Seborrheic Keratosis: Topical Treatment

What Is Seborrheic Keratosis?

Seborrheic keratosis is a benign growth that is commonly seen on the skin. Although they are harmless skin growth, it is very common to get them removed for aesthetic or functional purposes. These growths are also known as epidermal tumors. This skin condition is usually seen as a single lesion or group lesion form. The color of the lesion is usually brown to black, with a grainy and bumpy appearance. The size of the lesion can be small-to-large, bigger than 3 centimeters. Seborrheic keratoses are commonly seen in adults over 60 years of age in 90 percent of the cases. A person might see the beginning of the lesion in and around the late 30s, which grows with time.

What Are the Other Names of Seborrheic Keratosis?

Seborrheic Keratosis is referred to by the following different names:

• Senile warts.

• Wisdom warts.

• Brown warts.

• Basal cell papilloma.

• Aging barnacles.

What Are the Variants of Seborrheic Keratosis?

The following are the different variants of seborrheic keratosis:

• Solar Lentigo: It is a circumscribed flat patch that is usually seen at the site of sun exposure.

• Large Cell Acanthoma: This growth is usually seen at the photodamaged site with a scaly and tanned appearance.

• Lichenoid Keratosis: The lesion is seen on the forearm, hands, or chest in the sun-exposed areas. The lesion is brown to red in color and itchy.

• Stucco Keratosis: It is a benign and wart-like lesion usually seen at the distal part of the body.

• Inverted Follicular Keratosis: It is an asymptomatic benign lesion usually seen as papules or plaques.

What Are the Causes of Seborrheic Keratosis?

The exact reason behind this condition is still unknown. However, the following are the etiological factors associated with seborrheic keratoses:

• Age: Seborrheic keratoses are commonly seen in adults older than 50 years of age. Moreover, the lesion grows with advancing age.

• Sun Exposure: Few of the cases suggest a correlation between excessive sun exposure and the occurrence of this condition.

• Genetics: This condition is not contagious or viral, but some of the cases show a correlation between genetics and occurrence. The study shows that the condition runs in the family.

• Pregnancy or Hormone Therapy: Few cases suggest that the condition starts during pregnancy. Moreover, estrogen replacement therapy also seems to be an etiological factor behind this condition.

• Having Lighter Skin Tone: This condition is commonly seen among people of all skin tones, but people with lighter skin tones seem to be affected more.

What Are the Signs and Symptoms of Seborrheic Keratoses?

The followings are the signs and symptoms associated with seborrheic keratoses:

• Bleeding.

• Itching.

• Irritation from constant friction.

What Does Seborrheic Keratosis Look Like?

The following is the appearance of seborrheic keratosis:

• Location: The growths can be found at the following sites on the body:

  1. Scalp.

  2. Face.

  3. Chest.

  4. Shoulders.

  5. Abdomen.

  6. Back.

• Size: The growth on the skin varied in size. For instance, it can be at least 1 inch in size.

• Texture: The growths appear to be elevated and rough in texture. Sometimes the surface can be smooth and waxy too.

• Shape: The growth has a round or oval-shaped appearance.

• Color: Usually, the color of the growth is black or brown. However, in a few cases, it may appear to be yellow or white too.

How to Diagnose Seborrheic Keratosis?

There are the following diagnostic methods used for seborrheic keratosis:

• Physical Examination: The condition and the growth have very distinctive features, and it is very easy for a dermatologist to identify them by seeing the shape and the appearance of the growth.

• Dermoscopy: By using dermatoscopy, the growth can be identified. It is a small lighted microscope that dermatologists use for diagnosing conditions like seborrheic keratosis.

• Biopsy: If the dermatologist finds the appearance of the growth suspicious, they may go for a biopsy to check if the growth is benign or malignant.

How to Manage Seborrheic Keratosis?

The following are the management options available for seborrheic keratosis:

• Cryotherapy: During this treatment, the growth is frozen by liquid nitrogen after giving local anesthesia. Within a few days, the growth will shrink and fall off by itself. The side effect of this treatment is skin discoloration at the site.

• Curettage: In this treatment, a dermatologist will give local anesthesia and burn the growth with an electric current. Current is used to scrape away the remaining growth. In spite of the good results, the method leaves scars and requires post-operative treatment, and that is why patients usually do not go for this.

• Shave Excision: This treatment is opted for when a dermatologist needs to preserve or when the growth requires to be analyzed further. In this procedure, the healthcare providers shave the growth after local anesthesia.

• Laser Therapy: Laser therapy is a good option for treating this growth where removal, sterilization, and tissue sealing happen all at the same time. Although this treatment option is very quick, it leaves the site sore for some days.

• Topical Therapy: The above treatment options provide good results, but they have limitations such as the face and neck areas. Moreover, these treatment options leave post-inflammatory hyperpigmentation, pain, and discomfort. Due to that, the ideal treatment suggested by dermatologists for seborrheic keratosis is topical therapy. The topical solution of 40 percent hydrogen peroxide is used to treat growth. Hydrogen peroxide can cause many adverse effects such as edema, pruritus, scaling, or stinging sensation on the skin. It is important to apply as per the dermatologist’s recommendation. Depending on the growth at the site, the treatment shows results around a few days to a couple of months. Other than this, there are a few over-the-counter drugs that have shown promising results too. These drugs have little to no side effects and take a very short time to show results. The options include

  1. Vitamin D3 cream.

  2. Alpha hydroxy acid products include salicylic acid and glycolic acid.

  3. Tazarotene cream 0.1 percent.

Conclusion

Seborrheic keratosis is a benign growth that is very common among adults of advanced ages. Although the condition is noncancerous, the patients should get it checked by dermatologists for the condition. Depending on the size and site of the growth, the dermatologist may suggest different management options.