Not All Spots Are Created Equal

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When it comes to spots on the skin, it can be tough to determine what is what and which, if any, may be harmful to your health. Many spots may look alike, but all spots are not created equal—some are developed during exposure to the sun, while others are determined by genetics.

Three spots in particular, including seborrheic keratoses, liver spots, and moles, all may resemble each other in size, shape, and color, but each is developed (and can be removed) in different ways. Pasadena, CA dermatologist Sara Gaspard MD, gave us the low-down on ways to identify, and treat, these types of spots.

1.  Seborrheic keratoses

An overgrowth of skin that rests superficially, a seborrheic keratosis (or SK) typically appears as a “waxy” or “scaly” bump and is often dark in color. “Despite their shade, SKs don’t typically contain melanocytes and pose no risk of transformation into cancer,” says Dr. Gaspard.

“These types of spots will usually start to appear in one’s late 30s and on, and the chance of developing an SK depends mostly on genetics,” she explains. Traditionally, SKs are removed with cryotherapy, where liquid nitrogen breaks up the cells in the lesion and causes them to slough off. The removal of SKs is slowly changing, though, as new treatments come out into the market. A recent product released into the market called ESKATA® (hydrogen peroxide) topical solution, 40% (w/w), is the only FDA-approved, topical treatment that can treat raised SKs. ESKATA contains 40% hydrogen peroxide and is a soft-tip, pen-like applicator that can be applied directly to the raised SK.

2.  Liver spots

Lentigines, or commonly referred to as “liver spots,” are caused by chronic sun exposure and “have nothing to do with the health of your liver,” says Dr. Gaspard. Liver spots are flat brown lesions, uniform in color, and usually develop in areas where one is most exposed to the sun, including the face, décolletage, shoulders, and hands.

“Most liver spots are considered benign, containing cells called melanocytes, which produces pigmentation of the skin,” she explains. Although the majority of liver spots are non-cancerous, “there is a potential for one of the cells to go awry and to produce a form of skin cancer called lentigo maligna,” she warns.

Benign liver spots can be treated multiple ways, including liquid nitrogen and electrocautery, which destroys growths using heat. For a less invasive approach, “liver spots can be treated using chemical peels, lasers, lightening creams, or photo facials, too,” says Gaspard.

3.  Moles

Moles are a complex entity made up entirely of melanocytes. They begin to appear in childhood and can continue to develop and change until one reaches their mid 20s. Usually, moles develop because of one’s genetic makeup, and can then be compounded by the effects of the sun. “You can usually find moles on the most sun-exposed areas of the body,” says Gaspard.

Gaspard notes that identifying moles can be challenging, because they come in many different forms and structures. They can be flat brown spots or raised, brown or flesh-colored bumps. “Because these lesions are so varied and have the potential to develop into cancer, it’s best to have them evaluated by a board-certified dermatologist,” advises Gaspard. “The only way to definitively remove a mole is through a biopsy or excision, where they have to be cut out of the skin,” she says.

If you identify a spot, it is best to consult with a dermatologist or healthcare provider.

ESKATA is not approved for moles or liver spots.

Important Safety Information and Approved Use

ESKATA can cause serious side effects, including:

·  Eye problems.  Eye problems can happen if ESKATA® (hydrogen peroxide) topical solution, 40% (w/w) gets into your eyes, including: ulcers or small holes in your eyes, scarring, redness, irritation, eyelid swelling, severe eye pain, and permanent eye injury, including blindness.

·  If ESKATA accidentally gets into your eyes, your healthcare provider will tell you to flush them well with water for 15 to 30 minutes.  Your healthcare provider may send you to another healthcare provider if needed.

·  Local skin reactions.  Skin reactions have happened in and around the treatment area after application of ESKATA. Severe skin reactions can include: breakdown of the outer layer of the skin (erosion), ulcers, blisters and scarring. Tell your healthcare provider if you have any skin reactions during treatment with ESKATA.

The most common side effects of ESKATA include: itching, stinging, crusting, swelling, redness and scaling.

Your healthcare provider will not apply another treatment of ESKATA if your treated area is still irritated from the previous treatment.

Tell your healthcare provider right away if ESKATA gets into your eyes, mouth or nose during application.  ESKATA is for topical use on the skin only, and is not for use in your eyes, mouth or vagina.

These are not all the possible side effects of ESKATA.

Approved Use for ESKATA

ESKATA is a prescription medicine used to treat seborrheic keratoses that are raised.

ESKATA is for use as an in-office treatment. ESKATA is applied by your healthcare provider and is not for use at home.

You are encouraged to report negative side effects of prescription drugs to the FDA. Contact Aclaris Therapeutics, Inc. at 1-833-ACLARIS or 1-833-225-2747 or FDA at 1-800-FDA-1088 or

Please click here for full Patient Information for ESKATA.

ESKATA is a registered trademark of Aclaris Therapeutics, Inc. PP-ESK-US-0409 08-2018