Seborrheic Keratosis: Why It Appears So Differently on Our Skin

Seborrheic Keratosis: Why It Appears So Differently on Our Skin

If you’ve ever noticed strange, wart-like growths on your skin, chances are they could be seborrheic keratosis. While these growths are benign and generally harmless, they can look a little alarming, especially since they can vary so widely in appearance. One person might have small, flat, light brown spots, while another might develop raised, dark, scaly lumps.

The Variariations of Seborrheic Keratosis

1. Size and Shape

Small to Large: SKs can start as tiny spots (only a few millimeters in diameter) and grow over time into larger patches. Some can be as big as a few centimeters wide if not larger.
Flat or Raised: They can be flat or raised above the skin’s surface. Raised ones often have a dome-like shape and feel bumpy when touched, while flat SKs may blend in with the skin, making them less noticeable.
Irregular Shape: Seborrheic keratoses may have a smooth or slightly wavy edge, but in some cases, they can have a more irregular shape, making them look somewhat like a freckle or mole at first glance.

2. Color Variation

Light Tan to Black: The color of SKs can vary widely, ranging from light tan or beige to dark brown or even black. The reason for these color differences is due to the amount of pigment (melanin) present in the growth. More melanin results in darker lesions.
Multiple Colors in One Growth: Some SKs can have multiple shades in one growth—starting off lighter and becoming darker as they grow. This can make them appear multi-toned and even more unique in their appearance.

3. Texture

Smooth or Scaly: The texture of seborrheic keratosis can vary. Some are smooth and waxy, while others can be rough, flaky, or scaly. The scale might give the growth a “stuck-on” appearance, as if it’s been glued to the skin.
Crumbly or Crusted: In some cases, particularly with larger SKs, they can become somewhat crumbly or crusty. This texture is often a result of the keratin (a protein found in skin cells) buildup within the lesion.

4. Location and Growth Pattern

Areas of High Friction: Seborrheic keratosis is more likely to develop in areas where there’s more friction or sun exposure, such as the back, chest, face, and shoulders. The growth patterns also depend on individual skin types and exposure.
Clustered or Solo: Some people develop just one SK, while others might have multiple growths that appear in clusters. The growths may also appear gradually or all at once, creating a patchwork of lesions across the skin.

Why Does Seborrheic Keratosis Appear So Differently?

1. Genetics

Genetics play a major role in determining how and where seborrheic keratoses appear. If your family members tend to get SKs, there’s a good chance you might too. Some people are genetically predisposed to develop more of them or in certain areas of the body.

2. Sun Exposure

While seborrheic keratosis isn’t caused by sun exposure, the UV rays from the sun can exacerbate the condition and affect the size, shape, and color of SKs. Sun exposure increases the likelihood of developing them, and people who spend a lot of time outdoors may notice that their SKs become darker or more pronounced.

3. Aging

Seborrheic keratosis is more common as people age. The lesions may start to appear around middle age and become more numerous as time goes on. The growths also tend to become larger, thicker, and more pronounced as a person gets older.

4. Hormonal Changes

Hormonal changes can influence the development of seborrheic keratosis. For example, some pregnant women report new SKs developing, likely due to fluctuating hormone levels. Similarly, people undergoing hormone replacement therapy (HRT) or taking birth control may notice changes in the appearance of their SKs.

5. Skin Type and Ethnicity

Seborrheic keratosis may present differently depending on a person’s skin type or ethnicity. For example, people with darker skin tones may notice that their SKs appear darker or more pigmented. Additionally, those with oily or thicker skin may experience a different texture or shape compared to someone with more delicate skin.

When to Be Concerned

While seborrheic keratosis is generally harmless, it’s important to keep an eye on any skin changes. In rare cases, a seborrheic keratosis might resemble a skin cancer lesion, especially if it begins to bleed, itch, change in size, or have an irregular border. If you notice any unusual changes in a growth, it’s a good idea to get it checked.

Treatment Options

Using diathermy is for me the most effective and non invasive way of removing Seborrheic Keratosis. The healing process is fairly straight forward and mulitple blemishes can be treated in a session. Removing Seb K’s is one of the most rewarding things as a practitioner as it can be life changing for my client.