Seborrheic keratosis (SK) is one of the most common non-cancerous skin growths, often appearing in mid-adulthood and becoming more frequent with age. These benign growths are not contagious and do not pose a health risk, but many individuals seek removal for cosmetic reasons or because the growths become irritated by clothing. While the desire to remove these lesions at home is understandable, it is important to first understand the nature of the growth and the associated safety considerations.
Identifying Seborrheic Keratosis
Seborrheic keratoses present as distinct patches on the skin, often described as having a characteristic “stuck-on” or pasted appearance. They vary widely in color, ranging from light tan, yellow, or gray to dark brown or even black. The surface texture is typically dull, waxy, and verrucous, or wart-like.
The growths are usually raised above the surrounding skin, with sizes ranging from a millimeter to several centimeters in diameter. While they can occur almost anywhere on the body, they are most frequently observed on the trunk, scalp, neck, and face. Though generally painless, SKs can become itchy or inflamed, especially if they rub against clothing or jewelry.
Safety Warnings and Misdiagnosis Risks
The primary risk of at-home removal is misdiagnosing a potentially cancerous lesion. SKs can closely resemble dangerous skin conditions, including melanoma, basal cell carcinoma, or squamous cell carcinoma. A medical professional can usually differentiate these conditions through visual examination, sometimes using a dermatoscope, or by performing a biopsy.
Melanoma can sometimes be mistaken for a dark seborrheic keratosis, making professional screening essential for any new or changing growth. Individuals should immediately consult a dermatologist if a growth exhibits the ABCDE features of melanoma: Asymmetry, irregular Border, varied Color, a Diameter larger than a pencil eraser, or if it is Evolving (changing in size, shape, or color). Attempting to remove an undiagnosed growth at home delays proper treatment and can lead to serious consequences.
Self-removal attempts using unsterile tools, scratching, or picking can introduce bacteria, increasing the risk of a secondary infection. Damaging the skin layer can result in permanent scarring or post-inflammatory hyperpigmentation, where the treated area becomes noticeably darker than the surrounding skin. These cosmetic complications can often be more disfiguring than the original lesion.
At-Home and Over-the-Counter Treatment Options
Over-the-counter (OTC) products are available to manage seborrheic keratoses, though these treatments are generally less effective than professional procedures. OTC cryotherapy kits use a less potent freezing agent than the liquid nitrogen used in a clinic. These kits carry a higher risk of inconsistent application and skin damage, may not freeze the growth deeply enough for complete removal, and can result in unwanted changes to skin pigment.
Topical acids are another common at-home approach, particularly those containing high concentrations of alpha hydroxy acids like glycolic acid or salicylic acid. These agents work by chemically exfoliating the outermost layer of the skin. However, these products are designed to improve the appearance and texture, not reliably eliminate the entire growth.
Stronger topical treatments, such as a prescription-strength 40% hydrogen peroxide solution, have been approved for SK removal, but this concentration is not available over the counter. Any attempt to cut, burn, or physically scrape the lesion with non-medical instruments is strongly discouraged due to the high probability of infection, bleeding, and permanent scar formation.
When Professional Removal Becomes Necessary
Professional removal is necessary if the seborrheic keratosis is chronically irritated, bleeds, or if the diagnosis is uncertain. If a growth is suspicious for malignancy, a healthcare provider will perform a biopsy to confirm the diagnosis. Professional removal offers safer, more controlled, and more thorough elimination of the lesion with minimal risk of complications.
Dermatologists use several established clinical procedures, including cryosurgery, which involves freezing the growth with liquid nitrogen. Another common technique is curettage, where the growth is scraped off the skin surface, often combined with electrosurgery to destroy the base of the lesion. These professional methods minimize the risk of scarring and permanent pigment changes, especially when compared to unpredictable home remedies.