The Skin Lesion Guide
Seborrhoeic keratosis or melanoma? How to tell, and when to get it checked.
A seborrhoeic keratosis is benign and does not turn into melanoma, but the two can look alike, and only a clinician with a microscope can tell for certain. Here are the general features, the warning signs that mean get a spot checked, and where to go when something does not look right.
It is a common worry. A brown, raised growth appears, and somewhere in the back of your mind sits the question no one likes to ask: could this be a melanoma? Seborrhoeic keratoses are harmless, but they can look dark and uneven enough to give anyone pause.
The honest answer is reassuring and careful at the same time. A seborrhoeic keratosis is benign and does not become a melanoma. But the two can resemble each other, and no one, at Pink or anywhere else, can tell for certain which is which just by looking. This guide explains the general features that tend to set them apart, the warning signs that mean a spot should be checked, and why a proper look from a GP or skin-cancer clinic is the right move whenever there is any doubt.
Can a seborrhoeic keratosis turn into melanoma?
No. A seborrhoeic keratosis does not turn into a melanoma. Dermatologists are clear that seborrhoeic keratoses are not premalignant, meaning they are not growths on the way to becoming skin cancer. On its own, this is one of the most common and most harmless growths the skin makes with age.
There is one careful caveat worth stating plainly, because it is the reason this question matters. A separate skin cancer can, by chance, arise alongside or within the same patch of skin as a seborrhoeic keratosis. The keratosis does not cause it, and is not turning into it, but the two can look close enough that one is mistaken for the other. That is why a growth that is genuinely changing, rather than slowly thickening the way these normally do, is worth having looked at rather than assumed.
So the headline holds: a seborrhoeic keratosis is benign. The reason to stay alert is not that it transforms, but that the eye alone cannot always separate it from something that needs attention.
How can you tell a seborrhoeic keratosis from a melanoma?
There are general features that tend to distinguish a typical seborrhoeic keratosis from a melanoma, but they are reasons to get a spot looked at, not a way to diagnose yourself. A seborrhoeic keratosis is usually well defined, even in its waxiness, and has that stuck-on, sitting-on-the-surface look. A melanoma more often grows, changes and looks uneven over time. The trouble is that these are tendencies, not rules, and real spots do not always read from the textbook.
This is the part to hold on to: the features below help you decide whether to see someone, and they are not a test you can pass or fail at home. The most reliable thing anyone can say about a specific spot comes only after a clinician has examined it, and, if there is any doubt, looked at it under a microscope. That is the only way to tell for sure whether a growth is skin cancer. Reading a list and deciding your own spot is fine is exactly the trap this guide is built to keep you out of.
If you want the plain version: when in doubt, get it checked. That sentence is doing more work than any visual rule of thumb.
What are the warning signs I should get a spot checked?
The clearest way to know when to get a spot checked is the ABCDE guide, which Cancer Council Australia uses as a set of prompts to see your doctor, not as a way to diagnose a spot yourself. Cancer Council describes the signs to look for like this:
- A is for asymmetry. Spots that lack symmetry, where a line drawn through the middle would not match on both sides.
- B is for border. A spot with a spreading or irregular, notched edge.
- C is for colour. Blotchy spots with several colours, such as black, blue, red, white or grey.
- D is for diameter. Spots that are getting bigger.
- E is for evolving. Spots that are changing and growing over time.
Cancer Council also flags moles that itch or tingle, and moles that bleed or weep, as reasons to see a doctor, along with any new mole that appears after the age of twenty-five. As they put it, noticing one or more of these changes does not necessarily mean you have skin cancer, but it is important to visit your GP to have it investigated.
None of this is a verdict. It is a way of deciding that a spot deserves a professional look. If a growth matches any of these prompts, the next step is a GP or skin-cancer clinic, not a decision made at the bathroom mirror.
What happens if a seborrhoeic keratosis is left untreated?
Nothing harmful happens if a confirmed seborrhoeic keratosis is left alone. It is benign, and it is safe to leave once you know that is what it is. Many people live with several and never have a single one treated.
A seborrhoeic keratosis that is left in place will usually just persist, and may slowly thicken or darken over the years in the gradual way these growths do. It does not need removing for your health. People choose to have one treated when it catches on clothing or jewellery, is somewhere that bothers them, or they would simply rather it was gone. That is a cosmetic choice, and a perfectly good one, but it is a choice rather than a medical must.
The one condition on "safe to leave" is the one running through this whole guide: leave it alone once you are confident it is benign. If you are not sure, that confidence should come from a clinician, not from a guess.
Can a laser clinic tell me whether my growth is cancer?
No. Pink does not diagnose skin cancer and does not screen for it. Telling for certain whether a growth is cancer can only be done by a clinician who examines it and, where needed, looks at the tissue under a microscope. That is a medical assessment, and it belongs with a GP or a skin-cancer clinic, not with a cosmetic laser clinic.
