Laser Removal for Skin Tags and Seborrheic Keratosis: Pain, Healing Time and What to Watch For

Small raised bumps on the neck, underarms, face or under the breasts are often lumped together as “skin growths”. Medically, they can be different conditions: skin tags (acrochordons), seborrheic keratosis, moles, warts, milia, and even lesions that need to be checked for skin cancer. So choosing a laser doesn't start with “which machine?” It starts with being able to say what the spot actually is.

CO2 laser is one option for removing skin tags or seborrheic keratosis once a doctor has confirmed they are benign and suitable for removal. Its strengths are that it works on a precise spot, the depth can be controlled and it helps stop bleeding during treatment. It isn't the answer for every bump, though. If a spot looks suspicious, cutting or shaving it off to send for a biopsy may matter more than vaporizing it with a laser, because the laser destroys the tissue sample.

Key takeaways

• “Skin tag” and “seborrheic keratosis” aren't always the same thing. Skin tags are usually soft and hang on a small stalk. Seborrheic keratosis tends to be a rough patch or bump that looks stuck onto the skin.
• CO2 laser (10,600 nm) is absorbed by water in tissue, so it vaporizes the target layer by layer and suits suitable superficial lesions.
• Before laser, the spot has to be told apart from moles, warts and skin cancer. If it grows fast, changes color, has an irregular border, bleeds on its own, forms a sore that won't heal, or looks different from your other spots, a doctor must examine it and may need a biopsy.
• After treatment there can be a shallow wound, redness, a scab and a risk of dark marks, especially in Asian skin. No method guarantees no marks or no recurrence.
• Price doesn't depend only on the number of spots. It also includes the type, size, depth and location of the lesion, anesthesia, the doctor's fee, and pathology if a biopsy is needed.

Before laser: is it a skin tag or a seborrheic keratosis?

In everyday use, people mix up terms for skin tags, seborrheic keratosis, raised moles and little dark spots. Calling it the wrong name isn't a problem until you start treating it yourself with a caustic product, a thread, a cut or a laser without a diagnosis, because spots that look alike have different causes and different treatments.

Skin tags (acrochordons)

Skin tags are soft, non-cancerous growths, usually skin-colored, pink or brown, and they may darken with friction. Many have a small stalk that hangs from the skin. They're common on the neck, underarms, groin, under the breasts, eyelids and skin folds, places where skin rubs against skin, clothing, necklaces or a razor.

Skin tags become more common with age, body weight, pregnancy and family history, and are linked with insulin resistance, diabetes and metabolic syndrome. Having one or two doesn't automatically mean you have diabetes. If many appear quickly, or you have risk factors, a doctor may suggest a wider health check. More in what causes skin tags on the neck.

Seborrheic keratosis

Seborrheic keratosis is a benign skin growth arising from cells in the outer layer of the skin, and it becomes more common with age. It appears as a patch or raised bump that's brown, black, yellow or flesh-colored, sometimes rough or waxy, and it often looks as if it's been stuck onto the skin. It can show up on the face, neck, chest, back and trunk.

It isn't “a sun spot that's turned raised” (that's a solar lentigo, which is a different thing), and it isn't a skin tag, even though some have stalks or similar colors. It generally doesn't turn into cancer, but it can look like skin cancer, or a cancer can sit beside or beneath it. When the appearance isn't clear, a doctor may use a dermoscope and choose a biopsy instead of removing it right away.

Telling skin tags, seborrheic keratosis, moles, warts and dangerous lesions apart

