Seborrheic keratoses (SKs) are benign epidermal neoplasms occurring as waxy, brown-to-black papules and plaques. Patients frequently opt for removal due to cosmetic reasons or irritation. The present study assessed the efficacy and safety of topical treatments for SKs. It retrieved studies involving any topical medication indicated for SK removal from Embase, Scopus, PubMed, and Cochrane. 

The study found-

• Topical treatments with a good-to-excellent response are hydrogen peroxide, Maxacalcitol 25 µg/g, BID Tazarotene 0.1% cream, 5% potassium dobesilate cream, 1% diclofenac sodium solution, urea-based solution, and 65% and 80% trichloroacetic acid.
• They cause only mild and transient local skin reactions.
• Topical hydrogen peroxide revealed the greatest evidence for clinical clearance of SKs, although no studies directly compared hydrogen peroxide to current first-line treatments (e.g., cryotherapy or shave excision). 

The study results illustrate the viable and safe treatment of SK with topical therapies; however, there remains a need for topical treatments that reliably equate or exceed the efficacy of current first-line therapies.

Natarelli N, Krenitsky A, Hennessy K, Moore S, Grichnik J. Efficacy and safety of topical treatments for seborrheic keratoses: a systematic review. Journal of Dermatological Treatment. 2022. DOI: 10.1080/09546634.2022.2133532