Seborrheic keratosis is one of the most common benign skin growths, particularly among older adults. It usually presents as wart-like lesions and there’s usually a lot of them which keep increasing over time. Seborrheic keratosis often causes concern mostly for cosmetic reasons and worries about whether it could be something more sinister. In this article we explore exactly what seborrheic keratosis is, its causes, prevention and best treatments for removal of these wart-like growths. We’ll also discuss how to distinguish seborrheic keratosis from actinic keratosis and other precancerous or malignant conditions.
What is Seborrheic Keratosis?
Seborrheic keratosis is a non-cancerous (benign) skin growth that typically appears as a brown, black or pale raised area. These growths can vary in size from tiny spots to large patches and often resemble warts. They usually have a waxy, scaly, slightly elevated surface that may look stuck onto the skin. In fact, people often describe it as looking almost as if someone dabbed a blob of wax on their skin. The most common features are:
- Appearance: The colour ranges from light tan to black and the texture can be rough or smooth. They often, but not always, have a wart-like appearance.
- Location: Seborrheic keratoses most commonly occur on the face, chest, shoulders and back. However, they can actually develop anywhere on the body except the palms and soles.
- Growth Patterns: These growths often appear in multiples and can increase in number and size over time.
- Safety: Although they may appear unsightly, seborrheic keratosis lesions are entirely benign and not associated with skin cancer.
Seborrheic Keratosis vs Actinic Keratosis
Very often seborrheic keratosis is confused with actinic keratosis which is more serious condition. Although seborrheic keratosis is benign, actinic keratosis is actually a precancerous condition which has the potential to progress to skin cancer. It is vital to understand the differences between these two and you should always see a doctor if you find any new skin lesions. In general, the key differences between seborrheic vs actinic keratosis are:
- Causes: Seborrheic keratosis is primarily a result of genetic factors and age. Conversely, the cause of actinic keratosis is often exposure to ultraviolet (UV) radiation from the sun or tanning beds over a period of time.
- Appearance: While seborrheic keratosis is usually brown or black with a stuck-on appearance, actinic keratosis often presents as rough, scaly patches that can be red, pink or brown. Actinic keratosis is also flatter and less well-defined compared to the often elevated seborrheic keratosis.
- Health Risks: Seborrheic keratosis is benign and does not pose a risk of cancer. In contrast, actinic keratosis can develop into squamous cell carcinoma which is a type of skin cancer.
Beyond actinic keratosis, there are also other potentially cancerous skin lesions that can appear similar to seborrheic keratosis. Skin cancers such as melanoma, often presents as a rapidly growing, irregularly shaped lesion that may change in colour, size or texture over time. Skin cancer lesions may also bleed or ulcerate. Regardless, it is always best to see an experienced doctor to help make the correct diagnosis.
Seborrheic Keratosis vs Skin Warts
It’s also worth mentioning that seborrheic keratosis can be easy to mistake for warts due to its rough, raised and waxy appearance. That and the fact that the lesions can be numerous in number. However, there are distinct differences between the two:
- Origin: Warts are caused by the human papillomavirus (HPV) which also makes them contagious. They can spread to other areas of skin and even between individuals through contact. Seborrheic keratosis, on the other hand, is not caused by a virus and is not contagious.
- Appearance: Both can appear as rough and elevated lesions. However, warts tend to have a more cauliflower-like surface whilst seborrheic keratosis has a waxy, stuck-on look.
As with any new skin growth, it’s always wise to consult a doctor first to ensure proper diagnosis. This is also important as the treatment may differ between seborrheic keratosis and warts.
Causes & Risk Factors
Seborrheic keratosis is largely influenced by genetics and age. It is more common in people over the age of 50, though it can appear earlier. In general, the main contributing factors are:
- Genetic Predisposition: This condition tends to run in families, suggesting a genetic component. If your parents or siblings have seborrheic keratosis, you are more likely to develop it as well.
- Ageing: The likelihood of developing seborrheic keratosis increases with age. This is why it is often referred to as the “barnacle of aging“.
- Sun Exposure: Although not a direct cause, some studies suggest that UV radiation may play a role in triggering the growth of seborrheic keratoses, particularly in areas frequently exposed to the sun. However, the exact relationship between sun exposure and seborrheic keratosis is not as clear-cut as it is with actinic keratosis.
Preventive Measures
There are no surefire ways to prevent seborrheic keratosis due to its strong genetic component and natural association with aging. Although there is no definitive way to prevent these benign growths from forming, there are measures you can take to support overall skin health. This can help reduce the likelihood of developing multiple lesions. Firstly, ensure you protect your skin from excessive sun exposure through regular use of sunscreen, wearing protective clothing and avoiding peak sun hours. This is because UV radiation can sometimes play a role in the appearance and exacerbation of skin lesions. Secondly, try maintaining a consistent skincare routine that includes gentle cleansing, exfoliating and moisturising. This can keep your skin in good condition and improves its overall appearance which may minimises the visibility of and discomfort from existing seborrheic keratoses.
Treatment & Removal of Seborrheic Keratosis
Seborrheic keratosis is generally harmless and doesn’t require treatment unless it becomes irritated, itchy or bothers you cosmetically. Your doctor may also recommend removal for biopsy if there is any concern that it might be another condition like melanoma or actinic rather than seborrheic keratosis. The best treatment options for reduction or removal of seborrheic keratosis lesions:
- Cryotherapy: This is one of the most common treatments for seborrheic keratosis. It involves freezing the growth with liquid nitrogen, causing it to fall off over time. It’s quick and relatively painless. However, it may leave a lighter or darker spot on the skin which should return to normal with time. It may also require follow-up treatments if the lesion is large.
- Laser Therapy: This method uses laser light to remove the growth. Laser treatment is precise and effective, especially for larger or more stubborn lesions. It is a non-surgical option that minimises damage to surrounding tissue. However, it may require a few sessions for complete removal.
- Curettage: This is a surgical option that involves scraping off the growth using a special instrument called a curette. It’s often combined with electrosurgery to burn off any remaining tissue, ensuring the lesion is fully removed.
- Electrosurgery: This method uses electrical currents to burn off the lesions. It’s particularly effective for larger growths or those that are difficult to remove with other methods.
- Topical Treatments: Although less commonly used, certain topical solutions like Tretinoin and hydrogen peroxide can help remove or shrink seborrheic keratoses. These treatments are however less studied and often require a prolonged period of treatment and trial and error to find the right topical option for you.
The choice of removal method depends on the size, location and number of growths as well as patient preference. If diagnosis is needed then biopsy, curettage or excision are necessary to allow an undamaged sample to be sent for study in the laboratory. Curettage and electrosurgery usually require a bit of aftercare care for the treated area to prevent infection and promote healing. This includes keeping the area clean, applying any prescribed ointments and avoiding sun exposure until fully healed.
Despite its sometimes alarming appearance, seborrheic keratosis is a common and benign skin condition that poses no serious health risks. That being said, it is however important to distinguish it from conditions like actinic keratosis, melanoma skin cancer and warts as these have implications for management and treatment. Whilst you can’t really prevent it, if seborrheic keratosis lesions bother you, there are many treatment options for removal. Regardless of whether you prefer treatment or to leave them alone, you should always get any new skin growths checked out by your medical provider first to ensure that there’s noting more sinister.
At City Skin Clinic, we are passionate about personalised skincare and hair loss treatments. We offer safe and effective compound skincare treatments with prescription-strength ingredients including Tretinoin and Hydroquinone where appropriate through online skin clinic. Our doctors treat a range of conditions such as acne and scars, hyperpigmentation, melasma, skin ageing. To start your personalised skincare plan, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.
