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Seborrheic Keratosis

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Seborrheic Keratosis

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Seborrheic keratosis is the most common benign skin growth in older adults, which is commonly mistaken for melanoma. Read the article to know more.

Medically reviewed by

Dr. Jaydip Sinha

Published At August 29, 2019
Reviewed AtDecember 28, 2023

What Is Seborrheic Keratosis?

Seborrheic keratosis, otherwise called basal cell papilloma or seborrheic warts, is the most commonly seen noncancerous skin growth in adults. They are displeasing to the eye, but do not pose any harm. The only thing is, it is difficult to differentiate between this and melanoma, which is a severe type of skin cancer. If any new skin growth is observed or if a mole undergoes changes in color, shape, or texture, consulting with a doctor is advisable. The growth typically appears in pale, black, or brown hues and is commonly observed on the back, shoulders, chest, or face. Occurring predominantly in middle-aged individuals, seborrheic keratosis may result in single or multiple skin growths. Seborrheic keratosis is not contagious, and there is no risk of infection from an affected person.

What Are the Causes and Risk Factors for Seborrheic Keratosis?

As of now, the exact cause is not known. They seem to affect people as they age and are not contagious. It is seen to run in families, so genetics appears to play a role.

The factors that increase the risk of seborrheic keratosis are:

  • Old age (more common in individuals over 50).

  • Family history.

  • Frequent exposure to sunlight.

  • Skin folds and skin friction are commonly seen in individuals who are overweight.

What Are the Symptoms of Seborrheic Keratosis?

The symptoms of seborrheic keratosis include:

  • Looks like a wart.

  • Has a waxy surface.

  • Can appear on the face, chest, shoulders, groin, scalp, breast, or back.

  • May result in a single or cluster of lesions.

  • It can be light brown to black in color.

  • Being round or oval in shape.

  • Being flat or elevated.

  • Has a scaly surface.

  • Can be small or measure up to 1 inch.

  • Might be itchy.

They are not painful but can be aesthetically disturbing. Do not rub or pick them, as they can bleed, swell, or result in infection.

What Are the Types of Seborrheic Keratosis?

The following are the types of seborrheic keratoses:

  1. Common seborrheic keratosis.

  2. Reticulated seborrheic keratosis or adenoid seborrheic keratosis.

  3. Stucco keratosis.

  4. Clonal seborrheic keratosis.

  5. Irritated seborrheic keratosis.

  6. Seborrheic keratosis with squamous atypia.

  7. Melanoacanthoma.

  8. Dermatosis papulosa nigra.

  9. Inverted follicular keratosis.

How to Differentiate Seborrheic Keratosis From Melanoma?

Seborrheic Keratosis - This is a harmless skin growth frequently observed in older adults. It maintains a consistent size, appearing as light tan or brown in color with a waxy or scaly surface. Unlike melanoma, seborrheic keratosis does not bleed or ooze and has the potential to develop anywhere on the body.

Melanoma - Melanoma initiates as a mole or wart and is a form of skin cancer that can affect individuals of any age. Unlike seborrheic keratosis, melanomas exhibit rapid growth and spread, displaying a variety of colors on a smooth surface. Furthermore, melanomas have the potential to bleed or ooze.

What Are the Five Things to Know About Early Stage Seborrheic Keratoses?

The five important things to know about early stage seborrheic keratoses are mentioned below:

1. Noncancerous - Seborrheic keratosis is a noncancerous skin growth, and it's crucial to note that these common growths do not typically spread, pose no risk to overall health, and usually do not require treatment. Unlike moles, early stage seborrheic keratoses do not develop into melanoma. Although noncancerous, early stage seborrheic keratoses may resemble cancerous growths, leading dermatologists to recommend removal for biopsy and testing to rule out cancer. If confirmed as noncancerous, removal or other treatments are generally unnecessary unless the growth is causing discomfort, is unsightly, easily irritated, or prone to getting caught on clothing or jewelry.

2. Slow Growth - Another key point is that seborrheic keratoses grow slowly. While most growths will not spread extensively, some individuals may experience a higher number of growths that spread further. Although rapid growth does not necessarily indicate another condition, consulting a dermatologist is advisable for any new skin growth. Despite their slow growth, early stage seborrheic keratoses do not disappear on their own once they appear, and they are likely to persist indefinitely.

3.Variable in Appearance - The appearance of early stage seborrheic keratosis can vary significantly, making accurate self-diagnosis challenging. Consult a skilled dermatologist for a thorough examination to confirm the diagnosis and rule out more serious conditions. While seborrheic keratoses exhibit diverse appearances, common characteristics include:

  • Often occurring as multiple lesions.

  • Some have a rough, wart-like texture, while others are smooth and waxy.

  • Colors ranging from tan to dark brown or black.

  • Usually round or ovular, slightly raised, and appearing stuck onto the skin.

  • Sizes vary from very small to up to an inch in diameter.

