Understanding Seborrheic Keratosis: What These Growths Are
Seborrheic keratosis is one of the most common skin growths in adults, particularly as people age. These growths are benign, meaning they are not cancerous and do not spread to other parts of the body. According to dermatological research, seborrheic keratosis affects approximately 50% of people by age 50, and this percentage increases significantly in older populations. By age 60, roughly 75% of people have at least one seborrheic keratosis somewhere on their skin.
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These growths typically appear as waxy, scaly bumps on the skin. They can range in color from light tan to dark brown or black, and they often have a slightly raised, almost "stuck-on" appearance. The texture is typically rough or wart-like, though the growths themselves are smooth underneath the scale. Seborrheic keratosis most commonly appears on the chest, back, shoulders, face, and scalp, though they can develop anywhere on the body except the palms and soles of the feet.
The exact cause of seborrheic keratosis remains unclear, though genetics and sun exposure are believed to play roles in their development. Unlike melanoma or other forms of skin cancer, seborrheic keratosis does not develop from sun damage in the same way. However, genetics appear to be a significant factor—if your parents or grandparents had seborrheic keratosis, you are more likely to develop them as well.
One important distinction to understand is that seborrheic keratosis is purely cosmetic in nature. It does not cause cancer, and it does not become cancerous. However, these growths can become irritated if they are in areas where clothing rubs against them, such as under a bra strap or on the neck where a collar contacts the skin. When irritated, they may itch, bleed, or become inflamed. This irritation is sometimes the primary reason people seek removal options.
Practical Takeaway: Seborrheic keratosis is a common, benign skin growth that affects most people at some point, particularly as they age. Understanding that these growths are not cancerous and do not pose health risks can help you make informed decisions about whether removal is necessary for your situation.
Medical Diagnosis and When to See a Dermatologist
While seborrheic keratosis is generally easy to recognize, diagnosis by a qualified dermatologist is important, especially if you are unsure whether a growth is seborrheic keratosis or another type of skin lesion. A dermatologist can examine the growth and determine its nature through visual inspection alone in most cases. The diagnosis process is straightforward and does not require invasive procedures.
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Knowing when to see a dermatologist is important. You should schedule an appointment if you have a skin growth that is new or changing, if it is causing discomfort or irritation, if it is bleeding or oozing, or if you are simply concerned about its appearance. Additionally, if a growth has characteristics that concern you—such as rapid growth, color variation, or irregular borders—a dermatologist should evaluate it to rule out other conditions like melanoma or other skin cancers.
During a dermatology visit, the doctor will ask about when the growth appeared, whether it has changed, and whether it causes any symptoms. They will examine the growth and may ask about your personal or family history of skin conditions. In most cases, this visual examination is sufficient for diagnosis. If there is any doubt about the diagnosis, the dermatologist may perform a skin biopsy, which involves removing a small sample of the growth for laboratory analysis. A biopsy provides definitive confirmation of the diagnosis.
The cost of a dermatology consultation varies depending on your location, whether you have insurance, and the specific clinic or doctor you visit. Many insurance plans cover dermatology visits for diagnostic purposes, though coverage for removal procedures may vary. Some dermatologists offer cosmetic services on a cash-pay basis, with costs typically ranging from $200 to $600 for an office visit, depending on the region and provider.
It is also worth noting that not all skin growths are seborrheic keratosis. Growths that resemble seborrheic keratosis but have different characteristics may be solar lentigines, warts, moles, or other conditions. A dermatologist can differentiate between these conditions and recommend appropriate management for each.
Practical Takeaway: A dermatology consultation provides professional confirmation of diagnosis and allows you to discuss your specific situation with a qualified medical provider. This step is valuable whether you are considering removal or simply want peace of mind about a skin growth.
Removal Option 1: Cryotherapy (Freezing)
Cryotherapy, commonly called freezing, is one of the most widely used methods for removing seborrheic keratosis. This procedure involves applying liquid nitrogen directly to the growth, which freezes the tissue and causes it to slough off over the following weeks. The procedure is quick, typically taking only a few minutes, and can often be performed during a routine office visit.
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During a cryotherapy procedure, the dermatologist applies liquid nitrogen using a spray applicator or a cotton swab-like device. The intense cold damages the cells of the seborrheic keratosis, causing them to die. Patients typically feel a cold sensation and may experience brief stinging or burning. The procedure is generally well-tolerated without the need for anesthesia, though numbing cream may be applied beforehand if desired. Larger growths may require multiple freeze-thaw cycles to ensure complete removal.
After cryotherapy, the treated area will typically develop a blister or scab within a few days. This is a normal part of the healing process. The scab should not be picked or scratched, as this can increase the risk of infection and scarring. Most scabs fall off naturally within one to three weeks, revealing new skin underneath. During the healing period, the area should be kept clean and protected from sun exposure.
The advantages of cryotherapy include its speed, minimal discomfort, low cost compared to other methods, and ability to treat multiple lesions in one visit. The procedure does not typically require stitches or extensive wound care. Most people can return to normal activities immediately after the procedure, though strenuous exercise and swimming should be avoided for a few days to prevent infection.
Potential drawbacks include the possibility that the growth may not be completely removed on the first attempt and may require a follow-up treatment. Additionally, cryotherapy can occasionally cause temporary lightening or darkening of the skin in the treated area, particularly in people with darker skin tones. There is also a small risk of scarring, though this is uncommon when the procedure is performed by an experienced dermatologist.
The cost of cryotherapy typically ranges from $100 to $400 per treatment, depending on the number and size of lesions being treated and the geographic location of the clinic. Many insurance plans cover cryotherapy when it is performed for medical reasons, such as when the seborrheic keratosis is causing irritation.
Practical Takeaway: Cryotherapy is a quick, affordable, and relatively painless option for seborrheic keratosis removal that can be performed in an office setting with minimal downtime. It is particularly suitable for people seeking removal with minimal recovery time.
Removal Option 2: Curettage and Electrocautery
Curettage is a removal method that involves using a special instrument called a curette to scrape away the seborrheic keratosis from the skin surface. The curette is a small, spoon-shaped instrument with a sharp edge that allows the dermatologist to carefully remove the growth layer by layer. This method is often combined with electrocautery, a technique that uses electrical current to seal blood vessels and prevent bleeding from the area where the growth was removed.
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The procedure begins with local anesthesia to numb the area being treated. Once the area is numb, the dermatologist uses the curette to scrape away the seborrheic keratosis. The scraping continues until the growth is completely removed. If electrocautery is used, a small electrical device will cauterize the area to stop any bleeding. This combination of curettage and electrocautery is sometimes called electrodesiccation and curettage, or ED&C.
One advantage of curettage and electrocautery is that