Treating Seborrheic Keratoses

Expert Care for Common Benign Skin Growths

A brown patch that looks “stuck on” your skin isn’t necessarily cause for alarm. However, it’s one of the most common reasons people visit a dermatologist. If you’ve noticed a waxy, scaly growth that seems to have appeared out of nowhere, you’ll want to have it evaluated by an experienced dermatologist.

Seborrheic keratoses are benign skin growths that develop when skin cells cluster together on the outer layer of your skin. They’re harmless. They don’t turn into cancer. But they can look irregular or worrying, and sometimes they mimic melanoma or other concerning lesions.

At Connolly Dermatology, we provide expert evaluation and seborrheic keratosis treatment guided by evidence-based care. Our board-certified dermatologists assess, diagnose, and treat these growths, focusing on accurate identification and appropriate intervention when removal makes sense.

If you have a growth that concerns you, scheduling an evaluation with a dermatologist provides clarity. Have your skin assessed by the specialists at Connolly Dermatology and get the answers you need to move forward confidently.

Understanding Seborrheic Keratoses

How These Growths Differ From Moles and Skin Cancer

Seborrheic keratoses form when keratinocytes—cells that make up your skin’s outer layer—proliferate in one area rather than spreading evenly. Most people develop at least one by middle age, and they’re harmless.

These growths have a distinctive appearance. They look waxy or scaly with a raised, “stuck-on” texture. They’re usually brown but can also appear black, tan, pink, yellow, or even white. Size varies widely. Some remain small while others grow larger than a dime.

Once they appear, seborrheic keratoses typically remain stable or slowly grow thicker over time. They rarely disappear on their own.

Seborrheic Keratoses vs. Moles

People often confuse seborrheic keratoses with moles because both can be brown and raised. But there are key differences.

Moles develop from melanocytes—pigment-producing cells—while seborrheic keratoses form from keratinocytes. Moles tend to have a smooth surface and uniform color. Seborrheic keratoses feel rough or warty with a distinctive waxy appearance. The “stuck-on” look is the hallmark feature that dermatologists use to identify them.

Seborrheic Keratoses vs. Skin Cancer

Since seborrheic keratoses can look irregular, they sometimes resemble melanoma or other skin cancers. This visual similarity can create anxiety and make it challenging to determine what’s benign and what needs immediate attention.

Understanding how these lesions differ helps guide appropriate care.

Characteristic

Seborrheic Keratoses

Melanoma

Basal Cell Carcinoma

Surface Texture

Waxy, scaly, “stuck-on” appearance

Smooth or irregular; may ulcerate

Pearly, translucent; may have visible blood vessels

Color

Uniform brown, black, tan, yellow, or white

Varied colors within one lesion (brown, black, red, blue)

Pink, red, or flesh-colored

Border

Well-defined, clear edge

Irregular, notched, or blurred border

Rolled border; may have central depression

Growth Pattern

Slow, stable growth

Evolving; changes in size, shape, or color

Slow but progressive; may bleed or crust

Cancer Risk

Zero; completely benign

Malignant; requires urgent treatment

Malignant; requires prompt treatment

This table summarizes common differences, but not all lesions fit every description. Any new or changing spot should be evaluated by a dermatologist.

Are Seborrheic Keratoses Dangerous?

Seborrheic keratoses aren’t cancerous. They don’t become cancerous. They pose no health risk whatsoever.

That said, they can occasionally mask other lesions or make it harder to identify skin cancers during routine exams. If you have many seborrheic keratoses, careful monitoring ensures nothing concerning gets overlooked.

In rare cases, the sudden appearance of many seborrheic keratoses—called the Leser-Trélat sign—can signal an internal malignancy. This uncommon phenomenon warrants evaluation for gastrointestinal or pulmonary cancers.

Signs and Symptoms

Seborrheic keratoses can vary in appearance, which is why understanding their general features helps you notice changes that may need medical attention.

Size and Shape: These growths range from a few millimeters to several centimeters across. Most are round or oval. The edges are typically well-defined rather than irregular.

Color: Color varies widely. You might see light tan, brown, dark brown, black, or even yellowish tones. Some are so dark they’re mistaken for melanoma.

Surface: The surface feels rough, scaly, or waxy. It often has a raised, “stuck-on” appearance, as if someone placed a piece of wax on your skin. Some have small pits or ridges that look like fingerprints.

Texture: When you touch a seborrheic keratosis, it feels different from surrounding skin. It’s often thicker and may feel slightly greasy or waxy.

Location: They can appear almost anywhere on your body except the palms, soles, and mucous membranes. Common sites include the face, scalp, chest, back, and shoulders.

Changes Over Time: Most seborrheic keratoses remain stable. Some grow slowly thicker. Sudden changes in appearance deserve prompt evaluation.

Symptoms To Watch For

Most seborrheic keratoses don’t cause symptoms. They just exist on your skin without bothering you.

