About Seborrhoeic Keratosis
Affectionately termed ‘Wisdom spots’, Seborrhoeic warts (aka Seborrhoeic keratosis) are benign skin growths that get more common as we age. Although they have a ‘warty’ appearance, they are not caused by a viral infection. They are harmless skin growths of the upper layers of the skin (epidermis).
What Causes Seborrhoeic Keratoses?
Although very common in the population, the exact cause of seborrhoeic keratoses remains unknown. It is considered a sign of extrinsic aging and may be correlated to chronic UV exposure. Although a viral hypothesis had been put forth, it has not be clearly proven in recent studies.
What Does It Look Like?
Seborrhoeic keratoses tend to be concentrated over the face, neck, arms and trunk area, and multiple skin growths are the norm. Slowly growing, seborrhoeic keratoses are round to oval in shape with a rough surface and appear stuck onto the skin. In some cases, they can appear quite suddenly.
Early seborrhoeic keratoses look pale or light brown in colour, and they progressively get darker over the years. This may worry some patients about skin cancer, when they notice a change in colour and size of the seborrhoeic keratoses They may cause skin irritation, but more often patients complain that they are cosmetically unattractive.
What Are The Types of Seborrhoeic Keratoses?
How Is It Diagnosed?
Most of the seborrheoic keratoses can be diagnosed based on clinical appearance.
In cases where there is diagnostic doubt, a skin biopsy is undertaken to confirm the diagnosis and to exclude skin cancer.
Are Seborrhoeic Keratoses Harmful?
It does not cause any health problems. However, it may cause skin irritation, itchiness and bleeding if caught onto clothing or jewellery. Many individuals find it unsightly and prefer it removed especially on visible areas such as the face.
In rare circumstances, the eruptions of hundreds of seborrhoeic keratoses may be suspicious of an underlying tumour.
Treatment of Seborrhoeic Keratosis
As seborrhoeic keratoses are benign and harmless, most can be safely left alone.
For individuals who wish for it to be removed for cosmetic reasons, or the irritation that it causes, a variety of treatment methods for removal are to be considered.
- shave excision
- liquid nitrogen
- laser surgery
Laser Seborrhoeic Keratoses Removal
Carbon Dioxide (CO2) laser removal is an effective treatment to remove seborrhoeic keratoses in cosmetically sensitive areas such as the face.
Treatment is done under topical and local anaesthesia.
Laser surgery is associated with faster healing times and minimal scarring . Regardless of the treatment modality, there may be permanent changes in the skin in terms of colour but this usually fades over time. Seborrhoeic keratoses may still recur even after removal.
From experience, Dr Ng recommends removal of larger lesions that may be causing physical discomfort or skin irritation first. In cases where the lesion is suspicious, we may send the lesion for histology to confirm the diagnosis.
Treatment is done using topical or local anaesthesia for your comfort. The removal is virtually painless.
You would need to keep your wound clean and regular dressings if your seborrhoeic keratoses is especially large. A topical antibiotic is prescribed to reduce the risk of infection.
Regardless of the treatment modality, they can recur even on the previously treated area. Multiple treatments may be needed to achieve better clearance and results.
As with any surgical procedure, there is a risk of infection, bleeding, scarring, hyperpigmentation, hypopigmentation and scarring. However, theses risks are lower with laser-assisted seborrhoeic keratoses removal.
The cost of the seborrhoeic keratoses removal is from $350 onwards.
- Jackson JM, Alexis A, Berman B, et al.: Current Understanding of Seborrheic Keratosis: Prevalence, Etiology, Clinical Presentation, Diagnosis, and Management. J Drugs Dermatol. 2015;14(10):1119–25
- Gurel MS, Aral BB: Effectiveness of erbium:YAG laser and cryosurgery in seborrheic keratoses: Randomized, prospective intraindividual comparison study. J Dermatolog Treat. 2015;26(5):477–80. 10.3109/09546634.2015.1024597
- Sayan A, Sindel A, Ethunandan M, et al.: Management of seborrhoeic keratosis and actinic keratosis with an erbium:YAG laser-experience with 547 patients. Int J Oral Maxillofac Surg. 2019;48(7):902–7. 10.1016/j.ijom.2018.08.008