seborrheic keratosis is a noncancerous, benign skin lesion, meaning that it is not dangerous. Because of the rough, scaly texture of the lesions, the friction created when the lesion rubs against clothing can cause some irritation, itching, and bleeding. If that is the case, Dr. Green recommends having the lesion removed. Seborrheic keratosis can also resemble dangerous types of skin growth, such as actinic keratosis. For that reason, it is always best to have new growths examined and diagnosed by a dermatologist.

How to get rid of seborrheic keratoses

Seborrheic keratosis is a common skin condition that affects as many as 3 million Americans every year and appears most commonly in patients over the age of 50. Characterized by oval-shaped flat or raised light tan, brown, or black lesions, seborrheic keratosis is noncancerous. The lesions appear most often on the face, back, chest, and neck, and though they are not dangerous, some patients do not like the way they look or may find that the scaly, wart-like texture can irritate when it rubs against clothing. Luckily, many treatment options are available at Dr. Green’s New York City dermatology office, including laser treatments, prescription topical treatments, curettage, and electrocautery. To find out the best treatment option for your seborrheic keratosis, schedule your consultation with Dr. Green.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing her patients with the best non-invasive treatment options. Dr. Green takes a holistic approach and embraces a less-is-more philosophy, creating customized skincare routines and treatment plans that cater to the unique concerns and aesthetic goals of her patients. She is consistently identified as one of New York’s best dermatologists by Castle Connolly, New York Magazine, and Super Doctors for her dedication to her patients and expertise. Please call us at 212-535-3088 or email our New York City-based office today to schedule a consultation with Dr. Michele Green and find out the best seborrheic keratoses treatment option for you.