Seborrheic Keratosis: Harmless but Annoying Growths Explained

Seborrheic keratosis removal in New Braunfels is a simple, in-office procedure that eliminates these common, benign skin growths that become increasingly prevalent with age. If you’ve developed waxy, “stuck-on” bumps on your face, chest, or back — especially if they’re catching on clothing, irritating you, or concerning you cosmetically — understanding what seborrheic keratoses are, how they differ from concerning lesions, and your removal options will help you make an informed decision.

What Are Seborrheic Keratoses?

Seborrheic keratosis (SK) is a benign skin growth composed of proliferating epidermal keratinocytes. Despite the name, SKs have nothing to do with sebaceous glands — the terminology is historical. They are among the most common benign skin tumors in adults worldwide.

Seborrheic keratoses become steadily more common with age, and many adults develop several — sometimes dozens — over a lifetime. According to a comprehensive review by Hafner and Vogt (J Dtsch Dermatol Ges, 2008), SKs are among the most frequently encountered benign cutaneous tumors in clinical dermatology practice. The American Academy of Dermatology notes that most people get these growths when they are middle-aged or older, and most develop several.

SKs typically appear as:

• Waxy, scaly growths with a characteristic “stuck-on” appearance — as if they could be peeled off
• Tan, brown, or black discoloration (color varies considerably)
• Slightly raised lesions, usually 1mm–3cm in diameter
• Located most commonly on the face, chest, back, and shoulders — though they can appear almost anywhere except palms and soles

Are Seborrheic Keratoses Dangerous?

Seborrheic keratoses are completely benign. They are not cancerous, not precancerous, and do not transform into skin cancer. They are among the most definitively benign skin lesions a dermatologist can identify. However, they can become:

• Irritated or inflamed: SKs can catch on clothing or jewelry, becoming tender, itchy, or bleeding. This is called an irritated (or inflamed) SK and is one of the most common reasons patients seek removal.
• Cosmetically bothersome: Many patients feel self-conscious about multiple or prominent SKs, particularly on the face or neck.
• Diagnostically uncertain: SKs can sometimes mimic melanoma — particularly darkly pigmented or irregular-appearing SKs. Because certain melanomas can superficially resemble an SK, any lesion of uncertain identity should be evaluated by a board-certified dermatologist.

There is no medical necessity to remove an SK that is not causing symptoms or concern. Removal is elective.

What Causes Seborrheic Keratoses?

The development of SKs is primarily genetic and age-related. UV exposure may contribute, but is not required — SKs can and do develop on sun-protected skin. Somatic mutations in the FGFR3 and PIK3CA genes have been identified in a substantial proportion of SKs, including in familial seborrhoeic keratoses (Hafner et al., Br J Dermatol, 2008), pointing to a cell-proliferation pathway that is largely independent of UV-induced DNA damage.

An important clinical sign: the sudden appearance of multiple new SKs (called the Leser-Trélat sign) can occasionally signal an underlying internal malignancy, though this association is debated in the literature. New rapid-onset eruptions of many SKs warrant a dermatology evaluation.

Seborrheic Keratosis vs. Other Lesions

SK vs. Melanoma: Seborrheic keratoses can sometimes mimic melanoma — they may appear dark, irregular, or rapidly growing. Dermoscopy helps distinguish most SKs from melanoma through characteristic patterns — Braun et al. (Arch Dermatol, 2002) documented milia-like cysts, comedo-like openings, and fissures and ridges as the hallmark features of pigmented SKs. These same criteria were incorporated into the international dermoscopy consensus published by Argenziano et al. (J Am Acad Dermatol, 2003). No dermoscopic pattern is perfect, though — any lesion with genuine diagnostic uncertainty should be biopsied. If you are due for a broader check, our skin cancer screening in New Braunfels covers exactly this kind of evaluation, and our guide to telling melanoma from a normal mole walks through the warning signs.

SK vs. Actinic Keratosis (AK): AKs are precancerous lesions with a rough, scaly, sandpaper-like texture caused by UV damage — they require treatment to prevent progression to squamous cell carcinoma. SKs have a smoother, waxy, “stuck-on” appearance and are completely benign. A dermatologist can distinguish them clinically; biopsy confirms when uncertain. We covered this distinction in detail in actinic keratosis vs. skin cancer.

