Seborrheic Keratosis (Senile warts)

Seborrhoeic keratosis, also known as senile warts, is a very common, harmless skin condition. These growths are often waxy, slightly raised, and range in colour from light brown to black.

They tend to increase with age and may appear in large numbers, especially on the trunk, face, or neck. While they can look alarming, they are non-cancerous, non-contagious, and usually don’t require treatment unless they become irritated or for cosmetic reasons.

Seborrheic Keratosis (Senile warts), showing a dark, wart-like growth on the skin with a rough, scaly surface

Symptoms of Seborrhoeic Keratoses

The warts can become inflamed, which makes it difficult to distinguish from melanoma. Reassuringly, they often share similar features to the other seborrhoeic keratoses on the body. Any lesion presumed to be seborrhoeic keratosis that looks different from every other seborrhoeic keratosis on your body should be checked by your doctor or dermatologist. Seborrheic keratoses have a waxy, “pasted-on-the-skin” look. Some look like a dab of warm, brown candle wax on the skin. Others may resemble a barnacle sticking to a ship.

They are mostly hereditary and not caused by sun exposure. Sometimes they may erupt during pregnancy, following hormone replacement therapy or as a result of other medical problems.

Clinical features of Seborrhoeic Keratoses

• Location: Seborrheic keratoses can develop on nearly any part of the skin, except for the palms and soles. They are not found on mucous membranes.
• Size and Shape: These lesions vary in size from as small as 1 mm to several centimeters across. They can present as either flat or slightly elevated papules or plaques.
• Color: The color spectrum of seborrheic keratoses ranges from skin-toned and yellow to grey, various shades of brown, and even black. Some may display a combination of colors.
• Texture: The surface texture of seborrheic keratoses can be smooth, waxy, or resemble a wart.
• Distribution: They may appear alone or in clusters, commonly found on the scalp, under the breasts, along the spine, or in the groin area.
• Overall Appearance: Seborrheic keratoses typically look as though they are superficially attached to the skin, resembling barnacles.

What can I do?

Seborrhoeic keratoses are harmless, so in most cases, no treatment or care is needed. However, you can:

• Monitor for changes – keep an eye on the growth; if it changes in appearance, get it checked.

• Avoid scratching or picking – this can cause irritation or infection.

• Use moisturiser if the area becomes dry or itchy.

• Wear loose clothing to prevent friction if lesions are in areas prone to rubbing.

If the growth becomes bothersome for cosmetic or comfort reasons, speak to a doctor about removal options.

Should I seek medical care?

Seborrhoeic keratoses (also called senile warts) are harmless and do not turn into cancer, so treatment is usually not necessary. However, you should see a GP or dermatologist if:

• The growth changes in size, colour, or shape

• It starts to bleed, itch, or become painful

• It becomes infected or inflamed

• You’re uncertain if the lesion is a seborrhoeic keratosis

A dermatologist can remove the lesion and may send it for examination under a microscope (biopsy) to rule out skin cancer. If in doubt, always have it checked.

Treatment for Seborrhoeic Keratoses

Seborrhoeic keratoses are harmless and don’t usually require treatment. However, if they become irritated, catch on clothing, or are cosmetically concerning, they can be removed — typically in a private setting, as removal is not funded by the NHS.

Here are common removal methods:

• Cryotherapy: Freezing the lesion with liquid nitrogen. Best for thinner growths; may need repeat treatments.

• Curettage and Electrocautery: Scraping the lesion off under local anaesthetic, often followed by heat treatment to stop bleeding and prevent regrowth.

• Laser Treatment: Used to vaporise the lesion with precision, causing minimal skin damage.

• Shave Excision: A scalpel is used to shave the lesion off. This method may also be used for biopsy.

• Chemical Peels (e.g. trichloroacetic acid): Occasionally used to help shed the lesion, but less commonly offered.

Always consult a GP if a lesion changes, becomes itchy, bleeds, or causes concern — to rule out more serious conditions such as melanoma.