Keratosis: the rough spots
There are two kinds and only one needs watching. Telling them apart comes first, and it isn't done by eye.
The two of them, and how they differ
Seborrheic keratosis. A brown or black lesion that looks "stuck on" the skin, as if you could lift it off with a fingernail. Appears with age, is entirely benign, and is removed only if it bothers you or for appearance.
Actinic keratosis. A rough area, sometimes pink, that you feel more than you see — it catches under your fingertip. It shows up on heavily sun-exposed skin: face, ears, lower lip, bald scalp and the backs of the hands. It is a precancerous lesion and it does need treating.
Why the actinic one matters
A proportion of actinic keratoses can turn into squamous cell carcinoma. Not all of them, and not quickly — but there is no way to know which.
That is why they are treated even when they don't bother you, and why someone with several gets checked periodically: whoever has one usually has more, and the skin in that area carries accumulated damage.
How they are removed
- Cryosurgery for individual lesions.
- Topical treatment when there are many in one area.
- Electrosurgery for seborrheic ones that get in the way.
- Sun protection, which is what keeps more from appearing.
Frequently asked questions
Will drugstore cream take them off?
No. The seborrheic kind doesn't respond, and the actinic kind needs prescribed treatment.
Can I pick off a seborrheic keratosis?
No. It gets infected, bleeds and leaves a mark, and you lose the chance to confirm what it was.
How often should I be checked if I have several actinic ones?
Your physician decides; with significant sun damage it is usually more than once a year.
Shall we take a look?
An assessment tells you what you have and what to do about it. Message us on WhatsApp.
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