Seborrheic keratoses (SKs) are removed through in-office procedures like freezing, scraping, or laser treatment, with most growths gone within a few weeks. These waxy, stuck-on skin growths are completely benign, but many people want them removed for cosmetic reasons or because they catch on clothing and get irritated. Here’s what each removal method involves and what to expect during healing.
Why You Shouldn’t Remove Them at Home
The American Academy of Dermatology is direct on this point: do not try to remove a seborrheic keratosis yourself. Scraping, picking, or applying DIY remedies like apple cider vinegar or over-the-counter wart removers carries a real risk of infection and scarring. These growths sit on the skin’s surface but extend into it enough that amateur removal often damages surrounding tissue and leaves a worse cosmetic result than the original spot.
There’s also a diagnostic concern. Some skin cancers, including melanoma, can resemble seborrheic keratoses to an untrained eye. A dermatologist can identify specific microscopic features (tiny cyst-like structures and pore-like openings within the growth) that reliably distinguish a benign SK from something more serious. Melanomas consistently lack these features. Getting a professional evaluation before any removal ensures you’re not ignoring something that needs different treatment entirely.
Cryotherapy (Freezing)
Cryotherapy is the most common removal method when the diagnosis is straightforward. Your dermatologist numbs the area and applies liquid nitrogen to freeze the growth, which then falls off on its own within days to weeks. It’s quick, usually taking under a minute per spot, and doesn’t require stitches.
The healing timeline follows a predictable pattern. By the next day, a blister or blood blister forms and tenderness starts to fade. Around day seven, the surface turns dark red or brown and becomes scab-like. Over the next two to four weeks, this scab loosens and peels away, typically falling off completely within a month. One trade-off to know about: the skin underneath sometimes loses pigment and looks lighter than the surrounding area. This is more noticeable on darker skin tones and can be permanent.
Curettage and Electrodessication
Curettage means scraping the growth off with a small, spoon-shaped instrument after numbing the skin. It’s often combined with electrodessication, where a targeted electrical current burns the base of the growth to stop bleeding and destroy any remaining cells. This method works well for thicker, more raised keratoses that might not respond as cleanly to freezing.
The advantage of curettage is that it can provide a tissue sample for biopsy if your dermatologist wants to confirm the diagnosis under a microscope. Recovery is similar to cryotherapy, with a shallow wound that heals over several weeks. A study comparing electrocautery to laser removal found excellent clearance in about 67% of patients and very good results in another 27%, with only a small risk of scarring or infection (under 7%).
Laser Removal
CO2 lasers vaporize the growth layer by layer, giving the dermatologist precise control over depth. This precision translates to a slightly lower scarring risk compared to electrocautery. In a clinical comparison of 30 patients, the laser group had zero cases of post-procedure scarring or infection, while the electrocautery group had one case of each. Both methods produced identical clearance rates, so the choice often comes down to availability, cost, and your provider’s preference.
Laser removal tends to be more expensive and isn’t always covered by insurance, especially when the removal is cosmetic. It’s most useful for people with multiple SKs in visible areas like the face, where minimizing scarring matters most.
What Happened to the Topical Treatment
You may have read about a prescription topical solution containing 40% hydrogen peroxide (sold as Eskata) that was FDA-approved for in-office treatment of SKs. This product has been discontinued and is no longer available. There is currently no topical prescription treatment on the market specifically for seborrheic keratoses, which means procedural removal remains the standard approach.
Caring for the Wound After Removal
Proper aftercare prevents infection and gives you the best cosmetic outcome. If your removal left an open wound (as with cryotherapy or curettage), wash the site gently one to two times daily with cool water and soap. Pat it dry with a clean paper towel. Your provider will likely recommend applying petroleum jelly or an antibiotic ointment to keep the area moist, which helps prevent a hard crust from forming. If a bandage sticks to the wound, wet it before pulling it off.
If stitches were placed (less common with SK removal but possible for larger growths), keep the area covered and dry for the first 24 to 48 hours. After that, gentle washing is fine. Scalp wounds can be shampooed carefully.
Watch for signs of infection: increasing redness, pain that worsens instead of improves, yellow pus, or a fever above 100°F. These are uncommon but warrant a call to your provider. Most removal sites heal fully within four to six weeks, leaving behind skin that’s slightly lighter or pinker than the surrounding area. This color difference fades over the following months for most people.
Will They Come Back?
A removed seborrheic keratosis rarely regrows in the exact same spot. However, SKs are a product of aging skin, and new ones frequently appear elsewhere over time. People who develop one SK tend to develop more. There’s no proven way to prevent new growths from forming. Sun protection and gentle skin care are generally good practice, but even people with minimal sun exposure develop SKs. If new ones bother you, the same removal options apply each time.
Insurance Coverage
Insurance coverage depends on the reason for removal. If an SK is irritated, bleeding, or needs biopsy to rule out skin cancer, most insurance plans cover the procedure as medically necessary. Purely cosmetic removal is typically out of pocket. Cryotherapy and curettage are the least expensive options, while laser removal costs more per session. If you have multiple growths, ask your dermatologist whether treating several in one visit reduces the per-lesion cost, as many offices offer this.