However, some people experience:

• Itching or irritation
• Catching on clothing or jewelry
• Bleeding if scratched or bumped
• Discomfort in areas with friction
• Concern about appearance

If a seborrheic keratosis exhibits any of the following changes, see a dermatologist promptly:

• Rapid growth
• Color change
• Irregular borders
• Ulceration or bleeding
• Pain or tenderness
• A growth that looks distinctly different from your other seborrheic keratoses

These changes don’t necessarily indicate cancer, but they warrant professional evaluation to rule out melanoma or other concerning lesions.

Risk Factors for Developing Seborrheic Keratoses

The development of seborrheic keratoses is influenced by genetics, age, and environmental factors.

Age: These growths primarily affect people over 50. About 30% of people have at least one by age 40, and 75% by age 70. They’re rare in young adults.

Genetic Predisposition: Family history plays a significant role. About half of all cases involving multiple seborrheic keratoses occur in families, suggesting inherited susceptibility. Researchers have identified activating mutations in the FGFR3 gene in many sporadic cases.

Skin Tone: Classic seborrheic keratoses are more common in people with lighter skin. However, a variant called dermatosis papulosa nigra frequently appears in people of African, Asian, and Hispanic descent.

Sun Exposure: While seborrheic keratoses aren’t caused by sun damage in the same way actinic keratoses are, some studies suggest UV exposure may increase their occurrence.

Can You Prevent Seborrheic Keratoses?

There’s no proven way to prevent seborrheic keratoses, especially when genetics plays such a strong role. Still, there are steps you can take to protect your skin and support long-term skin health.

Know Your Skin: Become familiar with your skin’s normal appearance so you can recognize new or changing growths early.

Seek Regular Dermatologic Exams: Routine skin exams allow a dermatologist to monitor existing growths and identify concerning changes promptly.

Protect Against UV Radiation: Use broad-spectrum sunscreen, wear protective clothing, and avoid tanning beds. Limiting UV exposure supports overall skin health and reduces your risk of skin cancer.

Diagnosis and Evaluation

Evaluation by a dermatologist is central to managing seborrheic keratoses. Because these growths can resemble melanoma or other skin cancers, they should be examined carefully rather than assumed benign based on appearance alone.

During an appointment, your dermatologist uses a systematic approach to understand what you’re dealing with and whether any intervention is needed.

Visual Examination: In most cases, an experienced dermatologist can identify a seborrheic keratosis by sight. The characteristic “stuck-on” appearance, waxy texture, and well-defined borders are distinctive.

Dermoscopy: A dermatoscope provides magnification and specialized lighting that reveal structural features beneath the skin surface. Dermoscopy findings in seborrheic keratoses include comedo-like openings, milia-like cysts, and hairpin vessels. These details help distinguish benign growths from melanoma.

Digital Photography: Photographs of your growths may be taken and stored for future comparison. This makes it easier to detect changes during follow-up visits.

Biopsy or Shave Excision: When a growth shows features that raise concern—irregular borders, color variation, rapid changes—part or all of the lesion may be removed. The tissue is examined under a microscope to confirm the diagnosis and rule out skin cancer.

When Should You Get a Seborrheic Keratosis Evaluated?

You should see a dermatologist if you notice:

• A new growth that looks unusual
• A growth that’s changing in size, color, or texture
• A lesion that bleeds, itches, or becomes painful
• Multiple new growths appearing suddenly
• Any growth that concerns you

Even if a growth turns out to be a harmless seborrheic keratosis, getting it checked provides peace of mind.

Seborrheic Keratosis Treatment Options

Most seborrheic keratoses don’t require treatment. They’re benign and pose no health risk. However, many people choose to have them removed for cosmetic reasons or because they’re irritated by clothing or jewelry.

When removal is appropriate, several effective options exist.

Observation

If a growth is clearly a seborrheic keratosis and causes no symptoms, no treatment is needed. Your dermatologist will document the lesion and continue to monitor it during routine follow-up visits. This approach avoids unnecessary procedures while ensuring nothing concerning is missed.

Cryotherapy

Cryotherapy is the most common treatment for seborrheic keratoses. Liquid nitrogen is applied to the growth using a cotton swab or spray gun. The extreme cold destroys the cells, and the growth falls off within days to weeks.

This procedure is quick, well-tolerated, and doesn’t require anesthesia. Thicker growths may need multiple freeze-thaw cycles. After treatment, the skin may be lighter than surrounding areas. This usually fades over time but can occasionally be permanent.

Electrosurgery and Curettage

In this procedure, the growth is numbed with local anesthesia. An electric current destroys the tissue, and a curette—a small, spoon-shaped instrument—scrapes away the remains. The process is quick and effective.

