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Seborrheic Keratoses are often confused with warts or moles, but they are quite different. Seborrheic keratoses are non-cancerous growths of the outer layer of skin. There may be just one growth or many which occur in clusters. They are usually brown, but can vary in color from light tan to black and range in size from a fraction of an inch in diameter to larger than a half-dollar. A main feature of seborrheic keratoses is their waxy, “pasted-on” or “stuck-on” appearance. They sometimes look like a dab of warm brown candle wax that has dropped onto the skin or like barnacles attached to the skin.

CAUSES OF SEBORRHEIC KERATOSES
The exact cause of seborrheic keratoses is unknown; however, they seem to run in families. They are not caused by sunlight and can be found on both sun-exposed and non sun-exposed areas. Seborrheic keratoses are more common and numerous with advancing age. Although seborrheic keratoses may first appear in one spot and seem to spread to another, they are not contagious.

DEVELOPMENT OF SEBORRHEIC KERATOSES
Anyone may develop seborrheic keratoses. Some people develop many over time, while others develop only a few. As people age, they may simply develop more. Children rarely develop seborrheic keratoses. Seborrheic keratoses may erupt during pregnancy, following estrogen therapy, or in association with other medical problems.

FACTS ABOUT SEBORRHEIC KERATOSES
Seborrheic keratoses are most often located on the chest or back, although they also can be found on the scalp, face, neck, or almost anywhere on the body. The growths usually begin one at a time as small, rough, itchy bumps which eventually thicken and develop a warty surface.
Seborrheic keratoses are benign (non-cancerous) and are NOT serious. Unless they develop suddenly, they do not indicate a serious health problem. They may be unsightly, especially if they appear on the face. Removal may be recommended if they become large, irritated, itch, or bleed easily. A seborrheic keratosis may turn black and may be difficult to distinguish from skin cancer. Such a growth must be removed and biopsied (studied under a microscope) to determine if it is cancerous or not.

TREATMENT OF SEBORRHEIC KERATOSES
Creams, ointments, or other medication can neither cure nor prevent seborrheic keratoses. Most often seborrheic keratoses are removed by cryosurgery, curettage, or electrosurgery.

• Cryosurgery
Liquid nitrogen, a very cold liquid gas, is applied to the growth with a cotton swab or spray gun to freeze” it. A blister may form under the growth which dries into a scab-like crust. The keratosis usually falls off within a few weeks. Occasionally, there will be a small dark or light spot that usually fades over time.

• Curettage
The keratosis is scraped from the skin. An injection or spray is first used to anesthetize (numb) the area before the growth is removed (curetted). No stitches are necessary, and the minimal bleeding can be controlled by applying pressure or the application of a blood-clotting chemical.

• Electrosurgery
The growth is anesthetized (numbed) and an electric current is used to burn the growth which is then scraped off.

WHAT SEBORRHEIC KERATOSES ARE NOT
Although these growths are frequently confused with warts, moles, actinic keratoses and malignant melanoma skin cancer, they differ in a variety of ways.

• Warts are caused by a virus; seborrheic keratoses are not. Warts tend to develop more quickly. They do not get as dark in color, and they do not have a “pasted-on” appearance.

• Moles are skin-colored or tan to brown in color. Almost everyone develops 20-30
moles during his or her lifetime – usually during childhood.

• Actinic keratoses (solar keratoses) are considered the earliest stage in the development of skin cancer which is limited to the outermost layer of skin. Since they are caused by the sun, they most commonly occur on body areas such as the face, hands, forearms and the “V” of the neck which are exposed to sunlight. These growths are more common in pale-skinned, fair-haired, light-eyed individuals and are flatter, redder, scalier, and rougher than seborrheic keratoses. Any raised, reddish, rough-textured growth should be examined by a dermatologist.

• Melanomas are a serious form of skin cancer. They usually, but not always, are very dark brown to bluish-black growths. Melanomas may be confused with seborrheic keratoses because both can become very dark and irregular. Any growth that turns dark, bleeds, itches, or becomes irritated should be checked by a dermatologist since early detection of skin cancer is the best way to assure successful treatment.

A dermatologist is a physician who specializes in treating the medical, surgical and cosmetic conditions of the skin, hair and nails. To learn more about seborrheic keratoses, log onto www.aad.org, or call toll free (888) 462-DERM (3376) to find a dermatologist in your area.

© 2007 American Academy of Dermatology
American Academy of Dermatology
P.O. Box 4014, Schaumburg, Illinois 60168-4014
AAD Public Information Center: (888) 462-DERM (3376)
AAD Member Resource Center: (866) 503-SKIN (7546)
Web: www.aad.org

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