- Best Results1-2 sessions
- Treatment Recovery2-5 days
- Procedure Time3-20 minutes
- Skin SpecialistNurse
- Duration of ResultsLong-term
- AnaestheticNumbing
- Back to WorkNext day
- Cost$-$$
Age warts - seborrhoeic keratosis
Age warts are also known as seborrhoeic keratosis. As the name suggests, they increase with age. Treatments include freezing, surgical debulking, diathermy, as well as laser ablation. If you have age spots, discuss treatment options with your dermatologist.
FactsFacts on seborrhoeic warts
- A minority of warts may have foci of superficial skin cancer
- Simple treatments include freezing, curettage & shave excision
- Cryotherapy should not be used on darker skin types
- My clinical team primarily use high density CO2 lasers to treat warts
- DIY treatments include salicylic & lactic acid solutions
- The majority of seb warts are non-cancerous
What are age warts?
I refer to these as barnacles on the ship of life. Seborrheic keratosis are polymorphic, meaning they have many forms. These include-
- Classic seborrheic warts: looks like a wart only brown/black.
- Flat seb warts: looks like a mole or big freckles.
- Dermatosis papulosa nigra: Tiny black bumps on the face & neck.
- Cutaneous horn: Horn like projection.
- Inflamed wart or regressing wart: Looks red/brown.
- Idiopathic Guttate Hypomelanosis: white seb warts
If in doubt, see a dermatologist for a diagnosis & treatment plan.
Disclaimer: I do not treat warts. My work is procedurally based as I operate or laser complex conditions.
How do dermatologists manage age warts?
Dermatologists have many tricks to remove warts. The most common practices include-
- Curettage with a blunt or sharp instrument
- Shave with a blade
- Cryotherapy
- TCA-Phenol Chemical peels
- Lasers including CO2, erbium & thulium
- Excision
- Diathermy
The type of treatment depends on the type of wart, the location & skin type of the patient. There are many doors to the same destination.
Which treatment do I prefer to remove warts?
I have taught my team to remove seborrheic keratosis with CO2 lasers & curettage. This technique gives the best results & cosmesis without any scarring. I do not treat seborrheic warts as my work is focused on complex procedures. Please see my colleagues or my clinical nurses.
Will age warts & seborrheic keratosis increase in size & number?
Yes, they will, hence why they are called ‘age warts’. They will increase in size & number with increasing age. I refer to these as ‘barnacles on the ship of life.’
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Are seborrhoeic keratoses cancerous?
Most age warts are not cancerous, however if you have significant sun damage, skin cancer can arise in seborrheic keratosis. This is termed a collision tumor. The most frequent tumor associated with age warts is an intraepithelial carcinoma. It occurs in up to 10% of biopsies, usually as an incidental finding.
Rare associations include the sign of Lesser Trelat.
What topical creams can remove age warts?
The miracle solution for seborrheic warts was discontinued in 2019, namely 40% hydrogen peroxide, also known as Eskata.
New formulations for wart removal include WartPeel. This contains a chemotherapeutic agent known as 5 FU in a 2.5% concentration together with salicylic acid 17%. High strength skin acids can also treat warts.
How do you prevent seborrhoeic keratosis?
Unfortunately, there is no universally effective treatment to slow down ageing. The flipside is that if you develop a professional relationship with your dermatologist, they can treat early & small age warts with simple treatments such as cryotherapy & diathermy.
Some cases of seb keratosis can be reduced with anti-inflammatory creams. A simple hack is to treat smaller keratosis with over-the-counter wart kill.
Can you remove age warts at home?
Yes, if you are careful enough. Home remedies should always be approached with common sense. A simple method is as follows-
- Use Elastoplast tape. Cut a hole around the wart, leaving a 1.5 cm border
- This protects the surrounding skin
- Apply Wart Kill or high strength salicylic acid on the seborrheic keratosis
- Occlude with another layer of Elastoplast tape
- Repeat every 2-4 days till the wart is flat
Spot application with TCA 35 to 40% 3-5 coats with a fine brush is another simple DIY procedure.
Disclaimer: Exercise common senses when performing DIY treatments. Warts on the face should ideally be treated by a medical professional.
Can a plasma pen be used to treat seborrheic keratosis?
Yes. Seb keratosis, skin tags & DPN can be cautiously treated with plasma pen. Ideally see a skincare professional for this treatment. If you are going to attempt this at home, conduct a test spot (treat 1 -2 lesions first).
Disclaimer: Plasma pen has a very high incidence of scarring, especially when used to treat wrinkles. I do not recommend plasma for other skin conditions, however it can be an effective tool for warts, if used correctly.
Can seborrheic warts be treated with freezing?
Yes. This is a simple technique that your GP can perform. It is important not to be too aggressive with freezing or white scars may develop. You can also buy cryotherapy from a pharmacist; however it may be sensible not to attempt this yourself.
Why are treatments complex in darker skin types?
One of the more difficult cases are flat seborrheic warts in skin of colour– namely darker skin types. The reason is that hypo or hyper pigmentation may ensure. Cryotherapy should not be used in darker skin, lasers such as pico laser is the treatment of choice. Some lesions respond with one session, others may require 3-5. For raised warts, a CO2 or erbium laser is required.
