Q&A WITH DERMATOLOGIST EXPERTS
When a patient sees a dermatologist for evaluation of a lesion, the dermatologist often can simply look at the lesion and determine whether it’s benign or malignant or a seborrheic keratosis or not. If they’re at all suspicious of that growth, then many times they will do a biopsy.
A biopsy is a process where the dermatologist evaluates the lesion by removal of all or a portion of the lesion. This is done under local anesthesia, with minimal discomfort. That specimen is then sent to the lab for evaluation.
Sometimes the lesion can grow back if the entire lesion doesn’t go away or a remnant is still left. But most of the time, if an entire lesion is removed, it doesn’t grow back.
Patients who have seborrheic keratosis will ask “How did I get these?” “Can I prevent them?” Usually we see seborrheic keratosis developing in patients over 25 or 30 years old. There probably is a genetic tendency. There is a component of sun exposure that is probably involved.
Seborrheic keratoses are not transmitted like warts are, from one person to another. But there is a genetic tendency for certain people to develop them, so they might think that maybe they are contagious on their own bodies, but they are not.
If you have a seborrheic keratosis at 25 or 30, will you have 100 of them when you’re 80? And will SKs continue to enlarge with time? Some patients will develop more over their lifetime, and some patients don’t.
When is cryosurgery used for seborrheic keratosis? What can I expect if I am treated with cryosurgery?
A dermatologist will often choose cryotherapy as their treatment of choice for seborrheic keratoses that are very flat and thin. Cryotherapy can be painful. It’s a very cold feeling. You’re basically freezing the lesion.
Occasionally, after treatment with cryotherapy, the area can remain red or brown. This redness can last for weeks or months. Sometimes it heals just fine. But patients very often do lose their pigment and end up with white discoloration in the areas that were treated.
With curettage, the seborrheic keratosis is scraped off the skin. It’s usually used for keratoses that are thicker or larger. When curettage is used to remove your seborrheic keratoses, the doctor will often first inject the area with some lidocaine to numb it.
In African Americans, seborrheic keratoses have two different appearances. The first occur on the face, and they are called dermatosis papulosa nigra. We abbreviate it DPNs. So they are very small growths that protrude from the surface of the skin.
The best way to find a physician who is an expert in the treatment of seborrheic keratosis is to contact the American Academy of Dermatology. They have a great website. It’s www.aad.org. Well, there are several reasons to see your dermatologist if you have seborrheic keratosis.