Hongdae Dermatology: Differences Between Flat Warts, Syringomas, and Seborrheic Keratoses

Hello,

I am Dr. Go-eun Lee, Director at Nine Clinic Hongdae Branch.

Looking in the mirror, there comes a moment when you suddenly notice small bumps emerging on your forehead, cheeks, or around your eyes.

Many people initially dismiss them as milia or simple blemishes, only to visit a Hongdae dermatology clinic when they multiply or fail to resolve on their own.

Among the tiny, bumpy lesions that appear on the face, the most representative types are flat warts, syringomas, and seborrheic keratoses.

Although they may appear similar at first glance,

their root causes and morphological structures differ significantly.

Therefore, rather than removing them all with the exact same approach,

accurately diagnosing each type beforehand is essential.

Today, I will explain the distinctions between these three conditions and what you should consider when looking into CO2 laser treatments.

Spreading across the face? Could it be flat warts?

Flat warts are small, flattened viral warts that form on the skin's surface.

They frequently develop in clusters on the forehead, cheeks, jawline, or hands,

presenting in flesh tones or light brown shades, which makes them easy to mistake for tiny freckles or blemishes initially.

Flat warts are associated with Human Papillomavirus (HPV) infection.

Especially on the face, touching them or shaving can easily cause the virus to spread to nearby skin, giving rise to new lesions.

Therefore,

if you feel like "there were only a few at first, but suddenly they multiplied,"

it is crucial to evaluate their clinical presentation professionally rather than scratching or picking at them yourself.

Clustered like tiny millet grains under the eyes? Syringoma

If small, flesh-colored bumps are clustered beneath your eyes or around your eyelids,

they may likely be syringomas.

Syringomas are benign skin lesions originating from the sweat gland ducts,

frequently appearing symmetrically around the periocular area.

Due to their outward appearance,

many people confuse them with milia or small sebaceous bumps, but they are distinctly different lesions.

Furthermore, because the lesion structure of a syringoma extends deep into the dermis,

simply shaving or vaporizing the superficial skin surface often proves insufficient.

While they can be treated with modalities like a CO2 laser,

the risks of scarring and pigmentary changes must be carefully weighed, and recurrence or multiple treatment sessions may be required.

Given that the periocular skin is particularly delicate and thin,

it is vital to examine the lesion’s precise location, depth, and the patient's skin condition before determining the treatment intensity.

Raised and brownish? Check for seborrheic keratosis

Seborrheic keratosis is a common benign epidermal skin lesion found frequently in adults.

Initially appearing as light brown macules,

they tend to thicken over time, taking on an elevated, "stuck-on" appearance on the skin.

They can develop across various body regions—including the face, neck, and trunk—and vary widely in size and color.

While colloquially called "age spots" or "liver spots,"