Diagnosis and Treatment of Seborrheic Keratoses

A seborrheic keratosis can be diagnosed by examination alone.  A board-certified dermatologist is trained to recognize a seborrheic keratosis just by looking at it.  Occasionally, if it has turned very dark black in color, a skin biopsy may be done to ensure that it is not an atypical nevus or a melanoma.  

These growths do not turn into skin cancer, and despite their irregular appearance, there is no risk of melanoma arising from these lesions.  Therefore, treatment is aimed at cosmetics purposes.  Since they can be unsightly at times, some patients prefer to have them removed.  Also, at times they can become rubbed or traumatized, or they can become inflamed on their own.  If this happens, it is a good idea to have them removed.

If seborrheic keratoses are being removed because of inflammation or irritation in just one or two spots, insurance companies will typically cover the cost of the removal.  However, if they are being removed for cosmetic purposes, the patient is responsible for the cost of removal.

Because seborrheic keratoses are just on the surface of the skin, removal does not usually result in a great amount of scarring.  The most common method of removal and the method that is used when there are multiple lesions to be treated  is with liquid nitrogen therapy.  This results in the lesions turning red, making a small blister, and then ultimately scabbing off.  If there is just one or two irritated or troublesome lesions, these may be removed with curettage, which is scraping off the lesion after local anesthetic is administered.  There is minimal downtime, and usually there is minimal scarring.