African American skin and small growths on the face and neck

Hello doctor I'm a 60 year old African American female needing help, treatment or a medication that will eliminate what looks like warts or moles they normally are seen on African Americans around the eye and cheek area. These things are multiplying daily... well maybe not but they seem to be. Please I would appreciate any guidance, advice you would have, you see I still want to look beautiful. Thank you .

I’m so glad you mentioned this.  For a firm diagnosis, please ask your doctor.  Generally, these are small (1-3mm) dark brown papules (bumps) on the face and neck.  They are a type of seborrheic keratosis ……..only small.  Sometimes they are called stucco keratoses.  Often, but not always, they are hereditary.  Some of our patients have more than 100 of these.

While these are almost never a skin cancer, they can be annoying cosmetically to our patients.

What doesn’t work well (in my opinion)

  • Freezing these with liquid nitrogen because it causes a large dark mark after treatment that takes forever to resolve. The healing looks worse than the original problem.
  • Lasers generally don’t work unless a very experienced doctor is using a CO2 on what is known as the “surgical or cutting” mode, not the fractionated mode.

What DOES work well (also my opinion and a lot of experience)

Your doctor should have a protocol they follow before you sign on.  It’s fine if it’s slightly different than this, as long as they are experienced in treating these.

You can’t use this protocol if you have a pacemaker or defibrillator!  The sound wave interferes with it. Be sure to tell your doctor if you have any history of skin infections.

  • Pretreat the skin over the whole area (don’t spot treat) for two weeks with a hydroquinone (prescription) or stronger plant based lightening cream like Lytera
  • Pretreat for two weeks with minimum 10% zinc sunscreen (View Sunscreen Here) every morning, and wear a brimmed hat whenever outside.
  • Arrive one hour before for in office topical numbing cream to be applied.  Also they need to use a “plume/smoke evacuator.” And a zimmer cooler is helpful, but not necessary.
  • Using an electrocautery “pen” the doctor will remove them and then use a small curette to make sure gone.
  • Bland post care products applied and gone over with you.  Your doctor or nurse should provide these to you written out.
  • Sunscreen and hat daily as above for 4-6 weeks.
  • Also, your doctor may want to restart the lightening cream about 7-10 days after the procedure.

About 20-30 can be safely done in one treatment.   A check back with the doctor at 4-6 weeks is important.

Hope this helps!
Dr. Brandith Irwin
Founder, SkinTour
Director, Madison Skin & Laser Center
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Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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