Eskata – finally a new treatment for seborrheic keratoses

by Dr. Michael Contreras

Age spots, barnacles, senile warts… all names for the same annoying, raised growths that seem to come out of nowhere called seborrheic keratoses, or SKs as we like to call them.  Usually appearing in the late 30’s and 40’s, they pop up on the trunk, neck, face, scalp, arms, legs – everywhere!   They tend to be genetic, so look at your parents if you want a preview of what to expect.   “I know they’re ugly and a nuisance, and nobody likes them”, I’ll say, “but at least they’re benign”.  This is not as reassuring as I would expect sometimes to people who just want them gone.

SKs are raised brown spots with a wart-like thickening of the surface.  They can be unusual in shape and have irregular coloration, but they are benign and do not have an increased potential to turn into cancer.

Several methods can be used to treat SKs:

  1. Liquid nitrogen also known as “freezing” is the most common method used historically. Sometimes, areas heal with a white or lighter colored spot or areas of darkened pigmentation.
  2. Shave removal with a blade or scalpel, which can leave a scar.
  3. Curettage (scraping with a scooped shaped instrument) and dessication with electrocautery also with potential for scarring and pigment change.
  4. Laser ablation is sometimes selected
  5. Eskata

Eskata, approved by the FDA in 2018 for the treatment of seborrheic keratoses, is a novel topical concentrated hydrogen peroxide solution applied to the lesions by a healthcare provider in a clinical setting.

Why should I choose Eskata over another treatment?

  • Unlike the other options listed, Eskata has a low risk of pigment alteration of the treated skin, and it is safe for all skin tones and skin types. Your physician will be able to identify the SKs best suited to treatment with Eskata.

What can I expect during the treatment?

  • Eskata is applied in our office to SKs identified by your Dermatologist for treatment. During a short 15 minute appointment the cotton tipped applicator is applied to each lesion 4 times with a 1 minute interval between applications.  Lesions turn white in color, and you will experience some degree of itching, stinging, crusting, swelling, redness, and scaling.  Discomfort subsides quickly, and the redness, crusting and other skin reactions resolve in most patients within 2-4

Is Eskata covered by insurance?

  • Seborrheic keratoses are benign lesions and treatment is considered elective.

How much does Eskata cost?

  • Pricing is based on the number of applicators needed for treatment. Each applicator can treat up to 10 SKs, on average.  SKs that do not completely clear within 3 weeks after the first treatment can be treated a second time.   Please call AboutSkin for pricing details.

Because SKs are often irregular in shape and color, it is best to consult with your Dermatologist to ensure you do not have an atypical mole or melanoma before proceeding with treatment.  At AboutSkin your physician will identify the SKs that are amenable to treatment and biopsy any lesions concerning for skin cancer.  If you decide to treat SKs with Eskata you will be scheduled with one of our medical staff for application in the office.