Preventing and treating benign “barnacles” (seborrheic keratoses) on the body

I am a reasonably well-preserved 64yo woman who unfortunately is plagued with seborrheic keratoses on my face, chest and especially my back. Beyond liquid nitrogen, a less than satisfactory treatment what with surrounding skin darkening, incomplete eradication, and the necessity of repeat treatment ad infinitum, are there any other treatment options available? On my face/chest, I have tried Retin-A and alpha and beta hydroxy acid without success.

What causes seborrheic keratoses, anyway?  Some people have a genetic form (usually the multiple tiny ones on the face and neck) and you may notice that sun exposed areas tend to accumulate more. Please don’t self diagnose!  If you have any question about a growth, you gotta see a doctor!  Also, remember that insurance will pay for the diagnosis of these, but not the removal. Removal is usually not medically necessary and is a cosmetic procedure.

There is nothing that I have ever seen or heard of that makes these “barnacles” magically disappear. It’s a long term, chronic problem as you’ve mentioned.

For removal of seborrheic keratoses, the most common options are:

1. Liquid nitrogen: but it takes a long time to heal and often leaves a mark.

2. Using a hyfercator (small electric pen) plus a currette  (a small scraper):  this often heals a little faster, but requires numbing for large ones.

3. A laser like the CO2:  too expensive, usually.

For prevention of seborrheic keratoses (consistency is what matters in any case):


1. A lotion: choose one that prevents build of dead skin cells like a glycolic 10% (alpha hydroxy), beta hydroxy, or Amlactin.  There are plenty out there. You may need to try several to find one you like.

2. A back brush in the shower: this works to exfoliate the area. Light wash cloth or loofah in the shower is helpful, too. Don’t overscrub. Soap doesn’t help with these.


3. 2-4 cups of Epsom salts in a bath: soak for 10-20 minutes. Loofah, or use that wash cloth in the bath after soaking.

4. Or a salt based body scrub: use it on the entire body.  Don’t over scrub.

What doesn’t work to treat seborrheic keratoses:

1. Peels (except at prevention): they are too superficial.

2. Overscrubbing:  Irritating the skin could cause more.

3. Retin A and similar Vitamin A cousins:  these are great for preventing precancerous lesions, skin cancers and wrinkles, but they don’t work for these benign barnacles.

Hope this helps,   Dr. I

Dr. Brandith Irwin, MD

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