Small growths on the skin are among the commonest reasons people see a dermatologist. Most are harmless, some are contagious, and a few need a closer look. Here is how to tell them apart and what can be done.
Know what you have
Warts
Rough, raised bumps caused by the human papillomavirus (HPV). They are common on the hands, feet (where they are called verrucae) and face, and they can spread to other parts of your body and to other people. Some disappear on their own over months or years; others multiply.
Skin tags
Soft, small flaps of skin, often on the neck, armpits, eyelids and groin. They are harmless, but can catch on clothing or jewellery and become sore. They are more common with weight gain, diabetes and in pregnancy.
Moles
Clusters of pigment cells, flat or raised, usually brown. Most are harmless and stay the same for years.
Seborrhoeic keratoses
Waxy, “stuck-on” brown or black growths that become common with age, especially on the face, chest and back. Harmless, but they can itch or catch. Many small dark ones on the cheeks (sometimes called dermatosis papulosa nigra) are common in brown skin.
Others
Tiny, hard white bumps around the eyes are usually milia, small keratin cysts that a dermatologist can lift out. Yellowish patches on the eyelids (xanthelasma) can be a sign of raised cholesterol and are worth a blood test. A fast-growing red bump that bleeds easily (pyogenic granuloma) should be seen promptly.
Which ones need a doctor first?
Have a mole or spot checked before any removal if it:
- is new in adulthood, or changing in size, shape or colour;
- has an irregular border or several colours;
- bleeds, itches or forms a sore that does not heal;
- looks different from your other moles.
Removing a suspicious mole by burning it destroys the tissue a laboratory would need to check it. That is why a dermatologist examines first and, when needed, removes it surgically and sends it for testing.
How growths are removed
- Radiofrequency or electrocautery: a fine probe uses heat to remove or flatten the growth. Common for skin tags, small warts, seborrhoeic keratoses and dermatosis papulosa nigra. The area is numbed first.
- Cryotherapy: freezing with liquid nitrogen, often used for warts. It may need repeating every few weeks.
- Creams and solutions: for warts, salicylic acid and other treatments can work over weeks.
- Minor surgery: for moles that need laboratory testing or are deep.
Healing and aftercare
- A small scab forms and falls off within one to two weeks.
- Keep the area clean and apply the cream you are given.
- Avoid picking and scrubbing.
- Use sunscreen on healing skin to reduce the chance of dark marks.
- Contact the doctor if the area becomes increasingly red, painful or swollen.
The bottom line
Most small growths are harmless and can be removed simply if they bother you. The important step is a doctor’s look first, so that anything that needs testing is not burned away. See our guide to warts, moles and skin tags. Ask about removal at your consultation.
