Cosmetic Removal of Benign Skin Lesions

Seborrheic Keratoses

Seborrheic keratoses are benign tan to darker brown flat spots or brown to gray rough, warty, raised bumps located anywhere on the body. The flat brown spots are usually on areas exposed to the sun such as the face, chest, arms, and legs and are related to sun damage. Raised seborrheic keratoses are usually on the trunk, face, or scalp and the tendency to have them is inherited by your family genetics.  Treatment includes removal with cryotherapy (freezing with liquid nitrogen), chemical peels (flat brown spots only), or laser therapy. Redness and crusting can be expected after any of the treatments, and healing can take 1-2 weeks.

Skin Tags

Skin Tags are benign skin colored to slightly hyperpigmented fleshy bumps usually found on the neck, under arms, groin, and eyelids. These are extremely common and are more apparent as we age. Some people have a genetic predisposition to grow them. The lesions are also thought to be induced by being overweight and friction. Treatment of the lesions is safe and easy, most commonly removed using either cryotherapy (freezing with liquid nitrogen) or scissor excision (snipping them with fine scissors). The size of the skin tags determine which method will be utilized. If scissor excision is necessary the lesions to be treated are locally anesthetized with Lidocaine prior to removal making it a very comfortable procedure. We recommend applying Vaseline or Aquaphor to the treated areas multiple times daily to speed healing.

Sebaceous Gland Hyperplasia (Enlarged oil glands)

Sebaceous gland hyperplasia refers to benign enlarged and dilated oil glands. These appear as yellowish to pink bumps scattered on the face. They are more common in people with a history of oily skin. The most effective treatment is removal using either electrodessication or laser therapy. Electrodessication involves using an instrument called a Hyfrecator which heats the tissue allowing the lesion to be safely and gently removed without cutting the skin. Laser therapy is also an excellent treatment option for sebaceous hyperplasia. Carbon dioxide lasers such as the Ultrapulse Active Fx can be used to spot treat these lesions.

Prior to treatment with either method, an anesthetic cream is applied to the area to be treated for one hour. Dr. Daniels will then touch each lesion with the Hyfrector or ablate it with the laser, gently wipe the lesion off the skin, and apply Aquaphor as a healing ointment. The treated area will be pink and swollen for a few days, and crusts will form which will last one week. Keeping the area moisturized with Aquaphor will aid in healing. Two treatments spaced 6-8 weeks apart may be necessary. There is no true prevention of sebaceous gland hyperplasia, however using a topical retinoid regularly and glycolic or salicylic acid chemical peels may be helpful in controlling this condition.

Dermatosis Papulosa Nigra

Dermatosis Papulosa Nigra (DPNs) are benign dark brown bumps which imitate the appearance of moles that are often seen on the cheeks, temples, neck and chest. DPNs are most common in people of color; occurring in over 35% of African-American patients.  There is a genetic tendency to have DPNs and more lesions appear with age. These lesions can be treated safely and effectively with several modalities including electrodessication with currettage, cryotherapy, scissor excision, and laser therapy. Due to the inherent tendencies of skin of color to be more sensitive to injury, certain techniques are safer than others. The most common method is electrodessication and curettage whereby the lesions are gently heated and wiped off the skin. Laser therapy using a Nd:Yag or 532 nm laser is another superb option. There is mild discomfort during the procedure and therefore, prior to treatment with either method, an anesthetic cream is applied to the area to be treated for one hour. Significant improvement can be achieved in one 15 minute treatment session however more treatments may be needed depending on how many lesions are present. The treated area will be pink and swollen for one day, and crusts will form which will resolve in one week. Keeping the area moisturized with Vaseline is beneficial.

Milium

Milia are tiny benign skin colored to white firm bumps on the face. They are small cysts which are pockets of trapped dead skin cells and oil in the upper layer of the skin. Milia are common in newborn skin in which case the lesions resolve spontaneously with time. Milia are extremely common in adults as well, and are associated with sun damaged skin as well as injured skin.  Hydrafacial MD treatments, topical retinoids, glycolic acid chemical peels, and gentle exfoliation with devices such as a Clarisonic® Brush can help to prevent these. However, once Milia are present on the skin, topical therapies will not remove them. Treatment involves numbing the individual lesions with local anesthesia, making a narrow and shallow incision over the bump, and using a comedo extractor to push out the contents of the cyst. Antibiotic ointment is applied to the treated areas. It takes one week for the areas to heal completely. Applying Vaseline generously helps the crusting to subside faster.

Benign Moles

Cosmetic mole removal is an option when the mole is not causing any symptoms and is not clinically worrisome for abnormal changes, but removal is still desired. Insurance covers removal of clinically suspicious lesions and inflamed or irritated moles, however they do not cover removal otherwise. Moles are removed either by shave excision, punch excision, or excision with layered closure. Your Physician will discuss with you the best excision option for the type of mole that you have, and what the procedure and healing process entails.

Fibrous Papules

A fibrous papule is a firm skin colored bump that most often occurs on the nose but can appear elsewhere on the face. They are usually dome shaped shiny lesions 2-6 mm in diameter. Although it looks similar to a skin-colored mole, it is more firm in texture. Fibrous papules are harmless but persist unchanged if left untreated.  The most common treatment is removal using either electrodessication or shave removal. Electrodessication involves using an instrument called a Hyfrecator which heats the tissue allowing the lesion to be safely and gently removed without cutting the skin. Shave excision requires local anesthesia and gently removing the bump through cutting it and making the surface flesh with the skin’s. With either method, we ask that you keep the area moisturized with Vaseline until it completely heals.