Is Sebhorreic Keratosis Removal possible with CoolPeel? (Photo)

Question

Hi there, I’ve seen several doctors about a raised, textured, benign SK on my cheek that is growing with age. I have tried cryo and it helped, but would like removal with minimal scarring so i can at least conceal with makeup. I am interested in laser, but am sensitive to bright light near my eye. Pico and BBL I have tried, but cannot due repeat sessions due to it triggering headaches. Interested in plasma pen or electrocauterie as well!

Anna Chacon, MD, FAAD · Answer

Thank you for sharing all the details about your SK and your previous treatments. I understand your goal of removing the lesion while minimizing scarring and avoiding triggers like bright light near your eyes.

CoolPeel for SK removal:
CoolPeel (a type of CO₂ laser) is primarily designed for skin resurfacing and improving texture, fine lines, and pigmentation. While it can sometimes be used for superficial raised lesions, it is not the first-line treatment for thicker, raised seborrheic keratoses. The depth and thickness of the SK can make complete removal with minimal sessions challenging.

Other laser options:

Pico and BBL lasers are generally better for pigment issues rather than thick, raised SKs. Since you’ve had headaches triggered by these, repeated sessions may not be ideal.

Electrocautery or plasma pen:

These are often more precise for raised SKs, especially in sensitive areas near the eyes. Electrocautery can effectively remove the lesion while minimizing downtime and scarring if done carefully.

Plasma pens are also an option, though they tend to work best for smaller or flatter SKs.

Cryotherapy:

Cryotherapy works well for small lesions, but thicker SKs may require multiple sessions and sometimes leave slight pigment changes.

Summary:
CoolPeel is likely not the most effective single treatment for a raised SK, especially near sensitive areas. Electrocautery or plasma pen approaches are often more precise and can help reduce scarring while addressing your cosmetic concerns. Your sensitivity to light and previous headaches also make these options preferable to repeated laser sessions.

Nelson Lee Novick, MD · Answer

I have been using simple low intensity electrcautery for removing Seborrheic Keratoses from all locations for well over three decades with gratifying results. The site is numbed with a small amount of local anesthetic, the low intensity electrocautery is applied quickly to soften the keratoses after which a gauze pad is used to wipe the melted keratosis away. The procedure takes only a couple of minutes to perform. No expensive light and laser treatment with its risks of dyspigmentation, particularly in individuals with skin of color. What's more unlike many of the here-today-gone-tomorrow, heavily hyped and social media promoted gizmos out there, electrocautery has stood the test of decades of time for both safety and efficacy. Hope this helps, happy holidays and best of luck.

Is Sebhorreic Keratosis Removal possible with CoolPeel? (Photo)

Answers (2)

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