Lesion	What it usually looks like	Common places	Contagious?	What to watch for
Skin tag	Soft, skin-colored to brown, often on a small stalk and slightly mobile	Neck, underarms, groin, under the breasts, eyelids	No	Can be confused with warts, raised moles or some cancers
Seborrheic keratosis	Rough or waxy patch or bump that looks stuck on, in many shades	Face, neck, chest, back, trunk	No	Dark or inflamed types can look like melanoma
Mole (melanocytic nevus)	A spot or bump of pigment cells; flat or raised; one color or several	Anywhere on the body	No	A new or changing mole needs assessment before it's destroyed
Wart	Hard or rough skin, sometimes with tiny black dots; some are long and tag-like	Hands, feet, face, around nails, genitals	Yes, from HPV	Treatment and controlling spread differ from skin tags
Milia	Small white or yellow hard bumps under the skin, with no stalk	Around the eyes, cheeks, forehead	No	Don't squeeze or burn deeply yourself. See milia vs skin tags
Skin cancer	A dark spot, flesh-colored lump, sore, shiny bump or scaly patch that doesn't go away	Anywhere, including palms, soles and nails	No	Needs a doctor's diagnosis and maybe a biopsy. Don't burn it off before it's assessed

This table is only a first guide. A photo or looking in the mirror can't confirm the type of every lesion, especially dark ones, inflamed ones, or ones on the eyelids and genitals.

Warning signs: don't rush to burn or laser

Have a doctor look at it directly before any procedure if you notice any of these:

• It's grown fast or changed clearly over weeks to months
• It has an asymmetrical shape, a notched or blurred border
• It has several colors in one spot, such as black, brown, red, white or blue
• It bleeds on its own, keeps forming a sore, has a scab that won't go away or doesn't heal in the time it should
• It itches, hurts, burns or is tender without clear friction
• It's a firm lump attached to deeper skin, growing, or has a dip in the middle
• It's a shiny, flesh-colored or pink bump with tiny visible blood vessels or a raised edge
• It's a new spot in adulthood, or one that clearly looks different from your other spots
• It's a dark mark on the palm, sole or under a nail, or a nail band that's wide or changing
• You have a weakened immune system, past skin cancer or a family history of melanoma

For pigmented spots, the ABCDE rule can help: Asymmetry, Border, Color, Diameter and Evolving. But a spot under 6 millimeters can still be abnormal, so the most important thing is change, and difference from your other spots.

If the doctor suspects cancer, the way to confirm is a biopsy sent for pathology. Don't vaporize the whole lesion with CO2 laser first, because that destroys the structure the pathologist needs and can delay necessary treatment.

What is CO2 laser removal?

A CO2 (carbon dioxide) laser emits infrared light at 10,600 nm, which water in cells and tissue absorbs well. The energy turns to heat quickly, vaporizing or cutting the target tissue and helping small vessels clot, so there's less bleeding and the doctor can control how far the treatment goes layer by layer.

Machines may have continuous, pulsed, superpulse or ultrapulse modes, which deliver energy and spread heat in different ways. What you need to know is that the doctor chooses the mode and depth to suit the type of lesion, size, location and skin tone. Not every machine or setting gives the same wound and result. For more on the principle, read what a CO2 laser is.

How is CO2 laser used for skin tags?

For small skin tags, a doctor may use the laser to cut at the stalk or carefully vaporize the base, which helps stop bleeding and lets many be treated in one visit. But some clearly stalked tags may suit snipping with sterile scissors or electrosurgery better, because it's quick and a sample can be kept if needed.

How is CO2 laser used for seborrheic keratosis?

For a clearly diagnosed seborrheic keratosis, the doctor can vaporize or shave off the excess tissue at a superficial skin level. Size and thickness affect the number of passes and the chance of marks. A very thick spot, or one that looks suspicious, may suit shave excision or curettage, which allow a sample to be sent for testing.

Laser isn't the only way: comparing options for removing skin tags and seborrheic keratosis

