Definition and Overview
Skin tags are painless, noncancerous skin growths that resemble small, skin-coloured balloons hanging on a thin stalk. They form when blood vessels and loose collagen fibers form tiny outgrowths on the surface of the skin. Skin tags are the most common bump on adult skin occurring in more than 75% of the adult population. Although less common, they can also develop in babies and toddlers.
Skin tags start very small (approximately 2 mm to 1cm). Some remain small but others can grow up to 5cm. They can occur on any part of the body but they often develop on dry skin folds where the skin rubs against itself, such as the underarms, under the breasts, neck, eyelids, and groin.
Although skin tags share some similarities with warts, they are not the same. Warts tend to be rougher and are often flat while skin tags are generally smoother and look like small bumps. Also, unlike warts, skin tags are not contagious and not commonly caused by human papillomavirus (HPV), although some cases can be associated with HPV.
Skin tags are generally harmless but patients can have them removed through nonsurgical procedures, including cauterisation and cryosurgery.
Causes of Condition
Some studies suggest that skin tags can form when clusters of collagen and blood vessels become trapped inside a thicker part of the skin. Others studies, on the other hand, suggest that they are signs of increased risk of cardiovascular disease, atherosclerosis, or some metabolic syndromes.
Factors that can increase the risk of developing skin tags include:
A family history of skin tags
High blood pressure
High cholesterol levels
Obesity - Overweight people with excess skin folds are more prone to developing skin tags than those with an ideal body weight.
Pregnancy - Changing hormone levels and increased levels of growth factors during pregnancy can cause skin tags to develop.
Some types of human papilloma virus (HPV)
Wearing tight clothes - Repetitive friction caused by wearing tight clothes may contribute to the formation of skin tags.
Skin tags usually cause no other symptoms other than the presence of flesh-coloured or slightly darker skin growths on dry skin folds. Generally, they are painless but they can bleed or cause discomfort if nearby skin or clothing rub against them and cause irritation.
Who to See and Types of Treatments Available
In general, skin tags do not require treatment because they generally do not cause physical pain or harm. However, if they become bothersome, such as when they bleed each time they rub on clothing or if there are just too many of them that they cause cosmetic issues, treatment can be recommended.
Patients who wish to have their skin tags removed can consult a dermatologist (skin care specialist), an internal medicine doctor, or a family physician. If skin tags develop close to the eyelid margin, an ophthalmologist (eye specialist) must be consulted before any type of treatment is initiated.
Before the growths are removed, doctors assess them carefully to ensure that they are indeed skin tags. If the growths are bleeding, rapidly changing, or have an unusual presentation, a small tissue sample is obtained for laboratory analysis to ensure that they are not skin cancer.
Skin tags are removed through:
Cauterisation - This method uses an electrically heated instrument to burn the skin tag. The procedure is often performed with a numbing agent or under local anaesthesia if a significant number of skin tags is involved. Following the procedure, the patient is usually prescribed with pain medications to manage pain that is expected to linger for a couple of days.
Cryosurgery - With this method, the skin tag is frozen using liquid nitrogen to remove abnormal tissue. The liquid can be sprayed on the skin tag or delivered through a tube called a cryoprobe. Cryosurgery is highly effective but it carries the risk of damage to nerve tissue. Following the procedure, it is common for patients to experience localised pain and redness, which are often alleviated by mild analgesics.
Tying - Performed by tying the skin tag at its base with a dental floss or similar materials to block the blood flow. This will cause abnormal tissue to die and the tag to eventually fall off.
Excision - Involves cutting the tags using scissors or other similar tools. This is often recommended for large tags that do not respond to other types of remedies. The method is also highly effective but is often associated with excessive bleeding.
The long-term prognosis for patients who undergo skin tag treatment is often excellent. However, there is no guarantee that the growths will not recur.
Shah, R., A. Jindal, and N.M. Patel. “Acrochordons as a Cutaneous Sign of Metabolic Syndrome: A Case-Control Study.” Ann Med Health Sci Res 4.2
Kahana M, Grossman E, Feinstein A, Ronnen M, Cohen M, Millet MS (1 December 1987). “Skin tags: a cutaneous marker for diabetes mellitus.”. Acta Derm. Venereol. 67: 175–7. PMID 2438887.