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Seborrhoeic Keratoses by Dr Jennifer Crawley

What are seborrhoeic keratoses?

Seborrhoeic keratoses is a type of non-cancerous skin lesion. Seborrhoeic keratoses are soft, raised and either black, light or dark brown. They are more common as you grow older. They can be unattractive to look at, but the growths aren’t dangerous. In some cases, seborrhoeic keratoses can be challenging to differentiate from melanoma, a serious type of skin cancer. They are treatable.

What do seborrhoeic keratoses look like?

They are generally oval or round-shaped and crushed plaque-like lesions as if “stuck” on the skin. They are dry, rough-surfaced and may be scaly but are not painful. They may itch, catch on clothes, look like small squashed pigmented skin tags and cause worry if they are growing. They are superficial skin lesions that do not extend deeply.

Where can seborrhoeic keratoses be found?

Although at the beginning there may be just one, multiple lesions may later appear. The growths can be found in many body areas, including the face, neck, shoulders, back, chest, abdomen, backs of hands and front of legs.
Growths can be noticed anywhere on the body except on the soles of the feet or the palms.

People at risk of developing seborrhoeic keratoses

Older age

Seborrhoeic keratoses usually begin to appear around the age of 40 to 50 years old. It is estimated that over 75% of people aged 70 years have seborrhoeic keratoses.

Hereditary tendency

Many people tend to get them, which runs in their families, then it is called a hereditary tendency. The risk rises with the number of affected relatives.

Frequent sun exposure

Exposure to sunlight is a risk factor. It is important to note growths also appear on skin that is usually covered up when people go outdoors. Hence, they often appear on the backs of the hands, the face, the decolletage and shoulders plus back, in areas exposed to the sun.

When to see a dermatologist?

Seborrhoeic keratoses are typically easily identified by their appearance. Seborrhoeic keratoses aren’t harmful, but you should not ignore growths on your skin. A lesion that appears like seborrhoeic keratoses could be melanoma. It can be difficult to differentiate between harmless and dangerous growths. If you’re concerned about any growth, make an appointment with our dermatologists. It’s safer to be vigilant than disregard a potentially severe problem. Also, seborrheic keratoses can look ugly and simply require assessing and removal.

At Clinica, our dermatologists will exam your skin if:

  • It has a new growth.
  • There’s a change in the appearance of a current lesion.
  • There’s only one or several growths.
  • A growth has an unusual colour.
  • A growth has irregular borders.
  • A growth is painful.
  • You don´t like the lesion cosmetically as it is ugly.

How is seborrhoeic keratoses diagnosed?

Our dermatologists will diagnose seborrhoeic keratoses by examining the lesion by eye and using a dermatoscope to determine the likely diagnosis. Suppose there is any doubt about the nature of the lesion or lesions, the dermatologist will collect a biopsy of your suspected seborrhoeic keratoses and send the tissue to the laboratory for histopathologic analysis.
The biopsy will be investigated under a microscope by a trained pathologist. This helps your doctor diagnose the growth as either seborrhoeic keratoses or cancer.

What are the methods of treatment for seborrhoeic keratoses?

Seborrhoeic keratoses do not go away spontaneously. However, they are treatable by minor skin surgery, including biopsy, curetting or cryotherapy. Your doctor may choose to remove any lesions that have a suspicious appearance or are causing discomfort or are cosmetically unsightly.

Methods of removal

Three commonly used removal methods are:

  • Cryosurgery, which uses liquid nitrogen to freeze off the lesion.
  • Electrosurgery, which uses an electrical current to scrape off the lesion.
  • Curettage or shaving the seborrhoeic keratoses off surgically under local anaesthetic.
  • Surgical excision biopsy where the lesion is suspicious and requires histopathological analysis.Healing following any of these treatments is rapid, usually within 5 to days and does not usually leave a visible scar. Sometimes there may be a slight dip in the skin where the lesion was, which is barely detectable.

    Other lesions may occur if you tend to form seborrhoeic keratoses and as you get older, which can be treated.

What happens after seborrhoeic keratoses removal?

After your treatment, your skin may be lighter at the site of removal. The difference in skin colour becomes less noticeable over time. Occasionally, seborrhoeic keratoses won’t return, but it’s possible to develop a new one on another part of your body.

Book an appointment with one of Clinica’s Medical Dermatologists, Dr Jennifer Crawley, if you observe changes to your skin that concern you. Our dermatologists will investigate the skin changes to establish a cause and start treatment.

Dr Jennifer Crawley

Consultant Dermatologist
Children & Adults

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