Method	Best for	Strengths	Limits and risks	Sample for testing?
CO2 laser	Skin tags or seborrheic keratosis confirmed benign and suitable for ablation	Precise, controls bleeding, many spots at once, layer-by-layer control	Shallow wound, dark or light marks, scarring, infection, and tissue is destroyed	Generally not, if everything is vaporized
Snip / shave excision	Stalked skin tags, some raised moles, or spots that need a sample	Quick, shows the margins, can be sent for testing	Bleeding, a wound and scarring depending on size	Yes
Electrosurgery / electrodesiccation	Some skin tags and seborrheic keratosis	Good bleeding control, suits small spots	Heat spreads; dark marks or patchy color, scarring	Usually not, when tissue is destroyed
Curettage	Clearly diagnosed seborrheic keratosis	Scrapes the lesion off at the right level	Bleeding, color change, a mark may remain	Possible in some cases if the tissue is kept properly
Cryotherapy	Small skin tags or some seborrheic keratosis	No cutting, short time	Blisters, scabs, lighter skin, especially in darker skin; depth is harder to control	No
Ligation (tying off the stalk)	Small-stalked skin tags a doctor judges suitable	No energy used	Takes time to fall off; inflammation or infection if not clean; not for spots with unclear diagnosis	No

The AAD lists cryosurgery, electrodesiccation and excision as standard methods for skin tags. For seborrheic keratosis, cryosurgery, electrosurgery with curettage, or shave excision are usual when tissue needs to be tested. CO2 laser should be one of the options, not presented as the only answer for every kind of spot.

Who is laser removal for?

• People with skin tags or seborrheic keratosis that a doctor has examined and found benign
• Spots that rub on clothing, necklaces or bra straps, or that get caught by a razor and irritated or bleed repeatedly
• Spots in a place that interferes with vision or daily life. The eyelids in particular need a skilled practitioner and specific eye protection
• People who want them removed for cosmetic reasons and understand there will be a wound, redness or dark marks, and a chance of new spots in other places
• People with many spots, where the doctor feels treatment can be split by area or by visit to control inflammation and wound care

Who should wait, or have a detailed consultation first?

• The spot hasn't been clearly diagnosed, or has warning signs for skin cancer
• Infection, an open wound, a cold sore, inflamed rash or pustular acne in the area
• A history of keloids, raised scars, slow healing or severe post-inflammatory dark marks
• Poorly controlled diabetes, a weakened immune system or immunosuppressive medicine, which may raise the risk of slow healing and infection
• Taking anticoagulants, antiplatelet drugs, herbal medicine or supplements that affect bleeding. Tell your doctor and never stop medication yourself
• Recent sun exposure, sunburn or a current tan, because the chance of dark marks may be higher
• Pregnant or breastfeeding. Non-urgent cosmetic procedures are usually considered for postponing, at the doctor's discretion
• Spots near the eyes, eyelid margins, genitals or other areas with important structures. These need a specifically skilled practitioner and protection

What happens during treatment

1. History and diagnosis

The doctor asks how long you've had the spot, any changes, itching, pain or bleeding, your medical conditions, medications, history of scarring and skin cancer. They then examine it by eye and may use a dermoscope. If still unsure, they'll consider a biopsy or referral instead of rushing to a laser.

2. Planning the number of spots and the method

Each spot doesn't necessarily need the same method. One person might have skin tags, seborrheic keratosis, moles and milia in the same area. The doctor may choose CO2 laser for some, snipping for others, and leave alone any that need further assessment. Agree the scope and cost before starting.

3. Cleansing and anesthesia

Small spots may need only numbing cream or an injection of local anesthetic, depending on the number, size, depth and location. Numbing cream takes time to work, while an injection may sting or feel tight briefly. Eye protection, with goggles or special equipment, is essential when a laser is used.

4. Removal and stopping bleeding

The doctor delivers energy to the spot only, cutting the stalk or vaporizing tissue layer by layer, then checks the base. They shouldn't go deeper than needed, because that raises the chance of scarring and color change. Afterward they may apply ointment, a dressing, or leave the wound open depending on type and location.

5. Wound care advice and follow-up

Advice varies with depth and method, so follow the instructions from the doctor who treated you. If a sample was sent for testing, you must follow up on the pathology result even if the outer wound looks healed.

Does laser removal hurt?

During numbing cream you may feel numbness and tightness, and an injection may sting briefly. During the laser, you typically feel warmth, a sharp prick or a smell from vaporized tissue. How much you feel depends on the location, number of spots, size of the lesion, how anesthesia is given and your own sensitivity. Eyelids, around the nose and thin skin usually feel stronger than the trunk.

