When it comes to spots on the skin, it can be
tough to determine what is what and which, if any, may be harmful to your
health. Many spots may look alike, but all spots are not created equal—some are
developed during exposure to the sun, while others are determined by genetics.
Three spots in particular, including
seborrheic keratoses, liver spots, and moles, all may resemble each other in
size, shape, and color, but each is developed (and can be removed) in different
ways. Pasadena, CA dermatologist Sara Gaspard MD, gave us the low-down on ways
to identify, and treat, these types of spots.
An overgrowth of skin that rests
superficially, a seborrheic keratosis (or SK) typically appears as a “waxy” or
“scaly” bump and is often dark in color. “Despite their shade, SKs don’t
typically contain melanocytes and pose no risk of transformation into cancer,”
says Dr. Gaspard.
“These types of spots will usually start to
appear in one’s late 30s and on, and the chance of developing an SK depends mostly
on genetics,” she explains. Traditionally, SKs are removed with cryotherapy,
where liquid nitrogen breaks up the cells in the lesion and causes them to
slough off. The removal of SKs is slowly changing, though, as new treatments
come out into the market. A recent product released into the market called ESKATA® (hydrogen peroxide) topical solution, 40% (w/w),
is the only FDA-approved, topical treatment that can treat raised SKs. ESKATA
contains 40% hydrogen peroxide and is a soft-tip, pen-like applicator that can
be applied directly to the raised SK.
Lentigines, or commonly referred to as “liver
spots,” are caused by chronic sun exposure and “have nothing to do with the
health of your liver,” says Dr. Gaspard. Liver spots are flat brown lesions,
uniform in color, and usually develop in areas where one is most exposed to the
sun, including the face, décolletage, shoulders, and hands.
“Most liver spots are considered benign, containing
cells called melanocytes, which produces pigmentation of the skin,” she
explains. Although the majority of liver spots are non-cancerous, “there is a
potential for one of the cells to go awry and to produce a form of skin cancer
called lentigo maligna,” she warns.
Benign liver spots can be treated multiple
ways, including liquid nitrogen and electrocautery, which destroys growths
For a less invasive approach, “liver spots can be treated using chemical peels,
lasers, lightening creams, or photo facials, too,” says Gaspard.
Moles are a complex entity made up entirely of
melanocytes. They begin to appear in childhood and can continue to develop and
change until one reaches their mid 20s. Usually, moles develop because of one’s
genetic makeup, and can then be compounded by the effects of the sun. “You can
usually find moles on the most sun-exposed areas of the body,” says Gaspard.
Gaspard notes that identifying moles can be
challenging, because they come in many different forms and structures. They can
be flat brown spots or raised, brown or flesh-colored bumps. “Because these
lesions are so varied and have the potential to develop into cancer, it’s best
to have them evaluated by a board-certified dermatologist,” advises Gaspard.
“The only way to definitively remove a mole is through a biopsy or excision,
where they have to be cut out of the skin,” she says.
If you identify a spot, it is best to
consult with a dermatologist or healthcare provider.
is not approved for moles or liver spots.