Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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A seborrheic keratosis is benign and does not turn into melanoma, but the two can look alike, which is why a dark or changing growth should always be checked. As a rule of thumb, a seborrheic keratosis looks “stuck on”, waxy and uniform with a well-defined edge, while the warning signs of melanoma are asymmetry, an irregular border, more than one colour, a larger or growing size, and any change. The honest truth, though, is that you cannot reliably tell them apart at home: only a specialist, usually with dermoscopy, can be sure, and anything uncertain is removed and tested.
What a Seborrheic Keratosis Looks Like
A typical seborrheic keratosis has a reassuring, consistent look:
- “Stuck-on” appearance, as if glued to the surface of the skin.
- Waxy or warty surface, sometimes a little crumbly.
- A well-defined edge and a fairly even colour, from tan to dark brown.
- Often more than one, in someone over 40 who has had similar growths before.
| Feature | Seborrheic keratosis | Melanoma warning pattern |
|---|---|---|
| Surface | Waxy, warty, “stuck-on” | Often flat or nodular, may ulcerate |
| Edge | Well defined | Irregular, ragged, blurred |
| Colour | Fairly even, tan to dark brown | Multiple colours or uneven shades |
| Company | Usually one of many similar growths | The “ugly duckling” — unlike its neighbours |
| Behaviour | Slow, stable over years | Evolving: size, shape, colour, bleeding, itch |
| Under dermoscopy | Milia-like cysts, comedo-like openings | Atypical pigment network |
It is a benign overgrowth of surface skin cells and does not become cancerous. The full picture is in our complete guide to seborrheic keratosis.
The Warning Signs of Melanoma
Melanoma is a serious skin cancer, and catching it early matters. Dermatologists use the ABCDE guide for a suspicious mole or growth:
- A — Asymmetry: one half does not match the other.
- B — Border: an irregular, ragged or blurred edge.
- C — Colour: more than one colour, or uneven shades of brown, black, red or blue.
- D — Diameter: larger than about 6 mm, or growing.
- E — Evolving: any change in size, shape, colour, or new bleeding, itching or crusting.
The “ugly duckling” sign also helps: a growth that simply looks different from your others deserves a check.
Why They Can Be Confused
A seborrheic keratosis, especially a dark, irritated or atypical one, can mimic a melanoma to the naked eye, and occasionally a melanoma can hide among ordinary-looking growths. This overlap is exactly why self-diagnosis is not safe: a growth being “stuck-on” is reassuring but not proof, and reassurance from a quick glance is not the same as a proper assessment. If you are weighing up a specific growth, do not rely on a checklist alone, get it looked at.
“An ‘age wart’ that bleeds, itches, grows quickly, or simply looks different from its neighbours is the one I want to see the same week.”
When to Get It Checked, and How We Tell
See a specialist promptly if a growth is new, changing, asymmetrical, multi-coloured, bleeding, itching or ulcerated, or if it simply worries you. At the clinic a consultant examines it closely, usually with dermoscopy (a magnified, illuminated view that reveals features the eye cannot), which distinguishes the great majority of seborrheic keratoses from melanoma with confidence. Where there is any doubt, the safe course is to remove the growth and send it for histology rather than watch and wait. A classic, clearly benign seborrheic keratosis can simply be removed if you wish, as set out in the best treatment options. How dermoscopy makes these calls — the features it looks for and why it prevents unnecessary biopsies — has its own detailed guide.
A Real Case: the “Age Wart” That Wasn’t
This is not a theoretical risk — here is a recent case from our clinic. A patient self-referred with a raised, pigmented “age wart” on the back. To the naked eye it looked like a seborrheic keratosis. Under dermoscopy, it showed none of the expected SK features — no milia-like cysts, no comedo-like openings — and instead an atypical pigment network. That lesion was urgently excised rather than shaved, and histology confirmed an early melanoma. Caught at the cosmetic-appointment stage, because the lesion was examined properly before anyone treated it. The reverse happens just as often, and matters almost as much: a feared “melanoma” that dermoscopy confidently identifies as a harmless seborrheic keratosis within seconds — sparing the patient an unnecessary excision and the scar that would have come with it. Both stories argue for the same thing: look properly first, treat second. It is also why we never treat pigmented lesions blind — a point our home-remedies guide makes with some feeling.
A Note on the Scalp
“Seborrheic keratosis vs melanoma on the scalp” is its own search for good reason: the scalp hides lesions under hair, they are felt (or caught by a comb) before they are seen, and irritation from brushing makes even benign growths look angrier. The same rules apply, with less forgiveness for delay — a scalp lesion that bleeds with combing, grows, or cannot be confidently assessed in a mirror is a lesion for dermoscopy, not for guesswork.
Common Questions
- Can a seborrheic keratosis turn into melanoma?
- No. A seborrheic keratosis is benign and does not become melanoma. The reason it matters is that the two can look alike, so a dark or changing growth should be checked to be sure of the diagnosis.
- How can I tell a seborrheic keratosis from a melanoma?
- A seborrheic keratosis usually looks stuck-on, waxy and uniform with a clear edge, while melanoma warning signs are asymmetry, an irregular border, more than one colour, a larger or growing size and any change. You cannot be certain at home, though, so anything uncertain should be assessed by a specialist.
- How does the clinic confirm which it is?
- A consultant examines the growth, usually with dermoscopy, which shows features the naked eye cannot. If there is any doubt, the growth is removed and sent for histology rather than left.
- Are picture comparisons reliable for telling them apart?
- As education, yes; as diagnosis, no. Photographs show colour and outline but not the two decisive layers: how the lesion feels, and how it looks under dermoscopy — where SK features like milia-like cysts and comedo-like openings, or melanoma’s atypical pigment network, settle the question. Use pictures to learn the patterns, and a specialist to name your lesion.
- Should I worry about a stuck-on growth that has not changed?
- A long-standing, unchanging, classic seborrheic keratosis is very unlikely to be anything sinister, but if you are unsure, or it changes, have it checked. Reassurance from a specialist is quick and worthwhile.
The 2am Melanoma Panic Threads, Answered
“Google Images has convinced me it’s melanoma. Talk me down or book me in?”
Book you in — not because Google is right, but because certainty is cheap and worry is expensive. Image-search results over-represent dramatic melanomas and atypical SKs, so a night of scrolling reliably terrifies. Dermoscopy answers in minutes what image comparison cannot answer at all; most of these appointments end in relief.
“The dermatologist glanced at it for five seconds, said SK, no biopsy. Was that negligent?”
Probably the opposite — a classic SK under dermoscopy is genuinely a seconds-long diagnosis, the way a chess master reads a board. The pattern (milia-like cysts, comedo-like openings, stuck-on architecture) is unmistakable when present. The five seconds you should question are five seconds without the dermatoscope coming out.
“I have dozens of these. How am I supposed to spot a melanoma hiding among them?”
The ugly-duckling principle does the heavy lifting: you are not monitoring each lesion against a textbook, you are watching for the one that stops matching its siblings — darker, faster, itchier, or simply different. For heavily seeded skin, periodic professional checks (with photography for comparison) beat heroic self-surveillance.
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