Electrosurgery allows for precise removal with minimal bleeding. Some patients prefer this method because it provides immediate removal rather than waiting for the growth to fall off. Possible side effects include temporary redness, scabbing, and hyperpigmentation.

Shave Excision

For growths that need histopathologic confirmation, shave excision is preferred. The growth is carefully shaved off using a scalpel or razor blade after local anesthesia. The specimen is sent to a laboratory for microscopic examination.

This approach is ideal when there’s any uncertainty about the diagnosis. It removes the growth while allowing your dermatologist to confirm it’s benign.

Laser Therapy

Ablative lasers such as CO2 and Er:YAG can effectively remove seborrheic keratoses. The laser vaporizes the tissue with precision. Studies suggest Er:YAG laser shows faster healing and less hyperpigmentation than cryotherapy.

Laser treatment offers excellent cosmetic results and is particularly useful for growths on the face where scarring is a concern.

Topical Treatments

FDA-approved 40% hydrogen peroxide solution can be applied to seborrheic keratoses. It’s well-tolerated and effective, though mild side effects like erythema, scaling, and hyperpigmentation may occur.

Other topical agents—tazarotene, imiquimod cream, alpha-hydroxy acids, and vitamin D analogs—have shown varying degrees of success. These options work more slowly than surgical treatments but avoid procedures.

Will Seborrheic Keratoses Come Back After Removal?

Once a seborrheic keratosis is removed, it doesn’t return in that exact spot. However, new ones can develop elsewhere on your body. If you’re prone to seborrheic keratoses, you’ll likely develop more over time.

Why Choose Connolly Dermatology for Seborrheic Keratosis Treatment

Care Guided by Experience and Clinical Judgment

When a skin growth raises concern, patients want careful evaluation and straightforward answers. Connolly Dermatology provides expert, physician-led care for individuals seeking seborrheic keratosis treatment, with an emphasis on accuracy and appropriate intervention.

Board-Certified Dermatologists

Our dermatologists are experienced in diagnosing and managing benign skin growths and skin cancers. Decisions about your care follow current clinical guidelines and reflect evidence-based dermatology.

Advanced Diagnostic Technology

We use dermoscopy and digital photography to evaluate features that aren’t visible during a standard exam. These tools support accurate diagnosis while helping limit unnecessary biopsies.

Multiple Treatment Options

We offer cryotherapy, electrosurgery and curettage, shave excision, and topical treatments. Your dermatologist will recommend the approach that best fits your needs based on the growth’s size, location, and appearance.

Personalized Care Plans

Treatment plans are based on your individual concerns and preferences. If you want a growth removed for cosmetic reasons, we’ll discuss which method offers the best outcome. If observation makes more sense, we’ll explain why.

Patient Education and Support

During each visit, we explain what you’re seeing and answer your questions in plain language. We want you to understand your skin and feel confident about the care you’re receiving.

Comfortable, Compassionate Care

We understand that concerns about skin growths can create stress or uncertainty. Our team focuses on clear explanations, thoughtful communication, and minimizing discomfort during evaluations and procedures.

What To Expect During Treatment

Guiding You Through Evaluation and the Next Steps

Many patients feel apprehensive when a skin growth needs closer evaluation or possible removal. At Connolly Dermatology, we guide you through your treatment plan so you know what to expect before anything begins.

Before Your Appointment

Preparing in advance helps your dermatologist understand the whole picture. Take note of when you first noticed the growth and whether it has changed. Bring a list of your medications and any relevant family history. Photographs showing the growth over time can be helpful.

During the Evaluation

During your visit, your dermatologist will review your medical history and then perform a thorough skin exam. A dermatoscope may be used to examine specific growths more closely. Your dermatologist will explain what they’re seeing and take time to answer your questions.

If a growth appears to be a seborrheic keratosis and you’d like it removed, treatment can often be performed during the same visit. Cryotherapy takes just minutes. Shave excision or electrosurgery requires local anesthesia and usually takes less than 30 minutes. Most patients experience minimal discomfort and can drive themselves home afterward.

After Treatment

After treatment, you’ll receive clear instructions on caring for the area as it heals. Most sites heal within one to two weeks. Scarring is typically minimal.

If a biopsy was performed, results are shared as soon as they’re available, along with an explanation of what they mean and whether any next steps are needed. If the growth is benign, no further care may be required.

Get Clear Answers from Connolly Dermatology

Make Informed Decisions About Your Skin Health

Seborrheic keratoses are benign skin growths with a distinctive “stuck-on” appearance. They’re harmless and don’t turn into cancer. But they can look concerning, and sometimes they mimic melanoma or other skin cancers.

If you have a growth that concerns you or notice changes you can’t explain, a professional evaluation provides clarity and peace of mind. At Connolly Dermatology, our board-certified dermatologists offer expert assessment and personalized care for patients with seborrheic keratoses.

Schedule a visit with a dermatologist to get clear, informed guidance about your skin.