Once the anesthetic wears off, it may sting like a small graze. If pain keeps growing rather than easing, or there's swelling and heat, spreading redness or pus, don't wait it out, because it may signal infection or a deeper wound than expected.

How many days does it take to heal?

There's no number of days that fits everyone. Small, superficial spots often close over in about one to two weeks. Deeper wounds, larger spots, spots on the legs, or people who heal slowly may take longer. Early on it may be red, with a little fluid or a scab, and then the skin may be pink, brown or lighter than around it before gradually fading.

“Wound closed” doesn't mean “skin color back to normal”. Redness or dark marks after inflammation can take several weeks to several months, especially in skin with more melanin and sun exposure. Judging too early may make you think you have a scar while the skin is still recovering, but if the area is raised, thick, sunken or very discolored, go back to the doctor.

Aftercare for skin tag and seborrheic keratosis removal

The treating doctor's instructions come before any general advice, because a cut, a shallow burn and a deep vaporization are cared for differently. The basics for a small skin wound are:

1. Wash your hands before touching the wound every time.
2. Clean gently with water and a product your doctor allows. Don't scrub, rub, or use alcohol or hydrogen peroxide on your own.
3. Pat dry and apply medicine or petrolatum as instructed. If you're told to cover the wound, change the dressing with a clean technique.
4. Don't pick at scabs, squeeze, or cut away tissue that's still attached, because it raises the risk of bleeding, infection and dark marks.
5. Avoid swimming pools, hot tubs and soaking until the wound has closed. Avoid heavy sweating and friction while the wound is fresh.
6. Skip scrubs, exfoliating acids, retinoids and irritating products on the wound until your doctor says it's okay.
7. Once the skin has closed, protect it from the sun with clothing, a hat and a broad-spectrum SPF 30 or higher sunscreen, to reduce redness and dark marks.
8. Go to your follow-up, especially if you had many spots, deep ones, or a biopsy result to hear.

The AAD recommends keeping small skin wounds clean, moist with petrolatum and covered as appropriate, since wounds kept moist and protected generally heal better. But don't put antibiotic ointment on every wound yourself, because some people develop contact allergy and it isn't always necessary. For more, see our facial wound care guide.

Signs to contact the clinic

• Bleeding doesn't stop after continuous pressure with clean gauze as advised
• Pain, swelling, redness or warmth that is getting worse instead of better
• Pus, an unusual smell, a thick yellow crust or fever
• A wide blister, deep black color or unusually pale skin
• Marked eyelid swelling, blurred vision or eye pain after treatment near the eyes
• The original spot doesn't go away, grows back quickly, or bleeds after the wound has closed

Side effects and risks

Expected effects

Stinging, redness, mild swelling, a little fluid, a scab, and temporary pink or brown color are part of recovery in many cases. How strong they are depends on depth, number of spots, location and how your skin responds.

Dark marks or patchy color

Post-inflammatory hyperpigmentation (PIH) is an important risk after CO2 laser, especially with a lot of inflammation, picking at scabs or sun exposure. Hypopigmentation, where the skin is lighter, may be temporary or last a long time. A review of CO2 laser found PIH rates varied widely between studies and treatments, so no one should promise “no dark marks”. People with a history of PIH should tell the doctor before treatment. If marks do develop, general guidance is in how to fade dark marks after inflammation, but don't buy bleaching products or strong acids to dab on the wound yourself.

Raised scars or sunken marks

These can occur if the wound is deep, infected, picked at, or if you tend to form keloids. Even small spots can't be guaranteed 100% scar-free. Removing to a suitably shallow level and caring for the wound properly lowers the risk, but doesn't bring it to zero.

Infection, bleeding or slow healing

These are uncommon when done with clean technique, but the risk is higher in people with poorly controlled diabetes, a weakened immune system, or poor wound care. Burning or cutting at home makes depth and bleeding harder to control than treatment in a clinic.

