A skin tag is a small, benign tag of skin which may have a peduncle or stalk. It looks like a small piece of soft, hanging skin.
They can appear on any part of the body, but they normally occur in areas where skin may rub against skin or clothing, such as folds of skin, the eyelids, armpits, under the breasts, the groin, the upper chest, and the neck. They often appear in groups.
Skin tags are also known as acrochordon, cutaneous papilloma, or cutaneous tags, fibroepithelial polyp, fibroma molluscum, fibroma pendulum, soft fibroma, and Templeton skin tags.
Skin tags are easily removed for aesthetic and cosmetic reasons, for example, by excision, cryotherapy, or some over-the-counter treatments. Sometimes they rub off painlessly.
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What are skin tags?
Skin tags are invariably benign, or noncancerous, tumors of the skin. A skin tag causes no symptoms or complications, unless one is repeatedly rubbed or scratched, as may happen with clothing, jewelry, or when shaving. Very large skin tags may burst under pressure.
They consist of a core of fibers and ducts, nerve cells, fat cells, and a covering or epidermis.
The surface of a skin tag may be smooth or irregular in appearance. They are often raised from the surface of the skin on fleshy peduncles, or stalks. They are usually flesh-colored or slightly brownish.
Skin tags start quite small, flattened like a pinhead bump. Fully grown, they can range in diameter from 2mm to 1cm. Some reach 5cm.
Causes and risk factors for skin tags
As skin tags tend to occur in skin creases or folds, it is believed they are mainly caused by skin rubbing against skin. They are very common, and more likely after midlife.
They are said to be caused by bunches of collagen and blood vessels which are trapped inside thicker pieces of skin.
Skin tags are more common in:
- People who are overweight and obese, partly because they have more skin folds and creases, and because of associated hyperinsulinemia and inflammation
- Individuals with diabetes and insulin resistance
- People with the human papilloma virus (HPV)
- Those with a hormone imbalance; changes in levels of estrogen and progesterone may increase the risk of skin tags
- Pregnant women, most likely because of hormonal changes.
Skin tags have been associated with diabetes and insulin resistance, obesity, dyslipidemia, which includes high cholesterol levels, hypertension, and elevated high-sensitive C-reactive protein, which is a marker for inflammation.
This suggests that skin tags may offer an external sign of an increased risk of atherosclerosis and cardiovascular disease.
There may be a genetic component. People with close family members who have skin tags are more likely to develop them themselves.
Rarely, skin tags are associated with Birt-Hogg-Dubé syndrome and polycystic ovary syndrome (PCOS).
Birt-Hogg-Dubé syndrome is a rare genetic condition characterized by skin tumors and skin tags, and sometimes cancerous tumors in the kidneys and the colon.
Treatment and removal of skin tags
Skin tags are usually harmless, and people often have them removed.
Large skin tags that rub against clothing, jewelry or skin may be removed to avoid irritation. Removing a large skin tag from the face or underarms can make shaving easier.
The following procedures may be used to remove skin tags:
- Cauterization, when the skin tag is burned off using heat, through electrolysis
- Cryosurgery, in which the skin tag is frozen off with a probe containing liquid nitrogen
- Ligation, which interrupts the blood supply to the skin tag
- Excision, removing the tag by cutting it out with a scalpel.
These should be performed only by a dermatologist or similarly trained medical professional.
Skin tags on the eyelid may need to be removed by an eye specialist, known as an ophthalmologist.
Removing a skin tag at home is not normally recommended due to a risk of bleeding and possible infection.
Some simple solutions can be used at home, for example, tying a piece of dental floss around a very small skin tag that is not in a sensitive area. This deprives the tag of blood, so that it falls off. It is also possible to freeze a tag with over-the-counter (OTC) medications similar to those used in wart removal. The tag normally falls off after 7 to 10 days.
There is no evidence that removing skin tags encourages more of them to develop.