What Do We Treat?

Lesions

Seborrheic Keratoses (SK) are the most common skin lesion. Although their exact cause is unknown, they tend to be most common on sun-exposed areas in older patients, most commonly on the face, neck and trunk. Typically, SKs have sharp borders, a tan-brown-black color, a “glued on” appearance, and may be crusty, warty, or occasionally smooth. Irritated or irregularly shaped SKs may be mistaken for skin cancer or melanoma, but SKs have no malignant potential. Because they are very superficial lesions, we can remove them by a variety of methods with little or no scarring.

Actinic Keratosis (AK) are flat, superficial, crusty (keratotic) premalignant lesions which may develop in areas exposed to the sun. They are most common in fair skinned patients with a long history of solar exposure, especially on the nose, forehead, ears, neck and hands. Color may vary from red to white to brown, depending on the thickness of crusty skin attached to the lesion. Over time, AK may enlarge, thicken and gradually transition into squamous cell carcinoma (SCC). We can treat AKs by a variety of methods, with the goal being to remove the superficial AK completely, without removing deeper normal tissues. Topical cream or lotion can be applied to individual lesions or to entire affected areas, and more recently, a topically applied immunomodulator drug has been shown to be very effective. Individual lesions may be frozen with liquid nitrogen spray. We also use curettage (scraping), dermabrasion and deep chemical peels on individual lesions and larger areas of involvement. The most precise treatment method involves selective vaporization with the CO2 laser.

Sebaceous hyperplasia or Adenomas are benign growths or enlargements of sebaceous glands in the skin. The exact cause is unclear, but they are probably not related to chronic sun exposure. They are most common on the facial skin, especially the cheeks, nose and forehead, in persons over 30. Over time more growths may develop, giving the skin a pebbled appearance. Individual growths rarely will exceed 1/4 in. in diameter, but because of their elevated, lobulated appearance with a central dimple, they are commonly mistaken for basal cell carcinoma. The most common treatment is superficial removal by freezing, cauterization or laser.

Skin Tags or Acrochordons are common growths affecting 1 in 4 people, usually beginning in their 20’s. They are most common in the armpits, groin and neck and begin as a small brown bump that may enlarge to a pea-sized nodule attached with a narrow stalk. Most individuals have only a few tags in a particular area, with the neck the most common site for numerous lesions. Skin tags have no malignant potential, and can easily be removed with scissors, cauterization, or CO2 laser.