Incomplete removal or recurrence

A removed spot may leave a base or come back raised if it wasn't fully taken out, but going too deep to “get it done in one go” raises scarring. Skin tags that have been removed usually don't regrow from the same spot, but new ones can appear elsewhere. The same goes for seborrheic keratosis, which can appear anew with age and skin factors. A new spot doesn't necessarily mean the earlier laser failed.

How many sessions of CO2 laser removal are needed?

A number of small skin tags or shallow seborrheic keratosis spots may be cleared in one treatment per spot, but that can't be guaranteed for every spot. Large, thick or deep spots, ones near important structures, or hundreds of spots may be split up to control wounds and dark marks. After the skin recovers, the doctor assesses whether the base needs to be treated again.

Splitting treatment isn't always a sign the machine isn't effective. Sometimes it's to limit the total wound area and see how the skin responds before treating a wide area, especially in people who get PIH easily.

How is the price worked out?

Searches in Thailand show people care about both “price per spot” and “package price”, but prices are hard to compare directly because one “spot” can mean very different things. Factors include:

• The number, size, thickness and depth of the lesions
• The location. Eyelids or curved areas need high precision
• The type of lesion and the right method. Some spots suit laser, and some need cutting or testing
• Numbing cream, injected anesthetic, eye protection and dressing materials
• The doctor's fee, take-home medication and follow-up visits
• Pathology fees, if a sample has to be sent

Before buying an all-in package, ask whether the doctor examines every spot first, whether there are limits on size or area, whether anesthetic and medicine are included, how much a biopsy costs extra, and what happens if a suspicious spot is found. A package built around a count of spots with no screening step may not meet your safety needs.

Why you shouldn't burn, cut or use acid to remove them yourself

Mole and skin tag products sold online may contain strong acids, which can burn the skin and lead to infection, dark marks and scars. Tying off or cutting a spot yourself risks bleeding and contamination. Most importantly, you may misdiagnose the spot and destroy a skin cancer, so it gets found late.

The FDA says there are no legally marketed over-the-counter drugs for removing moles, seborrheic keratosis or skin tags, and warns about injuries and scarring. The AAD stresses that warts and skin tags are treated differently, and using wart remover on a skin tag can damage normal skin.

Clinic checklist for skin tag and seborrheic keratosis removal

1. They diagnose before counting spots, and don't treat every lesion as a seborrheic keratosis.
2. A doctor assesses suspicious spots and can send a biopsy, or there's a clear referral route.
3. They explain options other than laser, such as snipping, shaving, cryotherapy or electrosurgery.
4. They take a history of medications, diabetes, immune status, scarring and local anesthetic allergy.
5. They have eye protection and laser plume extraction, especially when treating near the face.
6. They give written wound care instructions and a way to contact them if bleeding, infection or an unusual wound occurs.
7. Pricing is transparent: whether it includes the doctor's fee, anesthetic, medicine, follow-up and pathology.
8. They don't guarantee no marks or that every spot is gone for good, because the result depends on the lesion type, depth, skin tone and how the wound heals.

You can see The Vanish Clinic doctors, look at the Central Ladprao branch, or contact The Vanish Clinic to ask about the assessment process before treatment.

Doctor Insight

On the day a patient asks for “laser for all the spots on my face”, the key is not to start by counting spots. One face can have seborrheic keratosis, dermatosis papulosa nigra, raised moles, milia and sebaceous growths together. The right method differs for each, and some spots shouldn't be lasered at all until they've been assessed further.

Summary: laser removal is safe when it starts with the right diagnosis

CO2 laser can remove some skin tags and seborrheic keratosis precisely, but safety doesn't come from the machine alone. It comes from identifying the lesion correctly, choosing a suitable depth, protecting the eyes, caring for the wound and following up. If a lump shows warning signs, getting a biopsy matters more than speed or a smooth finish.

If you're concerned about price, compare the scope of service, not just the per-spot number, and avoid dabbing acid on, cutting or tying off lesions yourself. Besides the risk of scarring and infection, you could miss a skin cancer diagnosis.

Skin tag and seborrheic keratosis laser removal: frequently asked questions

Is laser for seborrheic keratosis the same as laser for skin tags?

