The medical rule I've heard is that you're not supposed to pick at zits or skin growths, because you'll only make them worse — or cause an infection. But apparently this rule doesn't apply to seborrheic keratoses. According to Dr. George Lundberg, Editor in Chief of MedGenMed, go ahead and pick 'em. Or rather, use "fingernail surgery" to remove 'em. That's what he does!
However, Lundberg's advice hasn't met with universal approval from the medical community. Among the resonses to his editorial on MedGenMed is this one:
To the Editor:
I find your piece embarrassing and unworthy of your Internet service.
If you had bothered to do some research, even just reading eMedicine, you would find that curettage, not excision, is the recommended treatment -- a far more sterile version of a fingernail surgery. The curettage procedure is usually nonscarring though rarely some mild hypopigmentation may result.
The use of fingernail surgery is to be condemned as it is a bacterially contaminated area.
Picking at one's own skin with the fingernails is a bad habit and in its extreme form can become obsessive and result in scarring -- a disorder known as neurotic excoriation.
Many elderly gentlemen will pick at solar keratoses on their scalp, leaving it in a persistent state of bleeding and infection; I sincerely hope that you are not headed in this direction.
If your medical colleagues excise your seb warts or cause significant scars, or if you suspect that they choose their therapies on the basis of cost benefit to themselves, I suggest you take the matter up with your State Medical Board rather than indulging in self-injury.
If there is any doubt about the diagnosis, the curetted specimen can be sent for pathology.
Cheers,
Philip Bekhor
Melbourne, Victoria, Australia
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