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Seborrhoeic Keratosis

Seborrhoeic keratosis is a common benign skin growth that appears as a waxy, scaly patch that looks “stuck onto” the skin. Though harmless, it can resemble skin cancer. It typically develops after age 40 and may appear anywhere except the palms and soles, varying in colour from light beige to dark brown or black.

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Overview

What Is seborrhoeic keratosis?

Seborrhoeic keratosis (sometimes called a seborrhoeic wart or basal cell papilloma) is a benign overgrowth of the outer layer of the skin (the epidermis). It is not caused by infection or linked to skin cancer, although these growths can sometimes resemble malignant lesions.

They can appear anywhere on the face, trunk, back, arms, or legs, but are most common on areas exposed to sunlight such as the chest and upper back. The texture can vary from smooth and waxy to dry, crusted, or wart-like.

Symptoms and Causes

How does seborrhoeic keratosis develop?

eborrhoeic keratoses vary in appearance, but they share several characteristic features:

  • Texture and surface: Lesions often feel waxy, rough, or crumbly, resembling candle wax or crusted barnacles.
  • Colour: They may range from light yellow or tan to dark brown or black, sometimes darkening with time.
  • Shape: Usually round or oval with sharply defined borders.
  • Location: Commonly found on the face, scalp, chest, shoulders, and back.
  • Sensation: Usually painless but can become itchy, irritated, or inflamed, especially if rubbed by clothing or jewellery.

What causes seborrhoeic keratosis?

The exact cause remains unclear, but several factors appear to contribute to their formation:

  • Ageing: The condition becomes more common with age and affects most people over 50.
  • Genetics: A family history of seborrhoeic keratoses increases the likelihood of developing them.
  • Sun exposure: Prolonged ultraviolet (UV) exposure may play a role in triggering or worsening lesions.
  • Hormonal changes: Some people notice an increase in lesions during pregnancy or after hormone therapy.

Seborrhoeic keratoses are not contagious and cannot be passed from person to person.

Diagnosis and Tests

Diagnosis is usually made through a visual and physical examination by a GP or dermatologist. The distinctive “stuck-on” appearance often provides enough information for identification.

If there is uncertainty, especially when a lesion appears dark, irregular, bleeding, or changing, further tests may be performed to rule out melanoma or other types of skin cancer.

  • Dermatoscopy: A magnified inspection tool used to evaluate pigment patterns and surface features in detail.
  • Skin biopsy: A small tissue sample is taken and examined under a microscope to confirm the diagnosis.

Management and Treatment

Seborrhoeic keratoses are benign and usually do not require treatment unless they cause discomfort, irritation, or cosmetic concern. Some people choose removal for aesthetic reasons or when lesions frequently become inflamed.

Treatment options

  • Cryotherapy: Freezing the lesion with liquid nitrogen so that it blisters and eventually falls off. Suitable for smaller or thinner lesions.
  • Curettage and electrocautery: The lesion is gently scraped off under local anaesthetic, followed by light cauterisation to stop bleeding and smooth the skin.
  • Laser therapy: Uses focused light to target pigmentation and raised tissue. Often preferred for facial or visible areas to minimise scarring.
  • Shave excision: A minor surgical procedure where the lesion is shaved flat with a scalpel under local anaesthetic.
  • Topical treatments: Occasionally, a prescribed topical agent such as a hydrogen peroxide solution may be used for superficial lesions.

These treatments are safe and effective when carried out by qualified clinicians. Temporary redness or pigmentation changes may occur after removal.

Outlook/Prognosis

Seborrhoeic keratoses are completely benign and do not transform into skin cancer. Many people develop multiple lesions over time, and new ones may continue to appear with age. Once removed, the same lesion will not recur, but others can develop elsewhere.

Although harmless, seborrhoeic keratoses can sometimes cause cosmetic distress or discomfort. Regular skin monitoring remains important, as other conditions such as melanoma can look similar.

Prevention

Can seborrhoeic keratosis be prevented?

There is no guaranteed way to prevent seborrhoeic keratosis since it mainly results from ageing and genetic factors. However, the following measures may help reduce risk or slow development:

  • Protect your skin from UV damage: Use broad-spectrum sunscreen and limit excessive sun exposure.
  • Maintain healthy skin: Keep your skin clean and moisturised to avoid irritation or dryness.
  • Regular skin checks: Monitor for any new, changing, or unusual lesions and seek medical advice if concerned.
  • Avoid scratching or picking: Repeated trauma can irritate or inflame existing lesions.

Regular skin monitoring and early medical consultation are key to maintaining healthy, evenly pigmented skin.

Get a Professional Skin Assessment

If you have rough, waxy, or dark patches on your skin that are changing in size, shape, or colour, Aventus Clinic can help. Our dermatology specialists provide thorough skin assessments and safe, effective treatment options.