Seborrheic Keratosis Treatment in Pune

A seborrheic keratosis or senile wart is a harmless skin growth. It is a common sign of skin aging. It is very common in adults over the age of 60 years. These occur in both males and females of all races. Usually, the growth begins to erupt in middle age.

Seborrheic keratosis is a brown or black growth. Usually, it is seen on the chest, back, head and neck. Seborrheic keratosis can appear anywhere on the skin except the palms and soles. They originate from cells called keratinocytes. Their appearance and continued progression may get worrisome for people. But they are neither contagious nor premalignant or malignant lesions.

Some of the other names for seborrheic keratosis are basal cell papilloma, senile wart or brown wart. Seborrheic keratosis is actually a misnomer. To explain, the growth is neither limited to a seborrheic distribution (scalp, mid-face, chest, upper back). Moreover, it is not derived from sebaceous glands or associated with sebum.

Dos & Don’ts for Getting Seborrheic Keratosis

DO: Use a back-brush or loofah to get rid of dead skin cells.
DO: Consult a doctor in the initial stages itself.
DO: Use broad-spectrum sunscreen daily.
DO: Remove any jewellery that might irritate the keratosis.

DON’T: Leave the house without sun protection.
DON’T: Ignore initial stages of any skin condition.
DON’T: Scrub your skin too roughly.
DON’T: Pick at the scabs or attempt to extract them by yourself.
DON’T: Touch the lesion.

Causes of Seborrheic Keratosis

The exact cause of seborrheic keratosis is unknown, However, ageing is the usual cause for seborrheic keratosis. Other risk factors include:

• Genetics: This skin condition runs in families.
• Frequent sun exposure: UV light may play a role since the growths most commonly appear on areas exposed to sunlight.
• Friction: Skin friction can be a factor since they often appear in skin folds. While they are not painful, they may itch or become irritated.
• Pregnancy: Pregnant women may notice a sudden onset of seborrheic keratosis.

Symptoms of Seborrheic Keratosis

Seborrheic keratosis is degenerative in nature, growing in number with age. Here’s how they can be described:

• Location:
  They may be solitary or in groups. Generally, they are found on the scalp, shoulder, chest, abdomen, or back.
• Texture:
  The growths start off as small, rough bumps. Eventually, they get thicker and develop a warty surface. Generally, they have a waxy and ‘stuck on’ appearance.
• Shape:
  Usually, the shape is round or oval. However, they may also be flat or raised.
• Colour:
  Most commonly brown, but may also be skin-coloured, grey, yellow, black, white, or mixed colours.
• Size:
  They range from one millimetre to several centimetres in diameter.

Complications

Seborrheic keratosis is not premalignant. However, it may be difficult to tell a cancerous skin growth apart from it. Especially if the cancer cells coincidentally arise with or within it. Also, very rarely, eruptive seborrheic keratoses may denote an underlying internal malignancy.

An irritated seborrheic keratosis can become red and inflamed. This gives rise to eczematous dermatitis around it. Subsequently, this will trigger new seborrheic keratoses to appear.

Red flag signs:

To avoid complications, visit your doctor immediately if the following should occur:

• New growth or change in the appearance of an existing one.
• A large number of growths occurring within a short period.
• A single growth (since seborrheic keratosis usually appears in multiple numbers).
• A growth with irregular borders (blurred, jagged) or an unusual colour (purple, blue, reddish-black)
• Irritated or painful growth
• Growths or sores that do not heal

Treatment of Seborrheic Keratosis

In most cases, a dermatologist will be able to determine if your skin growth is a seborrheic keratosis simply by looking at it. Also, in most cases, no treatment is necessary. Removal of the growth may be recommended in the following scenarios:

• The growth is difficult to distinguish from cancerous growth and requires microscopy.
• The growth causes itching or irritation due to friction with clothing or jewellery.
• For cosmetic purposes.

The modalities used for removal are:

• Cryosurgery

This is the most common method, especially for light-skinned individuals. About two-thirds of the patients involved use this method. Liquid nitrogen is applied to the lesion with a spray gun or a cotton swab. This freezes the lesion and destroys it. The inflamed keratosis falls off within a few days. Any blisters formed under the main lesion dry and form a scab which eventually falls off too.

This method is ideal for thin or small lesions, irritated growths and lesions found all over the body. This method has rarely caused a patient to bleed, does not consume much time, is easy to carry out and has a low risk of infection while being cost-effective.

It can be painful since the liquid nitrogen is at a freezing temperature of -196C or -320F. It can sting a lot when applied and some patients feel a lingering pain for over an hour. While being an imprecise technique since it can impact the skin in an unpredictable way, cryosurgery can cause hypopigmentation and hyperpigmentation. Most dark-skinned patients face hypopigmentation, a process in which the skin lightens in comparison to its natural colour.  Whereas hyperpigmentation refers to the darkening of the skin in comparison to its natural colour. Scarring is a potential risk. This treatment requires a few sessions to be successful.

• Electrodesiccation

Local anaesthesia is given to the patients. Then a needle-like metal tip creates an electric current. This burns off the lesion. For lesions that are on parts of your body that are highly visible, small and thick in nature or lesions present on dark-skinned patients, this is the best option.

There is no bleeding, scarring or hypopigmentation and the healing period usually lasts a week which is lesser in comparison to cryosurgery. Occasionally, electrodesiccation can cause hyperpigmentation.

• Electrocautery

This involves numbing the growth with an anaesthetic and then using an electric current to destroy it.

• CO2 Laser

After the injection of a local anaesthetic, an intense beam of light burns and vaporizes the lesion. The type of laser used varies, depending on the patient’s skin. This is the most suitable method for small and dark lesions. Additionally, there is no pain or bleeding and the recovery time is minimal.  However, this is an expensive method. Moreover, it may cause scarring.

• Chemical Peel

A chemical solution such as 70%, or trichloroacetic acid (TCA), is applied to the lesion. Usually, chemical peels are ideal for thin facial lesions with lighter skin types.

However, it can not remove thick or dense keratosis. The skin feels raw and swollen. It is tough to predict how each patient’s skin will react. This treatment requires considerable post-procedure care. Additionally, the healing period lasts long. Moreover, this treatment requires multiple sessions.

Lastly, though the growth rarely recurs, new ones may appear in other areas of the body.