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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The best treatment for a seborrheic keratosis is the one matched to the growth, and for most growths that is a shave excision. Because a seborrheic keratosis sits only in the top layer of skin, shaving it off under local anaesthetic gives precise depth control, needs no stitches, heals neatly and has a low recurrence rate (about 5%). CO2 laser is used for larger or recurrent growths, and cryotherapy for very small ones. Here is how the options compare and why shave excision is usually the best choice.
The Treatment Options Compared
All are done under local anaesthetic (lidocaine) by a consultant. The method is chosen to suit the growth:
| Method | Best for | Recurrence | Back to normal skin | Tissue can be tested? |
|---|---|---|---|---|
| Shave excision (default) | Most growths | About 5% | 2–3 weeks | Yes |
| CO2 laser | Larger or recurrent growths | About 2% | 3–4 weeks | No (ablative) |
| Cryotherapy (freezing) | Very small growths, under 0.5 cm | About 10% | ~2 months to markless | No |
You may also see curettage & cautery (electrocautery) offered elsewhere — a scrape-and-heat-seal technique with broadly comparable results. Our default remains shave excision because it combines the same single-visit convenience with precise depth control and, crucially, tissue that can be sent for testing.
The procedure itself, step by step, is in our complete guide to seborrheic keratosis removal.
Why Shave Excision Is Usually Best
A seborrheic keratosis is an overgrowth of the surface skin only (the epidermis), so it does not need to be cut deep. Shaving it off flush with the skin gives the surgeon precise depth control, so just enough is taken: it needs no stitches, gives an excellent cosmetic result, and has a low recurrence rate. It also lets the growth be sent for testing if there is any question about the diagnosis. By contrast, laser and cryotherapy carry a slightly higher risk of lightening the skin (hypopigmentation) and scarring, which is why they are reserved for specific situations (larger or recurrent growths, or very small ones) rather than used as the default.
“I had a small lesion removed at London Skin Clinic. Lovely staff, and the clinic itself was easy to find, luxurious and clean. I recommend it highly.”
Niall A., verified Google review
What Each Method’s Recovery Looks Like, Day by Day
After a shave excision, the wound is covered with a Kaltostat dressing for three days — it absorbs any blood and encourages healing. By day three a scab has formed; it falls off after about five to seven days, leaving a pink mark that fades to normal skin colour within two to three weeks.
After CO2 laser, Vaseline is applied and the wound is left uncovered. A scab forms within 24 hours and falls away after four to seven days; the pink area beneath blends with normal skin over three to four weeks.
After cryotherapy, the lesion darkens into a crust within two days, which lifts off over about a week. The pink-red base fades over the next three weeks, and by around two months there is usually no visible mark — though in darker skin types some lightening (hypopigmentation) can persist, which is one reason freezing is reserved for the very smallest growths.
The full aftercare detail lives in our guide to seborrheic keratosis healing time.
The Risks, Honestly
Seborrheic keratosis removal sits at the gentle end of minor surgery, but “low risk” deserves specifics. The growth lives only in the epidermis, so treatment is shallow: pain is not one of the risks — lidocaine numbs the area completely, and most patients describe only the brief sting of the injection. The realistic considerations are: a small chance of the growth returning at the same spot (about 5% after shave, 2% after laser, 10% after freezing); pigment change, mainly lightening with laser and cryotherapy and more noticeable in darker skin; a faint flat mark where a larger lesion sat; and — the one genuine danger, which has nothing to do with the procedure itself — treating a misdiagnosed lesion. That last risk is exactly why anything that cannot be confidently distinguished from a melanoma is excised and sent for histology rather than frozen or lasered blind.
What to Be Wary Of
Be cautious of any treatment that removes a pigmented growth without first confirming the diagnosis. A seborrheic keratosis can look like a melanoma, so it should be assessed by a consultant, and a growth that is rapidly growing, ulcerated or unusual is removed and sent for histology rather than simply frozen or burned off. Over-the-counter acids and home freezing kits are not a good idea, both because they cannot tell what the growth is and because they can scar or fail to clear it. The safe, effective route is a proper assessment and removal; the diagnosis is covered in seborrheic keratosis vs melanoma.
