Seborrhoeic Keratosis

Seborrhoeic keratosis are also known as senile warts, barnacles and benign keratosies. They are raised, with a stuck on appearance anywhere on the skin except the palms and soles of the feet and are often dark brown and have a waxy top. Whilst the exact cause of these very common benign lesions is unknown, there is an association with age >30, family history, friction and sunlight. There are also lesser well known associations with biological therapies and internal malignancies (Leser Trelat syndrome). Whilst benign, these lesions are a major cosmetic concern and a range of therapeutic interventions are available to remove them, including cryotherapy, currette and electrodesiccation, shave excision and ablative laser. Intense Pulse Light (IPL) is not a suitable modality in this instance as seborrhoeic keratoses are an exophytic proliferation of keratinocyes representing mass and not colour contrast amenable to selective wavelength absorption. For the same reasons, non ablative lasers are also ineffective in the treatment of these lesions.