When to See a Dermatologist

Schedule an evaluation if:

• A growth is new and you’re unsure whether it is benign
• A growth is changing in appearance, size, or color
• A growth is irritated, bleeding, or persistently tender
• You want removal for cosmetic or functional reasons
• Multiple new SKs have appeared suddenly

Seborrheic Keratosis Removal Methods

Cryotherapy (Freezing): Liquid nitrogen applied directly to the SK freezes and destroys it in seconds, with no anesthesia required. Over the following 1–3 weeks, the lesion develops a blister or scab and sloughs off naturally. Afterward, you may notice temporary redness, darkening, or lightening of the treated skin — especially with darker skin tones. Larger SKs may require a second treatment. This is the most common removal method.

Curettage (Scraping): After local anesthesia, the SK is scraped away with a curette and the base is cauterized to stop bleeding. Provides immediate removal and works well for larger, raised lesions. Healing typically takes 1–2 weeks.

Excision (Surgical Removal): For larger SKs or those in cosmetically sensitive areas where minimal scarring is desired, excision with suture closure provides precise removal and histologic confirmation.

Other approaches exist — ablative laser vaporization and prescription hydrogen peroxide 40% solution among them — but they are not treatments we perform here. Cryotherapy, curettage, and excision handle the overwhelming majority of seborrheic keratoses effectively, and if your case genuinely calls for something we don’t offer, we will tell you and refer you appropriately.

What to Expect After Removal

These methods produce good cosmetic results with minimal scarring when performed by a trained dermatologist. Expect some temporary redness, scabbing, and possible temporary pigment change at the treatment site — a point Jackson et al. (J Drugs Dermatol, 2015) emphasize particularly for patients with richly pigmented skin. Recurrence of an SK in the same location is uncommon, though new SKs may develop elsewhere over time as part of a genetic predisposition.

Removing a seborrheic keratosis is a close cousin of skin tag removal — both are quick, in-office procedures for benign growths. Either can be handled at a routine visit, often during a full-body skin exam.

Related Reading

• Actinic Keratosis vs. Skin Cancer: How to Know the Difference
• Skin Tag Removal in New Braunfels, TX
• Melanoma vs. Normal Moles: How to Tell the Difference
• Full-Body Skin Exam in New Braunfels: What Happens and How Often
• Skin Cancer Screening in New Braunfels
• Medical Dermatology at Elect Dermatology

References

1. Hafner C, Vogt T. Seborrheic keratosis. J Dtsch Dermatol Ges. 2008;6(8):664–677. PubMed
2. Hafner C, Vogt T, Landthaler M, Müsebeck J. Somatic FGFR3 and PIK3CA mutations are present in familial seborrhoeic keratoses. Br J Dermatol. 2008;159(1):214–217. PubMed
3. Braun RP, Rabinovitz HS, Krischer J, et al. Dermoscopy of pigmented seborrheic keratosis: a morphological study. Arch Dermatol. 2002;138(12):1556–1560. PubMed
4. Argenziano G, Soyer HP, Chimenti S, et al. Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet. J Am Acad Dermatol. 2003;48(5):679–693. PubMed
5. Jackson JM, Alexis A, Berman B, et al. Current understanding of seborrheic keratosis: prevalence, etiology, clinical presentation, diagnosis, and management. J Drugs Dermatol. 2015;14(10):1119–1125. PubMed
6. American Academy of Dermatology. Seborrheic keratoses: overview. AAD.org

Have a warty or waxy growth that’s bothering you — either cosmetically or because it keeps getting irritated? The board-certified dermatologists at Elect Dermatology in New Braunfels can evaluate any skin growth, confirm the diagnosis, and remove it safely in-office the same day when appropriate. We serve patients across New Braunfels, Seguin, San Marcos, and the Hill Country. Call (833) 353-2875 to schedule your evaluation at 2154 Gabriels Pl, Ste 103, New Braunfels, TX 78130. Most removals take just minutes, with little to no downtime.

Reviewed by Dr. Stahr