The same CO2 laser may be used in some cases, but the lesions aren't the same. A skin tag is an acrochordon, usually soft and on a stalk, while seborrheic keratosis is a patch or bump from the epidermis. A doctor has to diagnose before choosing the method.

Can CO2 laser remove seborrheic keratosis in one session?

Many small, shallow spots may be done in one treatment per spot, but thick, deep spots, spots in delicate areas or many spots may need to be split up or touched up. Going too deep in order to finish in one go raises the risk of scarring.

How long should I keep the wound away from water after laser?

There's no single number for every wound. Some methods allow gentle washing as instructed, while other areas need the wound kept dry at first. Follow your treating doctor's advice, and don't leave dirt on the wound or soak it without advice.

When should I pick at the scab after removal?

You shouldn't. Let it fall off on its own as the skin recovers. Picking before the skin has closed raises the chance of bleeding, infection, dark marks and scarring.

Does laser removal leave dark marks or scars?

It can: dark marks, patchy color, raised scars and sunken marks. The risk depends on depth, skin tone, location, inflammation, sun exposure, keloid history and wound care, so don't believe a guarantee of 100% no marks.

Will they come back?

A spot that's been fully removed may not return in the same place, but new ones can appear elsewhere with age, genetics and skin type. Skin tags can also reappear in folds where there's friction. You can't prevent all of them.

How much does skin tag removal cost?

It depends on the number, size, location, method, anesthetic, doctor's fee, follow-up and pathology. Have a doctor identify the lesion type before pricing, and ask clearly what the package includes.

Do lots of skin tags mean I have diabetes?

Not always. Skin tags are linked with age, friction, weight, pregnancy and genetics, but they're also seen more with insulin resistance and diabetes. If many appear quickly or you have risk factors, talk to a doctor about a health check.

Can a raised mole be removed with CO2 laser?

Some spots that a doctor confirms are benign might be considered, but moles come from pigment cells and may lie deep. A laser may leave cells behind, so it can return, or make it harder to monitor changes. If anything looks unusual, choose a method that lets a sample be sent for testing.

Can warts be treated with the same laser as skin tags?

Warts come from HPV and are contagious. Treatment may include medicine, freezing, electrosurgery or laser in some cases, but it requires a diagnosis and spread control. Don't lump them in with skin tags and sell the same package.

Can it be done near the eyelids?

Only when a doctor has diagnosed the spot and has skill with the area around the eyes. Eye protection suited to the laser must be used. Don't have it done where the only protection is closed eyes or cotton pads in place of standard equipment.

What if the spot bleeds after treatment?

Press firmly with clean gauze continuously as advised, and don't keep lifting it to look. If it won't stop, you're on blood-thinning medicine or there's heavy bleeding, contact the clinic or get treatment. Don't sprinkle powder or dab corrosive substances on the wound yourself.

Medical note

This article is general information. A skin lump can't be diagnosed from a description or a photo in place of an examination. If a spot grows fast, changes color, bleeds on its own, forms a sore that won't heal or you have a history of skin cancer, see a doctor before destroying any lesion.

References

American Academy of Dermatology Association. Skin tags: Why they develop, and how to remove them.

American Academy of Dermatology Association. Seborrheic keratoses: Diagnosis and treatment.

American Academy of Dermatology Association. 5 reasons to see a dermatologist for mole, skin tag removal.

American Academy of Dermatology Association. Skin biopsy: Dermatologist-recommended wound care.

American Academy of Dermatology Association. When is a mole a problem?

DermNet New Zealand. Skin tags (Acrochordons).

NHS. Skin tags.

U.S. Food and Drug Administration. Warning letter: no legally marketed OTC drugs for mole or skin-tag removal.

Seirafianpour F, et al. Efficacy and safety of cryotherapy, electrodesiccation, CO2 laser, and Er:YAG laser in seborrheic keratosis.

Bin Dakhil A, et al. Post-inflammatory hyperpigmentation after carbon dioxide laser: review of prevention and risk factors.