Seborrhoeic Keratoses: Common Skin Growths Demystified

It was a sunny Tuesday morning when Mrs. Evelyn Baker, a retired librarian in her mid-60s, visited my clinic. As she rolled up her sleeve, she revealed a cluster of small, dark, and slightly raised skin lesions on her forearm. “Dr. Priya,” she said hesitantly, “these spots have been appearing more and more. They don’t hurt, but they’re not very pretty, and I’m worried if they could be dangerous.”

Evelyn’s concern was valid. Skin changes can be alarming, especially as we age. I assured her that we’d address her worries and take a closer look.

What Are Seborrhoeic Keratoses?

“Evelyn,” I began, “what you’re describing are likely seborrhoeic keratoses. These are harmless, brown or black, slightly raised growths that often appear on the skin as we age. They’re sometimes referred to as ‘age spots’ or, less kindly, ‘barnacles of old age.’”

I explained that seborrhoeic keratoses are among the most common benign skin lesions. They may have a pitted, waxy, or even crusty appearance and seem as if they are ‘stuck’ on the skin rather than embedded within it.

Evelyn exhaled a sigh of relief. “So, they’re not cancerous?”

“No, they’re not cancerous,” I reassured her. “But it’s always a good idea to get any new or changing lesions checked by a doctor.”

Who Gets Seborrhoeic Keratoses?

Seborrhoeic keratoses are incredibly common. They typically appear in adults over the age of 40 and become more prevalent with advancing years. By the time most people reach their 60s, they’ve developed at least a few of these harmless growths.

I added, “Evelyn, both men and women can get them, and sometimes a family history of these spots can increase your likelihood of developing them.”

She nodded. “My mother had something similar, now that I think about it.”

Where Are Seborrhoeic Keratoses Located?

“Let me show you,” I said, pulling out a diagram. “They can occur almost anywhere on the body but are most commonly found on the chest, back, arms, and legs. However, they don’t usually appear on the palms, soles, or mucous membranes.”

Evelyn noticed a similar lesion on her lower leg and confirmed that they didn’t itch or cause pain. “I guess they’re just there, but they do make me self-conscious.”

What Are the Features of Seborrhoeic Keratoses?

As I examined Evelyn’s lesions under a magnifying glass, I pointed out their key characteristics:

• Flat-topped with a well-defined border.
• A pitted or waxy surface that gives a ‘stuck-on’ look.
• Ranging in color from yellow to dark brown or black.
• Varied shapes, from round to oval.
• Sizes ranging from a few millimeters to up to 5 centimeters.

I reassured her, “They may appear alarming because of their texture and color, but these growths are benign and don’t spread like skin cancers.”

What Happens to Seborrhoeic Keratoses Over Time?

“Over time, seborrhoeic keratoses may become darker, larger, or more numerous,” I explained. “Some may eventually fall off on their own, leaving a pale patch of skin behind.”

Evelyn asked, “So they’re here to stay unless they fall off?”

“Exactly,” I said. “But while they don’t cause harm, they can sometimes catch on clothing or look cosmetically bothersome.”

What Is the Risk?

I emphasized that seborrhoeic keratoses are non-cancerous and don’t pose any health risks. However, they can sometimes be confused with malignant growths like melanoma, which is why a professional evaluation is essential.

“If you notice rapid growth, bleeding, or significant color changes in any lesion, you should see a doctor immediately,” I added.

What Is the Treatment for Seborrhoeic Keratoses?

“Do I need to do anything about them?” Evelyn asked.

“Treatment is usually unnecessary,” I replied. “But if the lesions bother you or interfere with your daily life, there are options.”

Treatment Options:

1. Cryotherapy: Freezing the growth with liquid nitrogen, which causes it to fall off.
2. Curettage: A procedure where the lesion is gently scraped off after numbing the area.
3. Electrocautery: Burning the lesion off with a low-level electrical current.
4. Topical Treatments: Thin, superficial growths can sometimes be treated with prescription-strength creams or chemical peels.

“Many people opt for removal if the lesions become irritated or for cosmetic reasons,” I explained. “But this is entirely up to you.”

Evelyn asked if home remedies might work. “It’s best to avoid scratching or attempting to remove them at home,” I cautioned. “That could lead to infection or scarring.”

Research Insights

I shared with Evelyn some recent findings. A study published in Dermatology Research found that up to 90% of individuals over 70 have at least one seborrhoeic keratosis. Research also suggests that their appearance may be influenced by genetic factors and prolonged sun exposure, though their exact cause remains unknown.

Evelyn looked thoughtful. “So sunscreen won’t stop them?”

“Not exactly,” I said. “While sunscreen won’t prevent seborrhoeic keratoses, it can protect your skin from other sun-related issues, like premature aging and skin cancer.”

Preventive Measures and Regular Check-Ups

I advised Evelyn to monitor her skin regularly and schedule annual dermatology check-ups. “Photographing your spots can help track any changes,” I suggested.

I also explained that while there’s no way to prevent seborrhoeic keratoses, maintaining good skin health and addressing any new or unusual changes promptly is crucial.

A Positive Outlook

Evelyn smiled as she rolled down her sleeve. “Thank you, Dr. Priya. I feel much better knowing these aren’t something to worry about.”

I reminded her that while seborrhoeic keratoses are harmless, it’s essential to stay vigilant about skin health. “If you notice anything unusual, don’t hesitate to come back.”

FAQs About Seborrhoeic Keratoses