Seborrheic keratoses (SKs) are common, non-cancerous skin growths that often develop as people get older. These benign lesions do not pose a health risk, but their appearance can cause concern, leading individuals to search for removal options. The desire for a smooth complexion often prompts the question of whether these growths can be managed at home. While SKs are harmless, attempting removal without professional guidance introduces significant medical risks.
Identifying Seborrheic Keratoses
Seborrheic keratoses are characterized by a distinct appearance, often described as “stuck-on” to the skin surface, like a piece of wax or a barnacle. Their coloration is highly variable, ranging from light tan, yellow, or pink to dark brown or black. The texture is typically rough, waxy, or scaly, sometimes appearing crumbly or wart-like.
These growths can appear anywhere on the body, commonly occurring on the face, chest, back, and shoulders. SKs vary in size from tiny spots to more than an inch across, and they can be flat initially or slightly raised. While a person may have a single growth, it is common to develop multiple SKs in clusters over time.
The Need for Professional Diagnosis
SKs can mimic the appearance of other, more serious conditions, making a professional assessment necessary before considering removal. The primary concern is that a seborrheic keratosis can look similar to malignant melanoma, a potentially life-threatening form of skin cancer. Melanoma often presents with irregular borders and varied coloration, features that can overlap with those of a pigmented SK.
Only a trained dermatologist can properly differentiate between a benign growth and a malignant lesion, often using a specialized handheld microscope called a dermatoscope. If the visual diagnosis is uncertain, a biopsy is performed to send a tissue sample to a laboratory for microscopic analysis. This step is the only way to definitively rule out skin cancer, ensuring a person does not mistakenly treat a malignancy as a cosmetic issue.
The “ugly duckling” sign, where one spot looks different from all the others, is a common warning sign for skin cancer. Attempting removal on an undiagnosed lesion destroys the tissue needed for laboratory confirmation. This can delay the diagnosis of melanoma, which requires early intervention for the best outcome.
Why Home Removal Is Strongly Discouraged
Attempting at-home removal of seborrheic keratoses is strongly advised against due to negative outcomes and the risks of misdiagnosis. Methods like scraping, picking, or using unapproved chemical solutions create an open wound, significantly increasing the risk of bacterial infection. Such self-administered trauma can introduce pathogens and lead to localized cellulitis or other complications.
Physical removal methods performed without sterile technique and precise depth control often result in incomplete removal of the growth. This incomplete process can cause the SK to recur, and it raises the risk of permanent scarring and post-inflammatory hyperpigmentation. Over-the-counter wart removal products or unapproved freeze kits are not formulated for SKs and can damage surrounding healthy skin tissue.
The chemicals in these kits, such as high concentrations of salicylic acid, can cause severe irritation, burning, and permanent discoloration. Using sharp objects to scrape or shave the growths, besides the infection risk, almost guarantees a visible scar will form.
Professional Removal Techniques
Dermatologists offer several safe and effective in-office procedures for SK removal once the benign nature of the growth is confirmed. Cryotherapy is a common method, involving the application of liquid nitrogen to freeze the growth. The cold destroys the cells of the SK, causing it to blister and fall off within a few days or weeks.
For thicker or larger lesions, a combination of curettage and electrocautery is frequently used. Curettage involves scraping the growth from the skin surface, and electrocautery uses an electric current to burn the base of the lesion. These techniques allow for precise control over the depth of removal, which helps minimize the risk of scarring.
Ablative laser treatments are another option, particularly for flat or numerous lesions, as they vaporize the tissue with focused energy. These procedures are performed in a sterile environment, often with local anesthetic, ensuring minimal discomfort and a controlled healing process.