Pink's role is deliberately narrow and worth being honest about. The clinic removes seborrhoeic keratoses and other benign growths once they are confirmed benign. If a growth is new, changing, very dark or in any way unusual, a clinician at Pink will ask you to have it checked first and point you toward someone who can do that, rather than treat it. That is not a clinic passing the buck. It is the safe order of things: diagnosis first, cosmetic removal only once the growth is known to be harmless.
If you are weighing up where to start and a spot is worrying you, start with the check. You can always book your free consultation with Pink afterwards for the cosmetic side, once you know the growth is benign.
Do I need a skin check before having a seborrhoeic keratosis removed?
If there is any doubt about what a growth is, yes, have it checked first. If a clinician is confident a growth is a clearly benign seborrhoeic keratosis, a separate skin check is not required to remove it. The deciding factor is certainty, not paperwork.
For a textbook seborrhoeic keratosis, sitting on the surface, waxy, unchanged for a long while, cosmetic removal is straightforward and does not hang on a referral. The moment a growth looks less certain, very dark, recently changed, or different from everything around it, the order flips: it is checked first, by a GP or skin-cancer clinic, and treated cosmetically only once it is confirmed benign. When that line is unclear, Pink errs toward asking you to get it checked. It is the more cautious path, and on this topic the cautious path is the right one.
Where should you go to get a worrying spot checked?
A worrying spot should be looked at by a GP or a skin-cancer clinic. These are the services set up to examine, diagnose and, if needed, take a sample of a spot, which is the part Pink does not do. Your regular GP is a good first stop, and they can refer you on if a closer look is warranted.
Once a spot has been checked and confirmed benign, the cosmetic side is simple. If a seborrhoeic keratosis turns out to be exactly what it looked like and you would rather it was gone, that is when Pink's seborrhoeic keratosis removal comes in. For more on what a seborrhoeic keratosis actually is and why it appears, our guide on what a seborrhoeic keratosis is covers the ground. And if you are not yet sure what kind of spot you are looking at, the raised spot router helps you sort a skin tag from a mole from a keratosis.
Book your free consultation
Pink treats seborrhoeic keratoses that are confirmed benign, and refers anything that needs a closer look. If a growth is worrying you, see a GP or skin-cancer clinic first. If you already know it is benign and you would like it gone, a free consultation is the easy next step: a clinician looks at the growth and talks you through removal with the Er:YAG laser. You can book your free consultation online whenever you are ready.
Frequently Asked Questions
Can a seborrhoeic keratosis turn into melanoma?
No. A seborrhoeic keratosis is benign and does not turn into a melanoma. Dermatologists are clear that seborrhoeic keratoses are not premalignant. The one caveat is that a separate skin cancer can, by chance, arise alongside or within the same patch of skin, which is why a growth that is genuinely changing should be checked rather than assumed.
How can you tell a seborrhoeic keratosis from a melanoma?
A typical seborrhoeic keratosis tends to be well defined and stuck-on looking, while a melanoma more often grows, changes and looks uneven. But these are tendencies, not a test you can apply to your own spot. The only way to tell for sure whether a growth is skin cancer is for a clinician to examine it and, where needed, look at it under a microscope. When in doubt, get it checked.
What are the warning signs I should get a spot checked?
Cancer Council Australia uses the ABCDE prompts as reasons to see your doctor: asymmetry, an irregular border, several colours, a growing diameter, and a spot that is evolving or changing. They also flag moles that itch, tingle, bleed or weep, and any new mole appearing after the age of twenty-five. Noticing these does not mean you have skin cancer, but it is a reason to have a spot investigated by your GP.
What happens if a seborrhoeic keratosis is left untreated?
Nothing harmful. A confirmed seborrhoeic keratosis is benign and safe to leave. It will usually just persist and may slowly thicken or darken with age. It does not need removing for health reasons. Removal is a cosmetic choice, for when a growth catches, irritates or simply bothers you.
Can a laser clinic tell me whether my growth is cancer?
No. Pink does not diagnose or screen for skin cancer. Whether a growth is cancer can only be confirmed by a clinician who examines it and, where needed, looks at the tissue under a microscope. That assessment belongs with a GP or skin-cancer clinic. Pink removes growths only once they are confirmed benign.
Do I need a skin check before having a seborrhoeic keratosis removed?
If there is any doubt about what a growth is, yes. If a clinician is confident it is a clearly benign seborrhoeic keratosis, a separate skin check is not required to remove it. Where the picture is less certain, the growth is checked first by a GP or skin-cancer clinic and treated cosmetically only once it is confirmed benign.
Where should I go to get a worrying spot checked?
A GP or a skin-cancer clinic. These services can examine, diagnose and, if needed, take a sample, which is the part Pink does not do. Your regular GP is a good first stop and can refer you on. Once a spot is confirmed benign, Pink can remove it cosmetically if you would like it gone.
