The list of treatments mentioned in various sources for Seborrheic keratosis includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
The first step in getting correct treatment is to get a correct diagnosis. Differential diagnosis list for Seborrheic keratosis may include:
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Treatment is mostly for cosmetic reasons and should be guided by the patient’s preference. Treatment aims to remove exophytic warts and to ameliorate signs and symptoms. Topical drug therapy (10% to 25% podophyllum in compound benzoin tincture, trichloroacetic acid, or dichloroacetic acid) removes small warts. (Podophyllum is contraindicated in pregnancy.) Warts larger than 2.5 cm are generally removed by carbon dioxide laser treatment, cryosurgery, or electrocautery. Other treatments include Podofilox, Imiquimod, interferon, and combined laser and interferon therapy. No therapy has proved effective in eradicating HPV; relapse is common.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Treatment for warts varies according to the location, size, number, pain level (present and projected), history of therapy, the patient’s age, and compliance with treatment. Most persons eventually develop an immune response that causes warts to disappear spontaneously and require no treatment.
Treatment may include:
❑ Electrodesiccation and curettage: High-frequency electric current destroys the wart and is followed by surgical removal of dead tissue at the base and application of an antibiotic ointment (such as polysporin), covered with a bandage, for 48 hours. This method is effective for common, filiform and, occasionally, plantar warts. (See Removing warts by electrosurgery.)
❑ Cryotherapy: Liquid nitrogen kills the wart; the resulting dried blister is peeled off several days later. If initial treatment isn’t successful, it can be repeated at 2- to 4-week intervals. This method is useful either for periungual warts or for common warts on the face, extremities, penis, vagina, or anus.
❑ Acid therapy (primary or adjunctive): The patient applies plaster patches impregnated with acid (such as 40% salicylic acid plasters) or acid drops (such as 5% to 16.7% salicylic acid in flexible collodion or trichloroacetic or dichloroacetic acids), every 12 to 24 hours for 2 to 4 weeks. This method isn’t recommended for areas where perspiration is heavy, for those parts that are likely to get wet, or for exposed body parts where patches are cosmetically undesirable.
❑ 25% podophyllin in compound with tincture of benzoin (for venereal warts): The podophyllin solution is applied on moist warts. The patient must lie still while it dries, leave it on for 4 hours, and then wash it off with soap and water. Treatment may be repeated every 3 to 4 days and, in some cases, must be left on a maximum of 24 hours, depending on the patient’s tolerance. Avoid using this drug on pregnant patients.
During acid or podophyllin therapy, the patient should protect the surrounding area with petroleum jelly or sodium bicarbonate (baking soda). A small amount of 25% to 50% trichloroacetic acid (for venereal warts) is applied to the wart. After the wart turns white, the acid is neutralized with baking soda or water.
❑ Carbon dioxide laser therapy: This treatment has successfully treated genital warts.
The use of antiviral drugs is under investigation; suggestion and hypnosis are occasionally successful, especially with children. Patients can apply topical imiquimod cream to sites that aren’t thickly keratinized. It’s applied at bedtime three times per week. Imiquimod can be used alternately with a topical retinoid such as tazarotene, which may increase effectiveness.
Occlusion may be beneficial to persistent warts.
Source: Professional Guide to Diseases (Eighth Edition), 2005
When to expect improvement:
Source: The 5-Minute Pediatric Consult, 2008
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