Seborrheic keratoses are almost always harmless, but they can be removed if they bother you. The most common and effective treatments are cryotherapy (freezing), scraping, and electrocautery (burning with an electric current), all performed in a dermatologist’s office with local numbing. No single method is clearly superior to the others, so the choice usually comes down to the size and thickness of your growths, your skin tone, and your doctor’s preference.
Cryotherapy: Freezing the Growth Off
Cryotherapy uses liquid nitrogen to freeze and destroy the growth. It’s especially practical when you have multiple seborrheic keratoses because the dermatologist can move quickly from one spot to the next. The freezing takes seconds per lesion. Your skin blisters, the dead tissue peels away over the following days, and new skin forms underneath.
The main downside is a lighter patch of skin where the growth used to be. This hypopigmentation is more noticeable and more likely in people with darker skin tones. In lighter-skinned patients, the color difference tends to fade within several months. Scarring is rare as long as the freeze stays under 30 seconds beyond the initial ice ball forming, because that preserves the deeper skin layers needed for normal healing. Other temporary side effects include blistering and minor bleeding at the site.
Scraping and Electrocautery
Curettage (scraping) uses a scalpel blade to shave the growth off the skin’s surface after the area is numbed. It works well for thinner, flatter lesions and is sometimes combined with cryotherapy in the same session. For thicker growths, your dermatologist may use electrocautery, which burns the tissue away with an electric current. Electrocautery can also be paired with scraping: the blade removes the bulk, then the electric current cleans up whatever remains.
A head-to-head clinical study comparing electrocautery to CO2 laser ablation found no significant differences in treatment effectiveness, post-procedure complications, recovery time, or recurrence rate. In other words, the simpler, less expensive option performed just as well as the high-tech one.
Laser Removal
Ablative lasers, particularly CO2 lasers, vaporize the growth layer by layer. The precision can be useful for lesions in cosmetically sensitive areas like the face. But because lasers haven’t shown meaningful advantages over electrocautery or cryotherapy in clinical comparisons, they’re generally reserved for situations where a dermatologist wants finer control. Laser treatment also tends to cost more.
Topical Hydrogen Peroxide Solution
A prescription-strength 40% hydrogen peroxide solution is the only FDA-approved topical treatment for seborrheic keratosis. It’s applied directly to the growth in a doctor’s office, not at home. If the lesion hasn’t cleared after the first treatment, it can be reapplied three weeks later.
The results are modest compared to procedural options. In two large clinical trials, only 4% to 8% of patients had all four treated lesions fully clear by day 106. When looking at individual growths rather than full clearance of every treated spot, about 25% to 34% of lesions cleared completely, and roughly half were clear or nearly clear. So while this option avoids cutting, freezing, or burning, it works best for people who want mild improvement rather than guaranteed removal.
What Happens After Removal
Post-procedure care is straightforward regardless of which method was used. After the first 24 hours, gently clean the area daily with mild soap and water. Pat it dry, then apply a thin layer of petroleum jelly (Vaseline or Aquaphor) and cover with a non-stick bandage secured with tape. Repeat this daily until the wound has fully healed.
Healing typically takes one to four weeks depending on the size and location of the treated area and the method used. The new skin underneath will be pink at first and gradually blend with the surrounding skin over the following weeks to months. Protecting the healing area from sun exposure helps minimize any lasting color difference.
A removed seborrheic keratosis will not grow back at the same spot. However, these growths are a product of aging skin, and nothing about treatment prevents new ones from appearing elsewhere on your body. Many people return periodically to have new ones removed as they develop.
How Dermatologists Tell It’s Not Skin Cancer
Before treating a seborrheic keratosis, your dermatologist needs to confirm that’s actually what it is. These growths can sometimes mimic melanoma or basal cell carcinoma to the naked eye, particularly when they’re dark or irregularly shaped. Dermatologists use a handheld magnifying tool called a dermoscope to look for telltale features: tiny white cyst-like dots, dark pore-like openings, and a brain-like pattern of ridges and fissures across the surface. They also look for sharp borders and a characteristic waxy, “stuck-on” texture. If any features suggest something more concerning, such as blue-gray clusters or leaf-like structures associated with skin cancer, the growth gets biopsied before any cosmetic treatment.
Insurance Coverage for Removal
Because seborrheic keratoses are benign, insurance companies generally classify removal as cosmetic and won’t cover it. The exception is when a growth causes symptoms: persistent irritation from clothing or jewelry rubbing against it, recurrent bleeding, itching, or pain. If your dermatologist documents that a lesion is symptomatic, the procedure is more likely to be covered as medically necessary. Purely cosmetic removal typically runs anywhere from $100 to $400 per session out of pocket, depending on the number of growths treated, the method used, and your geographic area. It’s worth calling your insurance company beforehand to ask about their specific criteria.