Seborrheic Keratosis

What is a Seborrheic Keratosis?

Seborrheic keratoses (SKs) are noncancerous, raised spots on the skin that can be found all over the body, and become more common as we get older, especially after the age of 50. The people most likely to find an SK are those with family members who have them, though they can also appear during pregnancy or estrogen treatments. They aren’t preventable, do not appear to be caused by sun exposure, and are not a sign of a more serious problem except in rare cases when large numbers of SKs appear at once.

SKs generally start as small bumps and grow into a tan, brown or black spots with a flat, rough, or waxy surface that appear to be “pasted on” the skin. Though it may seem like it, they do not spread and they are not contagious. They are not more likely to turn into skin cancer than other noncancerous growths. While SKs are not a cause for worry, you should still check the spots regularly for changes. If an SK grows quickly, is easily irritated or itchy, bleeds or if many appear at once, consult your dermatologist.

It is easy for people to confuse SKs with other skin conditions. They can resemble warts, which are similar in color but caused by a virus. Melanomas and moles can also be irregularly shaped and dark in color. Actinic keratoses are generally redder in color and flatter than SKs and are a very early stage of skin cancer. Your doctor can usually diagnose a seborrheic keratosis visually and confirm the diagnosis with a biopsy if necessary. This is most commonly done under local anesthesia and involves removing the abnormality and a thin layer of the surrounding skin for examination under a microscope. After examining the sample, a Cockerell Dermatopathology dermatopathologist will provide your doctor with a definitive diagnosis.

 

Seborrheic keratoses are harmless and painless, but sometimes they can be difficult to distinguish from skin cancer, become irritated easily because of their location, or bother a patient because of their appearance or how they feel. They can also grow to over one inch in size. The growths usually don’t go away on their own and can last a lifetime, and there are no medicines or creams that can remove them. Your doctor can treat them under local anesthesia using cryosurgery (freezing the growth with liquid nitrogen), electrosurgery (using electrical current to burn it off), curettage (scraping the lesion off with a surgical instrument) or by shaving it off with a sharp blade. Since SKs are very superficial lesions, removal is simple and unlikely to leave a scar.

What You Need to Know

  • SKs are not cancer and are harmless

  • Checking your own skin once a month for abnormalities and changes in seborrheic keratoses can lead to early detection of any problems

  • Seborrheic keratoses can usually be diagnosed visually, though a biopsy may be necessary to be sure

  • Removal of a seborrheic keratosis is simple and should not leave a scar

Check Yourself

You can also help protect yourself by examining your own skin once a month. It is often difficult to diagnose skin cancer just by appearance. This is why it’s so important for you to check your own skin and notify your doctor of anything you find. Examine yourself from head to toe, using a mirror when necessary. Look for any changes to existing moles and freckles, sores that take more than 3 weeks to heal, spots that hurt or itch continuously, growths that have increased in size or are larger than a pencil eraser, irregular outlines or changes in color or texture. If you note any changes in your skin, see your dermatologist.  

Know Your Spots >>

Diagnosis and Treatment

Because seborrheic keratoses are benign, they most often do not need treatment. Your physician may remove a seborrheic keratosis when it:

  • Has physical characteristics that memic a skin cancer

  • Cause patient discomfort by getting caught on clothing or jewelry

  • The patient does not like the physical look of the lesion

 

If an SK has similar characteristics as skin cancer, your physician will likely shave off the growth with a surgical blade or rely on these other proven treatment techniques.

  • Cryotherapy: Applies liquid nitrogen, a freezing liquid, to the growth with a cotton swab or spray gun. The freezing of the lesion destroys the SK.  The dead SK tends to fall off within a few days. Sometimes a blister forms under the seborrheic keratosis and dries into a scab-like crust. The crust will then fall off within a few days.

  • Electrosurgery and curettage: Electrosurgery involves numbing the growth and using an electric current to destroy the growth. A scoop-shaped surgical instrument, a curette, is used to scrape off the treated growth. There can be a small amount of bleeding.

What is Dermatopathology?

The combination of pathology (using a microscope to identify diseases) and dermatology (diagnosing and treating diseases of the skin, nails and hair) is called dermatopathology. Dermatopathologists are highly trained physicians who examine tissue specimens under a microscope, use the medical information shared by your doctor and consult with him or her as necessary. This personal service and collaboration between your doctor and our dermatopathologists help ensure the most precise, conclusive diagnosis.

About Cockerell Dermatopathology

Cockerell Dermatopathology, located in the heart of Dallas’ medical district, was founded by Dr. Clay J. Cockerell, former president of the American Academy of Dermatology and internationally recognized dermatologist and dermatopathologist.  Cockerell Dermatopathology offers diagnostic excellence and unparalleled service in the evaluation of dermatologic disorders ranging from the routine to the most difficult. To best serve referring clinicians and their patients, Cockerell Dermatopathology continues to invest in the future by implementing advanced technologies within the laboratory. These new technologies produce higher quality slides to diagnose, improves turnaround time on routine cases and allows for quicker deployment of EMR interfaces.  From an academic standpoint, Cockerell Dermatopathology hosts numerous Internet-based continuing education events and has a 14-headed microscope for in-person training sessions. Cockerell Dermatopathology serves more than 800 clinicians from across Texas, the United States and abroad. With an accessible team of board-certified dermatopathologists and a highly trained support staff, Cockerell Dermatopathology’s vision is to treat every specimen as if it came from one of our own family members.