4. Location - Seborrheic keratosis can manifest in various areas of the skin. These growths may appear on any part of the body, with the face, head, neck, chest, shoulders, and back being the most common locations. While darker-skinned individuals are less prone to seborrheic keratosis, they may still experience small skin growths, typically around the eyes. The palms of hands and soles of feet are the only areas where early stage seborrheic keratoses do not develop.

5. Age-Related Factors - Seborrheic keratosis is a skin condition that can appear at any point in an individual's life. However, it tends to be more prevalent in adults aged 50 and above, with the likelihood of development increasing with age. While rare, children and younger adults may also experience seborrheic keratosis growths.

How Is Seborrheic Keratosis Diagnosed?

A dermatologist will be able to diagnose this condition by looking at the lesion. If needed, the dermatologist will take a sample from the growth or the entire lesion (biopsy) and send it to the lab. The tissues collected during the biopsy are then viewed under a microscope to detect cancer cells. Evaluation by a dermatologist is necessary if:

  • Numerous rapidly growing seborrheic keratoses are present.

  • Skin growths bleed or are easily irritated.

  • Seborrheic keratoses cause itching or pain.

  • Growth appears unusual, such as rapid growth, bleeding, turning black, or differing from other seborrheic keratosis spots, indicating a potential sign of skin cancer.

  • The skin growth looks flat, dry, or scaly, suggesting a precancerous growth that could develop into skin cancer.

  • Sudden appearance of numerous seborrheic keratosis growths and other new skin growths, signaling a potential warning sign of cancer in other body parts.

What Are the Treatment Options for Seborrheic Keratosis?

Generally, treatment is not necessary. But if the lesion is hard to distinguish from cancer, or if it is itching or causing discomfort or is a problem aesthetically, then the lesion is removed. Some of the treatment options include:

  • Cryosurgery - With a spray gun or cotton swab, liquid nitrogen is applied to the lesion, which freezes it. The lesion dries and falls off in a few days.

  • Electrocautery - Otherwise called electrosurgery, is a method where electric current is used to burn the growth.

  • Curettage - Here, a scoop-shaped surgical instrument (curette) is used to scrape off the growth.

  • Ablation - Here, a laser is used to vaporize the growth.

All these methods might leave a slight scar and sometimes cause new lesions to appear on other body parts.

Can Seborrheic Keratosis Be Treated at Home?

The effectiveness of home remedies is not proven and should not be tried without consulting a doctor first. Hydrogen peroxide solution, glycolic acid solution, lemon and vinegar mixture, tea tree oil, and others are believed to be helpful. These solutions, if applied to the lesion directly with a cotton swab, dries the lesion, which falls off eventually. Always be careful while trying these home remedies, as they can result in allergic contact dermatitis.

Conclusion:

A seborrheic keratosis removal may leave the skin looking paler than the surrounding skin. With time, this normally disappears. Sometimes it is irreversible. Most seborrheic keratoses that are excised never come back. But another could start somewhere else. The exact cause is unknown, but certain factors elevate the risk, including age over 50, hormonal fluctuations (such as hormone replacement or pregnancy), a family history of seborrheic keratoses, and having light skin.

Frequently Asked Questions

1.

What is the best treatment for seborrheic keratosis?

It is not always necessary to treat seborrheic keratosis. It can be treated if it becomes irritated and gets uncomfortable when it rubs against the cloth. Cryosurgery is the best treatment option. Here, liquid nitrogen is used to freeze the lesion and then it is excised.

2.

How do you get rid of keratosis?

Keratosis can be treated with the help of:
- Cryosurgery - The lesion dries and falls off when liquid nitrogen is applied to it.
- Electrocautery - Here, an electric current is used to burn the growth.
Curettage - A curette is used to scrape off the growth.
- Ablation - Laser is used to vaporize the growth.

3.

What is inflamed seborrheic keratosis?

When a seborrheic becomes red and inflamed due to constant friction or injury, it is called inflamed seborrheic keratosis.

4.

Can you scratch off a seborrheic keratosis?

Seborrheic keratosis is painless and usually does not cause any symptoms. If the lesion becomes itchy or inflamed, it is best to get it removed by your dermatologist.

5.

What does seborrheic keratosis look like?

The growth has a slightly elevated and looks waxy or scaly. It can be black, brown, or light tan in color.

6.

How to prevent seborrheic keratosis?

Seborrheic keratosis is a benign growth that commonly affects older adults. There is no way to prevent it.

7.

Can seborrheic keratosis appear suddenly?

The lesion can appear suddenly and can vary in size, shape, and color. It can appear on the back, shoulders, chest, and face.

8.

Does seborrheic keratosis grow?

Yes, the lesion can grow and become as large as 3 cm in diameter.

9.

Are seborrheic keratosis itchy?

The lesion is usually painless with no symptoms, but it might become itchy and irritated sometimes.

10.

Is there a seborrheic keratosis removal cream?

A topical cream that contains Tazarotene 0.1 % can be applied twice daily for 16 weeks can improve seborrheic keratosis.
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Dr. Jaydip Sinha
Dr. Jaydip Sinha

Dermatology

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