What about Vicks, creams and the internet’s favourite remedies?
Searches for “seborrheic keratosis removal Vicks” outnumber almost every other SK question, so the short version: no over-the-counter cream, balm or oil has evidence that it removes a true seborrheic keratosis, and the UK has no licensed topical treatment for them. The growth is a thickened plate of surface skin cells — menthol rub does not dissolve that. The longer answer, remedy by remedy, lives in our dedicated guide: seborrheic keratosis removal at home — Vicks, creams and what actually works.
What happens if you just leave it?
Usually: nothing dramatic. Seborrheic keratoses are benign, grow slowly, and do not turn into melanoma. The realistic costs of waiting are practical — they can enlarge, multiply, catch on clothing, itch or become irritated and inflamed — and diagnostic: a growth nobody has examined is a growth nobody has confirmed. Leaving a confirmed SK alone is a perfectly reasonable choice; leaving an unexamined “age wart” alone is a gamble on the label.
Cost
- Consultation: £100 (separate, not redeemable)
- Removal, first growth: £300
- Each additional growth in the same session: £200
- Histology, where needed: £180
Up to about ten growths can be treated in one session. Book a consultation.
Common Questions
- What is the best treatment for seborrheic keratosis?
- For most growths, shave excision under local anaesthetic, because it is precise, needs no stitches, heals neatly and has a low recurrence rate of about 5%. CO2 laser is used for larger or recurrent growths and cryotherapy for very small ones.
- Is laser better than shaving?
- Not usually. Laser is reserved for larger or recurrent growths because it works a little deeper, but it carries a slightly higher risk of skin lightening and scarring, so shave excision is the default for most growths.
- Can I treat it at home with acids or freezing kits?
- It is not advisable. Home treatments cannot confirm what the growth is, and they can scar or fail to clear it. A growth should be assessed by a consultant before removal.
- Is it painful to have a seborrheic keratosis removed?
- No. The area is numbed with lidocaine, so you feel a brief sting from the injection and nothing during the removal itself. Afterwards most patients need no more than the occasional paracetamol, if anything.
- Can a seborrheic keratosis be removed permanently?
- Yes — at that spot, with high reliability: recurrence is about 5% after shave excision, 2% after laser and 10% after cryotherapy. What removal cannot do is stop new, unrelated growths appearing elsewhere over the years, which is a feature of the skin type rather than a failure of treatment.
- Is there a cream that gets rid of seborrheic keratosis?
- No — there is currently no licensed cream in the UK that removes seborrheic keratoses, and over-the-counter acids and “removal” products risk scarring and treat an unconfirmed diagnosis blind. Physical removal by shave, laser or freezing remains the evidence-based route.
- Will the NHS remove a seborrheic keratosis?
- Almost never for appearance alone — seborrheic keratoses are benign, so their removal is classed as cosmetic and is not routinely funded. The NHS becomes involved when there is diagnostic doubt about a pigmented lesion, which is a skin-cancer-pathway question rather than an SK-removal service.
The SK Treatment Debates Reddit Never Settles
“Dermatologist froze mine and it came back within a year. Did they use the wrong method?”
Not wrong — but possibly mismatched. Cryotherapy has the highest regrowth rate of the three main methods (around 10%), and it struggles with thicker, larger lesions; it earns its place on the very small ones. A returned SK is the textbook candidate for shave excision or, if it keeps coming back, CO2 laser — which is exactly how we sequence it.
“I have 30+ of these on my back. Can they clear the lot in one appointment?”
Not in one sitting, and the reason is safety rather than pricing: local anaesthetic has a maximum safe dose, and ten fresh wounds is about the most that heals comfortably at once. A heavily seeded back is typically cleared over a few planned sessions — up to ten growths each.
“Everyone on the thread swears by Vicks. Surely that many people can’t be wrong?”
They can be — collectively and sincerely. SKs naturally flake, crumble and occasionally fall off on their own, so whatever was rubbed on that week collects the testimonial. There is no mechanism by which menthol ointment removes a plate of thickened epidermis, and no published evidence either. The crowd is honest; the attribution is wrong.
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