Seborrheic Keratosis: How to Recognize It and Options After Diagnosis

No. A seborrheic keratosis is not contagious: it is not passed on through contact with another person. The name seborrheic wart is misleading: it is not a wart caused by a virus. If new keratoses appear, it is because their number tends to increase with age, not because they have spread. A medical examination is still needed to confirm that your spot really is a seborrheic keratosis.

A diagnosed seborrheic keratosis does not turn into skin cancer. The danger comes from confusing it with other lesions: a very dark keratosis can look like a melanoma, and a dry, flat, rough spot that peels can be an actinic keratosis, some of which develop into cancer. A spot that changes, grows quickly, turns black, itches or bleeds must therefore be examined by a doctor before any removal, even if you think you recognize it.

Through a medical examination. A seborrheic keratosis often looks waxy and rough, as if stuck on the skin, and its colour ranges from pink to almost black. A solar lentigo is more typically a flat spot on an area exposed to the sun, but a keratosis can also be flat when it first appears. These reference points are therefore not enough: the doctor examines the spot and, if in doubt, may do a biopsy, meaning the analysis of a small skin sample.

No. Scratching, pulling off or trying to remove a keratosis yourself puts you at risk of infection. You would also be destroying a spot that has not been examined, when a lesion that looks like a keratosis can be something else, sometimes a melanoma. Have the spot examined first; if it bothers you, removal should then be discussed after diagnosis. It must be performed by a professional.

The first step is to have the spot identified by a doctor. Once a diagnosis has been made, CARE MD removes the keratosis using plasma, cryotherapy or CO2 laser, depending on the lesion and the skin; a physician or a nurse under medical supervision performs the removal. Discuss with the doctor which technique is suited to your skin, the possible marks, the number of sessions being considered and how long healing is expected to take. For plasma and CO2 laser, ask the doctor about the after-effects and risks specific to the procedure. Cryotherapy destroys the lesion by freezing it with liquid nitrogen. In general, a keratosis can also be removed by electrocautery: an electric current destroys the lesion after a local anesthetic. The risks and the care required differ depending on the method and need to be explained for the technique chosen.

The skin can stay lighter where it was treated; the difference usually fades, but sometimes remains. A treated keratosis can grow back, and others can appear elsewhere. After cryotherapy, redness, swelling, a blister, pain and then a scab are possible, and pulling off the scab makes a scar more likely. After cryotherapy, the skin can also become lighter or darker, especially on brown or Black skin; this change can be permanent. A white, flat scar rarely forms after this procedure. If the pain increases or you see pus, contact the professional who treated you or your doctor.

Removal on the face can be discussed once a diagnosis has been made. If its appearance bothers you, also consider the possible marks: the skin can stay lighter after removal, sometimes permanently. After cryotherapy, it can become lighter or darker, especially on brown or Black skin; a scar rarely forms and can be white and flat. A spot on the face that changes, itches or bleeds needs to be examined first. A seborrheic keratosis can also be found on the eyelid: CARE MD assesses and treats it after diagnosis, as it does elsewhere on the skin.