Benign Growths

Cysts

Cysts are common and may occur anywhere on the skin, especially the back. A cyst is an invagination of skin, which forms a sack beneath the skin’s surface. Because the lining of this sack consists of normal skin, it continues to shed skin cells just like our skin does. These dead skin cells become compressed and as more accumulate, the cyst grows into a lump. Occasionally, if the sack ruptures beneath the skin, an inflammatory reaction results that causes pain, redness, and drainage of a smelly fluid containing the dead skin cells. If this happens, you should make an appointment at the Gladstone Clinic for treatment to decrease the risk of secondary infection and scarring.

Although cysts are considered benign and can be watched without treatment, they can also be removed by simple surgery. During this outpatient procedure, the cyst is numbed with local anesthesia, and then its sack is carefully dissected out of the skin through a small incision. Once removed, the wound is stitched and a small scar results. Surgical excision is the most definitive way to remove cysts. If they are simply drained, they will refill over time.

Lipomas

Fatty tumors, also called lipomas, are common growths of fat cells. It is unclear why they develop, but genetics may play a role, since they are common in some families. In general, lipomas are harmless, but they can occasionally cause pain or become irritated when rubbed by adjacent skin or clothing. In these instances, lipomas can be removed by simple surgery. During this outpatient procedure, the lipoma is numbed with local anesthesia, and then it is carefully dissected out of the skin through a small incision. Once removed, the wound is stitched and a small scar results.

Seborrheic Keratoses

Seborrheic keratoses or “warty moles” are common skin growths that often appear in middle-aged and older adults as small rough bumps anywhere on the body. They range in color from white to black, but most are tan, brown, or gray. Although they may look worrisome, seborrheic keratoses are benign and do not require treatment.

Their cause remains unknown, but a combination of genetic make-up and possibly sun exposure might play a role in their growth. Seborrheic keratoses are most often diagnosed clinically by examining your skin. Rarely, a skin biopsy may be recommended to differentiate one of these growths from a skin cancer. If one or more of your seborrheic keratoses becomes inflamed, very itchy, or bleeds, it can be removed with liquid nitrogen, a scraping procedure, or a small surgical procedure.

Keloids

A keloid (key-loid) is a type of raised scar. Unlike other raised scars, keloids grow much larger than the wound that caused the scar.

Not everyone who gets a scar will develop a keloid. If you have keloid-prone skin, however, anything that can cause a scar may lead to a keloid. This includes a cut, burn, or severe acne. Some people see a keloid after they pierce their ears or get a tattoo. A keloid can also form as chickenpox clear. Sometimes, a surgical scar becomes a keloid.

In very rare cases, keloids form when people do not injure their skin. These are called “spontaneous keloids.”

A keloid usually takes time to appear. After an injury, months can pass before this scar appears. A keloid can also form more quickly.

Once it begins, a keloid can enlarge slowly for months or years.

Keloids do not turn into cancer.

The size and shape of keloids vary. On an earlobe, you’ll likely see a round, solid mass. When a keloid forms on a shoulder or the chest, the raised scar tends to spread out across the skin. It often looks like a liquid spilled on the skin and then hardened.

As these raised scars grow, they may feel painful or itchy. A keloid that covers a joint or large area can decrease a person’s ability to move that part of the body.

Treatment can help reduce symptoms like pain and itch. If the scar makes moving difficult, treatment can help a person regain some movement.

Treating a keloid, however, can be involved. To reduce the chance of another keloid forming after treatment, more than one type of treatment may be necessary.

No one treatment is best for all keloids. To give their patients the best results, the Gladstone Clinic chooses treatment based on the patient’s age, type of keloid, and other considerations. For example, one patient with a keloid on an earlobe may get better results if the scar is surgically removed in layers (called shaving) than surgically cut out.

Warts

Warts are benign (not cancerous) skin growths that appear when a virus infects the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). You are more likely to get one of these viruses if you cut or damage your skin in some way.

Wart viruses are contagious. Warts can spread by contact with the wart or something that touched the wart.

Warts are often skin-colored and feel rough, but they can be dark (brown or gray-black), flat, and smooth.

Warts: Diagnosis and Treatment

How does the Gladstone Clinic diagnose warts?

We can tell whether you have a wart by looking at it. In rare cases, we may need to perform a skin biopsy to be certain. If we need to perform a biopsy, then we will remove the wart and send it to a lab. At the lab, a small piece of the wart will be looked at under a microscope.

A biopsy is a safe and quick procedure to perform. It should not cause any anxiety.

How does the Gladstone Clinic treat warts?

Warts often go away without treatment. This is especially true when children get warts. In adults, warts may not disappear as easily or as quickly as they do in children. Although most warts are harmless, we do treat them.

You should also make an appointment at the Gladstone Clinic if you cannot get rid of the warts, the warts hurt, or you have many warts. We have many treatments for warts. The treatment used depends on the patient’s age and health as well as the type of wart.

The Gladstone Clinic may use one of the following treatments:

• Cantharidin: We may treat a wart in the office by “painting” it with cantharidin. Cantharidin causes a blister to form under the wart. In a week or so, you can return to the office and we will clip away the dead wart.
• Cryotherapy: For common warts in adults and older children, cryotherapy (freezing) is the most common treatment. This treatment is not too painful. It can cause dark spots in people who have dark skin. It is common to need repeat treatments.
• Electrosurgery and curettage: Electrosurgery (burning) is a good treatment for common warts, filiform warts, and foot warts. Curettage involves scraping off (curetting) the wart with a sharp knife or small, spoon-shaped tool. These two procedures often are used together. We may remove the wart by scraping it off before or after electrosurgery.
• Excision: We may cut out the wart (excision).

If the warts are hard-to-treat, we may use one of the following treatments:

• Laser treatment: Laser treatment is an option, mainly for warts that have not responded to other therapies. Before laser treatment, we may numb the wart with an anesthetic injection (shot).
• Chemical peels: When flat warts appear, there are usually many warts. Because so many warts appear,  “peeling” methods may be used to treat these warts. This means, you will apply a peeling medicine at home every day. Peeling medicines include salicylic acid (stronger than you can buy at the store), tretinoin, and glycolic acid.
• Bleomycin: We may inject each wart with an anti-cancer medicine, bleomycin. The shots may hurt. They can have other side effects, such as nail loss if given in the fingers.
• Immunotherapy: This treatment uses the patient’s own immune system to fight the warts. This treatment is used when the warts remain despite other treatments. One type of immunotherapy involves applying a chemical, such as diphencyprone (DCP), to the warts. A mild allergic reaction occurs around the treated warts. This reaction may cause the warts to go away.
• Another type of immunotherapy involves getting shots of interferon. The shots can boost the body’s immune system, which gives the body the ability to fight the virus.

Outcome

There is no cure for the wart virus. This means that warts can return at the same site or appear in a new spot.

Sometimes, it seems that new warts appear as fast as old ones go away. This happens when the old warts shed virus cells into the skin before the warts are treated. This allows new warts to grow around the first warts. The best way to prevent this is to have the Gladstone Clinic treat new warts as soon as they appear.