About Laser Ablation of Benign Skin Growths

There are a variety of benign skin growths, beyond enlarged oil glands (sebaceous hyperplasia), seborrheic keratosis, skin tags, dermatosis papulosis nigra, and xanthelasma (cholesterol deposits, that are common targets for laser ablation. While in the vast majority of cases these skin growths are harmless, many people are bothered by their appearance and will therefore seek to have them removed. Some of the more common benign growths that are frequent targets for laser ablation include:

• Angiofibromas: As the name implies, these growths are made of fibrous tissue and blood vessels. They appear as small, smooth, skin colored to red growths that tend to grow on the central face (especially the nose). When angiofibromas appear on the coronal margin and sulcus of the penis, they are known as pearly penile papules. Multiple angiofibromas can be seen in certain genetic syndromes such as tuberous sclerosis, multiple endocrine neoplasia, neurofibromatosis, and Birt-Hogg-Dubé. Topical therapy exists (sirolimus gel), but it is often extremely difficult to obtain insurance coverage unless you have one of the aforementioned syndromes, and the out-of-pocket cost is for most people is prohibitive.
• Syringomas: These benign growths are comprised of sweat gland cells and tend to be found around the eyes. While syringomas can occur in anyone, they are observed more frequently in women, as well as in individuals with Down syndrome. Although they occur sporadically in most individuals, autosomal dominant inheritance is possible, in which case a person will report that one (or even both) of their parents also had multiple syringomas.
• Milia: These are very small white to yellow cysts that contain keratin. They are very common on the face (particularly around the eyes) as well as on genital skin. Some people may have a tendency to develop milia after treatments such as chemical peels or laser resurfacing.

In addition to angiofibromas, syringomas, and milia, there are a number of other relatively less common, benign skin growths that are suitable targets for laser ablation. These include:

• Steatocystoma multiplex: This condition is characterized by multiple oil-filled cysts that can be found on the face in addition to the trunk, upper arms, scrotum, armpits, and chest. In severe cases, a person might display widespread cysts on many parts of their body. While steatocystoma multiplex can occur randomly, some people will develop these as the result of an autosomal dominant mutation, in which case a person will report that one (or even both) of their parents had similar cysts. The treatment for a solitary steatocystoma is surgical excision while laser ablation is a more appropriate option for steatocystoma multiplex.
• Eruptive vellus hair cysts: These are cysts that contain small tufts of fine hair within them, in addition to keratin and sebum. The treatment for a solitary vellus hair cyst is surgical excision, while laser ablation is a more appropriate option for eruptive vellus hair cysts, in which multiple cysts appear on the face and/or body.
• Osteoma cutis: This is a condition characterized by bone formation within the skin, as a result of trauma or inflammation (for example, acne), parathyroid dysfunction, or no apparent cause at all. For those without a history of trauma or inflammation at the site of bone formation, it is important for laboratory testing to be obtained to determine whether any calcium metabolism abnormalities are present that are driving the formation of these lesions.
• Trichilemmoma: This is a benign growth that is made of hair follicle elements. While trichilemmomas frequently occur in isolation, there are certain genetic syndromes that are associated with the development of multiple lesions. For example, multiple trichilemmomas occur in the setting of Cowden syndrome, which can also be associated with cancers of the GI tract, thyroid, and breast.
• Trichoepithelioma: This too is a benign growth made of hair follicle elements. Like trichilemmomas, trichoepitheliomas will usually occur in isolation, but are associated with various genetic syndromes when multiple lesions are observed. These syndromes include Brooke-Spiegler Syndrome, Multiple familial trichoepitheliomas, and Rombo syndrome. In the case of the latter, there is an increased risk of developing a type of skin cancer known as basal cell carcinoma, as well as other unusual skin findings, which makes the diagnosis of this important.

How are these various benign growths treated?

At the Gateway Aesthetic Institute and Laser Center, our board-certified dermatologists use a state-of-the-art erbium laser to precisely ablate various benign skin growths. The spot size that is used during this process is less than 1 mm in diameter, and thus allows for extremely careful destruction of the growth, while sparing damage to the surrounding skin. Although some physicians will recommend treatment with curettage (scraping with a sharp metal loop), freezing (cryotherapy) or burning (cautery or electrodessication), these approaches are imprecise and fraught with potential complications. Some of these complications include overaggressive treatment causing scarring, undertreatment where the growth is not completely removed, or pigmentary damage to the surrounding skin (either hyperpigmentation whereby the skin becomes darker, or hypopigmentation or even depigmentation, where the pigment is temporarily or permanently destroyed). Erbium laser in the hands of one of our extremely skilled physicians is the most effective way of treating a wide array of benign skin growths, giving you the best cosmetic outcome while leaving your surrounding skin untouched.

How long will I need to recover from having my benign skin growths treated with ablative laser?

Depending on the number of growths that you want to have treated, their size, anatomic location, and density, recovery time can range from a couple of days to several weeks. Areas with a more robust blood supply that are rich in follicles and glands will heal more quickly than areas of the body that lack these characteristics. For example, growths treated on the face and scalp will heal more quickly than those treated on other areas of the body. Recovery entails keeping the area clean and moist with ointment, and most importantly keeping the treated areas protected from the sun, so that they don’t become hyperpigmented. Once the treated areas have healed, it is possible to apply sunscreen and/or makeup over them to camouflage any residual redness, which will eventually fade with time.

Why trust Gateway Aesthetic Institute and Laser Center to treat my benign skin growths?

Our board-certified dermatologists at the Gateway Aesthetic Institute and Laser Center have decades of experience performing ablative laser treatments for a variety of benign skin growths using the most advanced erbium lasers. While many practitioners will offer to freeze, burn, or scrape off these growths, these approaches are imprecise, as well as fraught with a high risk of complications. Additionally, because some of these growths can be associated with underlying health conditions, it is important to have a board-certified dermatologist carefully examine your skin both before and during treatment, as well as obtain a thorough medical history, to ensure that these aren’t also present. Finally, because of our wide breadth of aesthetic offerings, it is possible for you to not only address your benign skin growths during a single treatment session, but to also incorporate many other ways to refresh the appearance of your face and skin on the same day, so that you are making the most efficient use of your recovery time, while on the journey toward looking like the best version of yourself.