14th July 2026

Management

Cherry angiomas are benign lesions and typically require no treatment. If removal is required, usually for cosmetic reasons, treatment options include curettage, electrocautery, or excision. 

Actinic keratosis: 

• Prevention and education: limit sun exposure, vigilant for any suspicious features
• Topical:
  • 5-fluorouracil: individual lesions
  • Imiquimod 5%: multiple lesions
  • Diclofenac gel: thin areas 
  • Tirbanibulin 1%: used focally or in broad areas
• Cryotherapy: single or multiple discrete lesions
• Photodynamic therapy: more effective than cryotherapy and associated with better cosmetic results
• Curettage or excisional surgery: discrete hyperkeratotic lesions 

Sebaceous hyperplasia is benign and does not require treatment unless for cosmetic reasons. If so, curettage or cryotherapy may be used.

Seborrheic keratosis:

• Irritated/itchy: corticosteroids
• Raised: curettage or cautery
• Flat: cryotherapy

Keratoacanthomas

• Complete excision, if not amenable to surgery, topical treatments such as retinoids and intralesional methotrexate may be used

Lipomas

• Usually not removed
• Complete excision is sometimes performed in those with fast-growing lipomas or for cosmetic reasons. 

Pyogenic granulomas are typically treated due to bleeding. Options include:

• Topical: 
  • Imiquimod 5%
  • Timolol gel 0.5%
  • Topical beta-blockers
• Intralesional steroid injection
• Curettage and cautery
• Excision with primary closure

References

• https://dermnetnz.org/cme/dermoscopy-course/dermoscopy-of-seborrhoeic-keratosis
• https://patient.info/doctor/seborrhoeic-wart
• https://patient.info/doctor/epidermoid-and-pilar-cysts-sebaceous-cysts-pro
• https://patient.info/doctor/keratoacanthoma-pro
• https://bestpractice.bmj.com/topics/en-gb/617/pdf/617/Seborrhoeic%20keratosis.pdf