Skin Lesions
There are many types of benign skin lesions and these tend to become more common with age. Whilst harmless they can be annoying and unsightly. Fortunately they can usually be removed with minimal scarring with minor surgery, laser treatments and other approaches.
| 15 min read

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Some of the most common benign skin lesions that I will treat are discussed below - although there are many more! It is important to emphasize that an accurate diagnosis is crucial before proceeding with any treatment for benign skin lesions, as it can be easy to miss a skin cancer or incorrectly identify a lesion leading to an inappropriate treatment.

Seborrheic Keratosis

Seborrheic Keratosis is a common skin condition that appears as warty growths varying in color from brown, black, or light tan. They are associated with aging and excessive sun exposure. Individuals may choose removal for cosmetic reasons or if they catch or cause discomfort during exercise. Removal methods include Cryotherapy (freezing), curettage (scraping), or carbon dioxide laser therapy.

Actinic keratoses

Actinic keratoses represent sun-damaged skin regions and mainly occur on body parts exposed to sunlight. Some actinic keratoses may heal naturally, particularly those that are smaller and less severe. However others require intervention. Individuals with a history of one actinic keratosis are likely to develop more in the future.

There are a number of different treatment options:-

  • Cryotherapy (freezing): This is a good option when there are a small number of lesions.
  • Topical treatments (efudix or imiquimod): This is good for treating a larger area or where there is a larger number of lesions. There will be a significant inflammatory reaction. Generally these are applied for 4-6 weeks, however there is some evidence that a short course of 5 days can also be effective.
  • Curettage and cautery: This is more suitable for thicker lesions or where there is concern that there may be skin cancer. The removed lesion can be sent for pathological analysis however there is more potential for scarring.
  • Photodynamic therapy: This is used for one or a small number of lesions. A gel is applied to the lesion for 1-2 hours and then a powerful light is shone onto the lesion for 10-15 minutes. This can be painful. The lesion will usually become inflamed and sore.
  • Daylight photodyamic therapy: This is used to treat larger areas such as the scalp or forehead. A gel is applied and then you will be exposed to sunlight for 2 hours.
  • Carbon dioxide laser resurfacing: This can be very effective for actinic keratoses and sun damage, however it has significant downtime and some risks.

Dermatosis Papulosa Nigra

Dermatosis Papulosa Nigra presents multiple, small, benign, dark marks on the skin. They are common among individuals with darker skin tones particularly on the face and neck. Treatment options include electrocautery, curettage or lasers.

Harmless Mole (Nevus)

Harmless Moles (Nevi) are common skin growths appearing as small, round, brown spots due to clustered pigmented cells. They are generally benign, however should be evaluated carefully prior to removal as skin cancers can appear similar. Removal for involves surgical excision - usually removing the mole flat with the skin surface to leave a small scar.

Lentigo (Freckle)

Lentigines (or freckles) are flat pigmented marks on the skin. Usually they are small but occasionally they can be larger. They are associated with sun exposure and more common in individuals with lighter skin. They are harmless, but can be unsightly. Careful sun protection and use of sunscreen can cause them to fade an minimize the formation of new lesions. They can be made less visible with a Pigment laser or Intense Pulsed Light.


Epidermoid and pilar cysts are both benign lumps that arise under the skin surface. Epidermoid cysts, commonly found on the face, neck, or back, arise from the surface lining of the skin. Pilar cysts arise from hair follicles and are mostly located on the scalp. Both are benign, however can become infected. Removal may also be desired due to aesthetic concern or discomfort. Cysts can be removed surgically - during the procedure it is essential to remove not only the cyst contents but also the lining of the cyst to minimize the risk of recurrence. learn more

Cherry Angioma / Haemangiomas

Cherry Angiomas are benign growths of blood vessels "haemangiomas". They appear as bright red spots on the skin. They become more common with age and some individuals have hundreds. They are harmless and don't necessitate treatment. However, they can be removed with Vascular Lasers, electrocautery, or Cryotherapy.

Prominent blood vessels

Telangiectasias are small broken blood vessles on the surface of the skin. They are most common on the face, neck and legs. Vascular Lasers, such as the pulsed dye laser can be highly effective. Another option is Intense Pulsed Light which can be particularly helpful when pigmentation is also present.

Spider Naevus

A Spider Naevus appears as a cluster of small blood vessels clustering around a central larger vessel. They are common on the face and in many cases have no obvious cause, however they can be related to hormonal changes, pregnancy or liver disease. Vascular Lasers are generally safe and effective. An alternative is electrocautery.


Lipomas are benign tumors composed of fat tissue. They appear as soft masses under the skin surface and are movable under the skin. Generally harmless, they often don't need any treatment, however, if they're painful, growing, or cosmetically concerning, they can be surgically removed under local anesthesia.


Dermatofibromas are firm skin lesions that often arise on the lower legs following minor injuries such as insect bites. They do not treatment unless they cause symptoms or there is uncertainty about the diagnosis. They are generally removed by excision (cutting and stitching) to leave a linear scar.

Viral Warts

Viral Warts are warty growths appearing anywhere on the skin, caused by the human papillomavirus (HPV). Whilst harmless they can be annoying. Treatment options include salicylic acid, cryotherapy (freezing), surgical removal, laser treatments or creams that stimulate the immune system.

Sebaceous Hyperplasia

Sebaceous Hyperplasia appears as small, yellowish skin bumps, primarily on the face. They represent enlarged sebaceous glands and are more common with aging and in association with rosacea. I prefer needlepoint electrocautery for removal of these lesions and there is generally minimal scarring. Topical retinoids such as tretinoin can reduce the formation of new lesions.


Milia are small white bumps or cysts appearing on the face due to trapped keratin. They often resolve spontaneously but can be treated by needlepoint electrocautery or needle extrusion. Topical retinoids can reduce the formation of these lesions.

Skin Tags

Skin Tags are benign skin-colored growths common on the eyelids, neck, or areas with friction such as the underarm area or groin. They can be removed if irritating or for cosmetic reasons by shave excision or cryotherapy.


Xanthelasma is raised yellowish fatty deposits under the skin, usually around the eyelids. They can be removed with carbon dioxide laser or electrocautery.


Syringomas are benign eccrine sweat duct tumors. They appear as small skin-colored bumps usually on the eyelids or upper cheeks. Where desired they can be removed with carbon dioxide laser or electrocautery, however this can leave small scars.

Keloid scars

Keloid scars are raised irregularly-shaped scars that grow beyond the original wound. They can be itchy, painful, and cosmetically concerning and often enlarge over time. They are more common in individuals with darker skin type. Keloids are difficult to treat and have high recurrence rates. Treatment options include steroid injections, vascular lasers, surgery and radiotherapy. learn more


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