Seborrheic Keratosis and Aging

Seborrheic keratosis is a benign tumor that forms in the epidermis, the outermost layer of the skin. These growths vary in size, color (from light brown to black), and texture (from waxy to scaly), and they can appear anywhere on the body, though they're most commonly found on the face, neck, chest, shoulders, and back. Seborrheic keratosis is often mistaken for warts, sebaceous keratosis, or even melanocytic nevi (moles). Despite their appearance, they are not cancerous and are usually harmless.

Seborrheic keratosis typically appears more frequently as people age. By understanding the factors behind this, you can better manage your skin health. Several key factors contribute to the increased prevalence of these growths as you get older:

Changes in Skin Cells and the Keratinocyte Mutation

As we age, our skin's ability to renew itself diminishes. The process of shedding dead skin cells slows down, leading to an accumulation of keratinocytes, the cells responsible for producing keratin. Over time, this buildup leads to the formation of seborrheic keratosis. Mutations in the fibroblast growth factor receptor, a key protein involved in cell growth, can also trigger the proliferation of these cells, causing the skin to form these growths.

Sun Exposure and Ultraviolet Damage

One of the most significant risk factors for developing seborrheic keratosis is prolonged exposure to ultraviolet (UV) light. Ultraviolet radiation from the sun can cause skin damage, leading to abnormal cell growth and lesions such as seborrheic keratosis. UV exposure is a known risk factor for other skin conditions, including actinic keratosis (a precancerous lesion) and skin cancer, including melanoma. Those with light skin, especially, are at a higher risk for these growths as they age. It is essential to protect your skin with sunscreen and undergo regular skin cancer screenings.

When seborrheic keratosis is suspected, a dermatology specialist will conduct a thorough physical examination and may recommend a skin biopsy to rule out malignancy. The pathology of seborrheic keratosis can be confirmed through histology, ensuring the lesion is benign. In cases where the lesion's appearance raises concerns, a differential diagnosis may be necessary to exclude other skin conditions, including melanoma, basal cell carcinoma, or seborrheic dermatitis.

At Tru-Skin Dermatology, we use dermatoscopy, a non-invasive tool that helps us closely examine the lesion for any unusual characteristics. If there is any suspicion of a malignant growth, a skin biopsy may be performed to provide further clarity.

While seborrheic keratosis is typically harmless, many patients seek treatment for cosmetic reasons or because the growth becomes irritated or itchy. There are several effective therapies available to remove seborrheic keratosis:

Cryosurgery (Cryotherapy):

Liquid nitrogen is applied to the growth, freezing it off. This is a quick and effective treatment, particularly for smaller lesions. The lesion will typically fall off within a few days. Cryotherapy is a common choice for treating seborrheic keratosis at Tru-Skin Dermatology.

Electrosurgery and Electrodesiccation:

This method uses electric current to remove the lesion. It may be combined with curettage, where the growth is scraped off after treatment with electric current.

Laser Therapy:

Laser treatment uses focused light to remove seborrheic keratosis without damaging the surrounding skin. This method is ideal for sensitive areas like the face or scalp.

Excision:

For larger growths or those causing irritation, a surgical scalpel may be used to remove the lesion completely. This method is typically done under local anesthesia.

Other treatments include imiquimod, a topical medication that can help reduce skin lesions, or curettage using a sharp instrument to remove the growth. Regardless of the treatment method, a patient's unique health and skin condition are considered when determining the most appropriate therapy.

Seborrheic keratosis is a common, benign condition that becomes more prevalent with age. While these growths are typically harmless, they can be a source of concern for many patients. Regular skin exams, especially for those with a history of sun exposure or genetic risk factors, are essential for monitoring your skin health.