Seborrheic keratoses: What are these growths on my skin?

As most of us enter our mid- to late thirties, we may start to experience skin changes. Normal aging may be associated with skin growths, such as skin tags, hemangiomas, brown spots ( lentigenes), and common skin lesions called seborrheic keratoses ( SKs).



What are SKs?

SKs are benign ( non-cancerous) growths that can be variable in size, shape, and color. They may be hereditary and it is common to see them passed down from parent to child. SKs can be tan, red, brown, black, or multi-colored. Sun exposed areas of the face, back, arms, and legs are the most affected areas. However, any area of the skin, including armpits, groin, breasts, or creases of the body may develop them. Lesions tend to have a stuck-on appearance and easily come off of the surface with a blade ore even the fingers. SKs may feel smooth, scaly, or rough.

Can SKs harm me?

While these skin growths have no known cancer potential, they may be symptomatic and cause itch and scaling, They may become easily irritated if bumped or traumatized by clothing or jewelry. They may mimic atypical moles or melanoma since they can be growing, changing, and symptomatic. Therefore, an experienced clinician should evaluate lesions with a dermatoscope or biopsy suspicious lesions to make sure that they are benign if there symptoms or abnormal growth patterns.

Can SKs be stopped or cured?

SKs are a normal skin finding due to small, benign mutations in parts of aging skin. There is no cure for them and treatments involve destroying lesions as they erupt.

How can I treat SKs?

There are several ways to combat the non-aesthetic presentation of SKs. While there may be a medical cause to treat SKs (irritation, pain, itch), most SK removals are done for cosmetic reasons and not covered by medical insurance.

  • Topical keratolytics ( ammonium lactacte, urea): this may help keep the skin smooth and minimize the presentation of lesions, especially smaller, scaly stucco keratoses on the arms, legs, and feet.
  • Topical retinoids: continuous use of retinoids in the forms of anti-aging creams or chemical peels may keep skin exfoliated chronically so that SKs do not form. They may also improve existing lesions but may be a less effective treatment.
  • Cryotherapy: destruction of SKs with liquid nitrogen in a health care provider's office. Side effects include pain, swelling, skin discoloration, and incomplete removal.
  • Curettage: after anesthetizing the area, the lesion is removed with a round blade instrument. This may leave a superficial scar or discoloration to the area but typically provides more complete removal.
  • Electrodessication and curettage: removal of the lesion with a round blade followed by cautery with a heat source to stop bleeding or further eliminate a lesion. This may lead to scarring and/or skin discoloration.
  • Surgical excision: for large lesions, excising the tissue may be necessary to give the best cosmetic outcome. While lesions are very superficial, an excision may minimize discoloration and scarring to a large area of skin.
  • Over-the-counter treatment modalities also exist, such as , but may not be effective since may not provide enough destruction to the lesion.