Seborrheic Keratoses – Bothersome Barnacles of the Skin!

Seborrheic keratoses of the back. Photo by James Heilman MD

One of the most frequent growths that brings patients into the office are seborrheic keratoses.  Frequently mistaken for moles, they are most commonly brown “stuck-on” growths that can occur essentially anywhere on the body.  They tend to arise in adulthood and have a likely genetic inheritance.  Most of my patients refer to them as barnacles, nuisance growths, age spots, or “moles.”

So now the important question… how do you get rid of them?

Seborrheic keratoses can be frozen off by a process called cryotherapy, scraped (curetted) off, cut out (not usually optimal), or burned off with an electric needle if small.  If they are pretty flat, lasers can be used to remove them as well.  Be careful how you get them removed though. I have seen patients left with bad darkening or lightening of the skin as well as scarring after removal.  As with most cosmetic procedures, it’s best not to be tan in general during the procedure as that could increase risk of pigmentary change of the skin.  If you are concerned about a particular growth or interested in removal, schedule an appointment with a dermatologist who can evaluate the growth to 1) make sure it is indeed a benign growth, and 2) counsel you on the best way to remove the growth.

Seborrheic keratoses – aka “Barnacles”

Seborrheic keratoses (SKs) account for many referrals to the dermatologist. What are seborrheic keratoses? If you’ve seen a dermatologist before, they may have been referred to as barnacles, wisdom spots, SKs, seb kers, or some other creative terms. Bottom line is, they are benign spots. Chances are mom or dad had them too and passed on some of the genes that dictate their growth to you. There are many flavors (or perhaps more appropriately, looks) to seborrheic keratoses. They typically look like stuck-on warty pigmented growths on the skin but they can also be smooth, barely raised, pink or non-pigmented. In general, they don’t cause problems so if your SK doesn’t bother you, don’t bother it! Unfortunately, sometimes they do get in the way — e.g. of your necklace, bra strap, waistband, eyeglasses, brush/comb, etc. Or maybe you’re just bothered by the way they look. (You can’t tell your SK where to grow and it might just crop up in a very visible area like the face.) In this case, talk to your dermatologist. There are various options for removal. Cryotherapy (the liquid nitrogen cold spray), curettage, and shaving are just some methods for removal. There are benefits and drawbacks to each so let a doctor take care of removal. You don’t want to exchange an SK for a scar. And you probably want a method that can keep your SK away for as long as possible. Some people also use a loofah sponge when showering or bathing to help even out the wartiness/roughness of the SK.

Just keep in mind, since seborrheic keratoses often are pigmented, it can be hard for the non-trained eye to distinguish a potential skin cancer from a seborrheic keratosis. So when in doubt, see a dermatologist for evaluation!