Small flat-topped growths caused by cutaneous HPV infection. A seborrheic keratosis is a common, harmless growth that looks stuck onto the skin, like a piece of wax or a small barnacle. They are not cancer and they do not become cancer. The reason to see a doctor is to be sure that is what you are looking at.
The same eight facts on every condition comparison.
Flat Warts A cluster of subtle raised spots sits on the back of the hand.
Classic seborrheic keratosis Raised, waxy, stuck-on growth.
Stucco keratosis Small white-gray bumps on the legs.
Dermatosis papulosa nigra Small dark bumps on the face.
Human papillomavirus infects surface skin cells and stimulates their growth. The localized thickening forms small, relatively flat-topped bumps.
A benign overgrowth of surface skin cells creates a localized plaque. Keratin and sometimes pigment collect in the growth, giving it a waxy, rough or stuck-on appearance.
Flat Warts. Common in children and younger adults, although possible at other ages.
Seborrheic Keratosis. Usually appears in adult life and becomes increasingly common with age.
HPV stimulates growth of surface skin cells.
Seborrheic keratoses are harmless growths of skin cells that become more common with age.
They often run in families.
Evidence labels come from each condition’s own treatment list.
A strong urea cream can soften and flatten the rough white growths that scatter over the lower legs, called stucco keratoses, if the roughness is what bothers you. It smooths the surface rather than removing the growth, and it has to be used continuously. It does nothing for thick, dark, stuck-on growths elsewhere.
Wart treatments are often tried on these because the surface looks similar. Salicylic acid can thin the rough top layer, but it does not clear the growth, and it irritates the normal skin around it. The bigger problem is that it is usually being used on something nobody has examined.
This is aftercare, not treatment. A thin layer of plain petroleum jelly over a treated spot keeps the scab soft and gives the neatest healing, under a small dressing rather than an adhesive strip. It does nothing to a growth that is still there.
Daily mineral sunscreen over a spot that has just been treated stops the temporary mark from darkening and helps it fade faster, which matters most on the face, chest and hands. It will not remove a growth or stop new ones forming. Sun is only one of several things that drive these, and age and family history matter more.
A clinician may choose topical treatment or a procedure; avoid strong home acids on face or genital skin.
A high-strength peroxide solution applied in clinic was approved for raised growths on the face and body. It cleared some growths, often needed repeat visits, and commonly caused stinging, crusting and pigment change. It was withdrawn from sale in the United States, so in practice removal is done by hand rather than with a liquid.
The growth is numbed and shaved off level with the skin in a few seconds. It is the method of choice when there is any question about what a growth is, because it produces tissue that can be sent to the laboratory. It leaves a flat mark that fades over months, and it does not stop new growths appearing elsewhere.
The growth is scraped off with a small curette and the base sealed with a fine electric tip. It is controlled and shallow, which is why it is often preferred for small facial growths and for the dark facial growths common on deeper skin tones. Scraping first still gives tissue that can be examined if there is doubt.
A few seconds of liquid nitrogen makes flatter growths blister and lift off over a week or two, and it is the quickest way to treat several at once. It destroys the growth, so nothing can be examined afterward, which is why it is not used on anything with a question attached. It is used cautiously on the face and on deeper skin tones, because the pigment cells are sensitive to cold and it can leave a pale spot.
An ablative laser can vaporise a growth precisely and is sometimes used when several need treating on the face. Like freezing, it destroys the tissue, so it is only for growths already confirmed as harmless. It is the most expensive of the options and it is not better than a curette for a single growth.
When a growth is changing, bleeding on its own, or simply looks unlike your others, part or all of it is taken after numbing and examined under a microscope. It is the only way to be certain, and the threshold for doing it is deliberately low, because the cost of a small biopsy is trivial next to missing a melanoma. An irritated growth is one of the commonest reasons a benign growth ends up being sampled.
Flat warts may clear spontaneously, but this can take months or longer. They can spread or recur; scratching and shaving over them may carry the virus to nearby skin.
Seborrheic keratoses appear slowly, change slowly, then stay. Two departures deserve attention: one growth that starts changing - growing, darkening, bleeding on its own, or itching persistently - and a sudden crop of many new ones over weeks to months.
They can spread along scratches or shaving lines.
Catching on clothing makes it flare
A growth caught by clothing, a strap or a waistband can turn red, swollen, itchy, crusted or sore, and can bleed. That is an irritated seborrheic keratosis. It settles, but it looks alarming and often prompts removal or a sample.
Have a new, growing, bleeding, painful or otherwise changing lesion examined.
Have a new, changing, bleeding or uncertain growth assessed; skin cancer can sometimes resemble a harmless stuck-on growth.
Small flat-topped growths caused by cutaneous HPV infection.
Do not pick or shave over lesions. Avoid strong home wart acids on the face or genitals.
Have a new, growing, bleeding, painful or otherwise changing lesion examined.
It could be, which is why it should be looked at rather than diagnosed at home. Melanoma is sometimes mistaken for a seborrheic keratosis, and a dermatoscope resolves most of these in seconds. The concerning features are change in size, shape or color, bleeding without being knocked, an irregular edge, and a growth unlike your others. Book rather than watch.
Age and family history account for nearly all of it. They accumulate steadily from the forties onward, and someone whose parents had many will develop many. A genuinely sudden crop over weeks to months, especially with itching, is different and worth examining.
No. Removal deals with that growth, not the age and inherited tendency behind it, so new ones can keep appearing elsewhere. That is expected, not a failed removal.
Often, at least for a while. A flat spot darker or paler than nearby skin is common, and dark marks usually fade over months. Pale marks can be permanent and are more noticeable on deeper skin tones, so ask about the method and do a test spot before treating a large area. Daily sunscreen on the treated spot makes a real difference.
Most likely it caught on clothing, a strap or a razor and became an irritated seborrheic keratosis. They look far worse than they are and they settle. Still have it looked at - an irritated growth is one of the harder ones to be sure about by appearance, and a growth that bled with nothing catching it is a different question.
As many as you and your doctor think sensible, usually in sessions rather than all at once. It is normally considered cosmetic, so ask about cost first. On the face, and particularly on deeper skin tones, start with a small test area and see how it heals.
Sources