Age warts in darker skin types should be treated by a dermatologist experienced in ethnic skin.
How do you remove an age wart from the eyelid?
The eyelid skin is super thin, & removal can be tricky. Your dermatologist may elect to laser the wart. Other options include surgical removal & cryotherapy.
In some cases, they may refer you to an ophthalmologist or an oculoplastic surgeon for excision.
Do seborrheic keratosis grow back after removal?
Most removed seborrheic keratoses do not return in the area treated. As sure as taxes, more will develop over time. Partially removed age warts do recur.
How does apple cider vinegar get rid of seborrheic keratosis?
No, it does very little for established seb warts. The literature suggests applying this 3-4 times a day for two or three months. There are more effective treatments as described above.
Can skin care acids remove seborrheic warts?
Yes. Acids can be useful in breaking down warts & in some cases completely removing them. They include-
- Salicylic acid 10-26%
- Lactic acid 20% +
- TCA or phenol peels (under supervision)
- High strength hydrogen peroxide 30-40%
A lower percentage of salicylic or AHA such as glycolic – lactic acid can help reduce the occurrence of warts. Sunscreen is debatable.
What are natural solutions for treating seborrheic warts?
If you are after solutions that work, liquid nitrogen is as natural as it gets. You are currently breathing nitrogen as you read this. 78% of air is nitrogen. Drop the temperature & you have liquid N2. See you GP for this naturopathic solution.
Other natural ways include monochromatic light. That is called a laser. A laser is light amplification. If tech scares you, try some salicylic acid, it is from willow bark (natural source). High strength AHA from sugar cane is as natural as it gets. Cansema is another solution that will replace your wart with a great big scar.
Who to see for age warts?
Discuss treatment options with your dermatologist. If you have multiple warts & would like removal, please book a consultation with my nursing team. They are highly trained in techniques such as laser ablation as well as curettage.
Disclaimer: I do not remove seborrheic warts as my work focuses on complex surgical & laser cases. The exception is treatment of complex cases of Seb keratosis in darker skin types. I employ pico & CO2 lasers in this situation.
How much are treatments?
Not much. Get a quote from my nurses. Medicare does not cover wart removal, nor does private health.
Disclaimer: I do not treat warts or skin tags. My work focuses on complex cases.
How can you prevent age warts?
Most cases are genetic, so it is really hard to prevent age warts. There are a few caveats.
Firstly, reduce scratching & inflammation, especially if you have itchy skin. A simple solution is aqueous cream kept in the fridge. Apply as required.
Secondly, a compounded solution of lactic or glycolic acid can be beneficial. You can obtain this from a dermatologist.
Thirdly, topical retinoids may play a role in prevention of seborrheic keratosis. A clinically prescribed formulation of retinoic acid, or trifarotene is better than retinol.
Remember to sun protect as age warts of the face can be UV exacerbated.
Davin’s Viewpoint on Seborrhoeic Warts
Seb keratosis is the most common skin lesion. They have many forms including raised, flat, white, black, brown, red. They can take on many shapes including a horn, a collision tumour or even a skin tag like lesion. Most warts can be diagnosed clinically. In some cases, your doctor may use a dermatoscope to identify the keratin pearls & whirls, as well as crypts. These are commonly encountered in these lesions if in doubt, a biopsy may be taken.
In Queensland, studies have shown that up to 10% or warts may contain skin cancer known as squamous cell carcinoma in-situ. This is also called Bowen disease or Intraepithelial Cancer. This is primarily seen in patients who exhibit extensive sun damage. The prognosis is excellent. Rare cases of other collision tumours have been described including BCCs & melanoma.
The natural history of seborrheic warts is one of persistence & growth. Some cases involve in time or following inflammation. Examples include lichenoid keratosis.
Treatments can be super easy or very difficult, depending on the skin type of the patient, location of the wart, & morphology. Raised keratosis on the back can be treated with cryotherapy or a simple shave, whilst flat warts on the face in darker skin patients (including Asiatic skin) can be extremely complex to treat. In these cases, pico lasers are best, however for thicker lesions may require CO2 lasers.
There are two special variants of seborrheic warts that deserve a mention. Firstly DPN or dermatosis papulosa nigra or Morgan Freeman disease. These are variants of Seb keratosis that arise on the face in darker or ethnic skin types. Treatments are simple – curette, pin point diathermy or erbium lasers with a focal 1 mm spot.
Another variant of Seb keratosis is called idiopathic guttate hypomelanosis. These lesions are white in colour & often flat. They occur on the arms & lower limbs, often after the age of 40. This form of age warts are difficult to treat.
DIY treatments can be effective for some cases. Compounded hydrogen peroxide, 30-40% can be effective, as can TCA 30-50%, phenol 88% as well as high strength salicylic acid. Obviously for warts in cosmetically sensitive areas, you are best treated by a dermatologist. Never-the-less, with a sensible approach, low risk seb keratosis can be a DIY job.
Disclaimer: I do not treat seborrheic warts in isolation. I may treat these if I am performing another procedure that requires a theatre list (laser ablation, medium to deep peels, surgical intervention). If you have warts or if you would like a diagnosis, please see my colleagues at Cutis.
