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Brown spot paranoia is “par”annoying and permeatingly pandemic. Probably at least once a day a person comes in for an appointment for a “mole check” to make sure nothing is “turning into cancer.” And, so often, the question arises about “moles” that look and feel a little or a lot different.
When they show me one, I usually say something like, “This is a seborrheic keratosis, not a mole. It typically has a warty, stuck or pasted-on appearance. It looks and feels like you could almost peel it off if you got your nail under it just right.” (Many have tried). “Even if it is flat,” I go on, “it still seems to look stuck on.”
Patient: “Oh, yeah, I see now. I’ve even tried to pick it off.” (Like I said.)
Me: “Uh, that won’t work. The top consists of dead cells. Keratin refers to dead cell layer, and -osis means condition of. But the bottom is alive, still there, and growing. It seems as if it is gone if the tops peels off, but the dead part will build up again.”
A mole is a growth of pigment cells. A seborrheic keratosis is a growth of epidermis. They are biologically totally separate entities. A seborrheic keratosis never, no never, turns into a skin cancer (Whew!).
Once said, the next response so often is, “Well, it is icky. And, I have a lot of them. So did my mom/dad/ aunt/uncle.”
Me: “Right. No one knows their cause. The tendency to grow them appears to be inherited. There is no stopping them if they will bloom. (Thanks, Mom!)”
They are as common as any other gizmo we sprout, but nobody seems aware of their existence. There is no medical treatment, such as a salve, to melt them away. They have to be physically destroyed, one by one, customarily by freezing with liquid nitrogen. This leaves no scars on faces and seldom on limbs and torsos. There is no need to cut them off, unless a biopsy is necessary to prove it is a seborrheic keratosis and calm nervous neurons about the chance of cancer in the critter. This is a good choice if it yields mental assurance that all’s well.
You can take comfort and peace of mind once you find that funny-looking fellow is friend, not foe. Being one of the select few who have a fabulously fertile field for seborrheic keratoses, I always tell patients I think they are a sign of intelligence. I rarely find argument with that premise. How about yourself if you, too, belong to the “flaky freckle fraternity”?
