Written by Dr. Paul M. Graham
One of the most common reasons for a visit to the dermatologist is a common benign skin lesion called a seborrheic keratosis. These skin lesions may cause a significant amount of anxiety due to the dark and irregular appearance. The good news is that these lesions are completely benign with no associated risk. On the other hand, they may appear similar to more serious skin lesions such as skin cancer including squamous cell carcinoma and melanoma. This emphasizes the importance of having a dermatologist conduct a thorough skin exam for any pigmented or scaly skin lesion to reduce the risk of overlooking a skin cancer.
Seborrheic keratosis are a sign of skin aging and start to occur in individuals in their 30’s and 40’s. Over 90% of individuals over the age of 60 have at least one of these skin lesions with some having hundreds. These lesions are commonly found on the face, chest, back, and abdomen. The exact cause is still not entirely clear but is thought to develop for various reasons including prolonged exposure to the sun’s UV radiation, genetic factors, skin friction, and viral cause. Scientist have found mutations in various genes that may predispose to the development of skin lesions. They typically begin as small tan to brown spots with small minute scales and develop into darker, rough, elevated growths. Over time, some of these lesions may become irritated or fall off due to trauma from scratching or tight-fitting clothing. In some cases, these skin lesions may begin to bleed and may require removal to resolve.
Most of the time, seborrheic keratosis do not need to be treated. If treatment is desired, there are many ways to remove these lesions. The most common treatment performed by dermatologists is the use of liquid nitrogen. Liquid nitrogen works by the formation of ice crystals outside the cell, leading to cellular dehydration/shrinkage and eventually cell death. This causes the formation of a small blister cavity, causing the skin lesion to fall off and heal over 2 weeks. Another way to treat these involves using an instrument called a curette. A curette is a sharp tool used to “scrape” off the surface of the skin which contains these skin lesions. Lastly, a device called an electrocautery use electrical energy to lightly “burn” off theses lesion using low energy.
All of these treatment options work in properly selected patients and can be conducted on the same day of the doctor’s visit. It is important to keep in mind that these procedures are not without their risk. The most common side effect is redness, swelling following the treatment. Rare risk includes a superficial skin infection, hyperpigmentation, and scarring.
It is vital that if you develop such skin lesions to schedule an appointment with your dermatologist for a comprehensive evaluation to rule out the presence of skin cancer or other skin disorders. For more information on what to look for in abnormal moles and skin lesions, please read our other articles entitled: The Most Common Types of Skin Cancer, Melanoma Awareness Month: What You Need to Know!, When Should I Get My Moles Checked?
Follow this link to find a dermatologist near you: Find A Dermatologist
Due to the similarities to melanoma and other pigmented lesions, use this chart below to help recognize features that may be a sign of skin cancer.
References:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732998/#!po=27.7778
- https://www.dermnetnz.org/topics/seborrhoeic-keratosis/
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