Skin Tag

Nearly half of all adults will develop at least one skin tag during their lifetime. While skin tags are benign and don't require medical intervention, many people choose to have them removed for cosmetic reasons or comfort. Understanding what causes these growths and the available skin tag treatment options can help people make informed choices about their skin health.

What Is a Skin Tag?

Skin tags, medically known as acrochordons, are small, soft pieces of hanging skin that protrude from the skin's surface. These benign growths consist of a core of fibres, ducts, nerve cells, and fat cells, all surrounded by a covering of normal skin.

These harmless growths typically appear as flesh-coloured or slightly brownish protrusions, often raised from the skin on fleshy stalks called peduncles. While most skin tags start as tiny, flattened pinhead-sized bumps, they can range in size from 1 millimetre to 1 centimetre in diameter.

Skin tags commonly develop in areas where skin frequently rubs against itself or clothing, including:

• Neck and collar area
• Underarms (axilla)
• Eyelids
• Groin region
• Under the breasts
• Inner thighs
• Around the anus

These growths comprise collagen (a type of protein) and blood vessels wrapped in skin. While they may appear concerning to some people, skin tags are harmless and do not develop into cancer. They might occasionally become irritated if caught on clothing or jewellery, but they do not cause discomfort or health issues.

Symptoms of Skin Tags

Most individuals with skin tags experience no physical discomfort or symptoms. However, these small overgrowths can present various symptoms depending on their location and size.

The most common symptoms associated with skin tags include:

• Friction discomfort when they rub against clothing or jewellery
• Bleeding or soreness if caught or snagged
• Tenderness in areas of frequent friction
• Itching due to constant contact with garments
• Minor irritation during daily activities like shaving

Causes and Risk Factors of Skin Tags

The development of skin tags is closely linked to genetic and environmental factors. Medical research has identified several key mechanisms contributing to their formation, particularly friction and skin-to-skin contact in specific body areas.

Several medical conditions and lifestyle factors increase the likelihood of developing skin tags. These include:

• Obesity or excess weight- causing increased skin friction
• Type 2 diabetes due to insulin resistance
• Pregnancy-related hormonal changes
• Polycystic ovary syndrome (PCOS)
• Family history of skin tags
• Advanced age, as tags become more common with ageing
• People who frequently wear jewellery or tight-fitting 

Complications of Skin Tags

Physical complications may develop when skin tags are subjected to regular irritation:

• Inflammation and Soreness: Tags can become painful when rubbing against clothing or jewellery
• Infection Risk: Particularly in areas with high moisture or friction
• Size Changes: Some tags may enlarge due to irritation
• Cosmetic Concerns: Visible tags may cause emotional distress

The most serious complications often arise from attempted self-removal of skin tags. Using over-the-counter products or attempting home removal methods can result in excessive bleeding, scarring, or infection. Additionally, there is a risk of misidentifying other skin conditions as skin tags, potentially leading to delayed treatment of more serious conditions.

Diagnosis

The diagnostic process typically involves three main steps:

• Physical examination of the growth
• Review of medical history
• Assessment of risk factors

During the examination, doctors differentiate skin tags from other similar-looking skin conditions such as moles, warts, seborrheic keratosis, and, in rare cases, skin cancer. While most skin tags can be diagnosed through visual inspection alone, certain situations may require additional investigation.

Additional testing becomes necessary when skin tags display unusual characteristics such as:

• Bleeding or irregular colouring
• Rapid growth or changes in appearance
• Multiple colours, including red, pink, brown, or black
• Atypical size or shape

In these cases, doctors might recommend a biopsy, where the tissue is removed and examined under a microscope to verify the diagnosis and rule out other conditions. 

Treatment

While these benign growths don't typically require removal, many people choose treatment for cosmetic reasons or to prevent irritation from clothing and jewellery.

Professional Medical Procedures:

• Cryotherapy: A quick freezing technique using liquid nitrogen
• Cauterisation: Burning off the tag using specialised electrical equipment
• Excision: Surgical removal with a scalpel or scissors
• Ligation: Cutting off blood supply using surgical thread

When to See a Doctor

Individuals should seek medical guidance immediately if any of these warning signs appear:

• Abrupt changes in the shape or size of existing skin tags
• Bleeding or persistent pain
• Colour changes, especially multiple colours within one growth
• Development of numerous new tags in a short period
• Tags that become repeatedly irritated or infected

Prevention

Key preventive measures that can help reduce skin tag formation include:

• Maintaining a healthy weight through regular physical activity and balanced nutrition
• Wearing loose-fitting clothing to minimise skin friction
• Choosing jewellery that doesn't rub against the skin
• Keeping skin folds clean and dry
• Using a moisturiser regularly to reduce skin irritation
• Avoiding accessories that consistently rub against the neck, causing skin tags on the neck region

Conclusion

Skin tags remain a common skin condition that affects many adults throughout their lives. People can reduce their chances of developing new skin tags through simple lifestyle changes, managing medical conditions, and keeping skin folds clean and dry. Regular skin monitoring helps catch any unusual changes early, allowing for timely medical intervention when needed.

FAQs

1. Are skin tags common?

Skin tags affect most of the people at some point in their lives. These growths become more prevalent with age, particularly after 40 years. Women and men are equally likely to develop skin tags, though pregnancy and weight gain can increase their occurrence.

2. How do skin tags affect my body?

Skin tags typically don't cause any physical harm or discomfort to the body. However, they may become irritated when rubbed against clothing, jewellery, or other skin surfaces. While they don't pose health risks, some people may experience emotional distress due to their appearance.

3. Will I need any tests?

Most skin tags can be diagnosed through visual examination alone. However, if a growth appears unusual or suspicious, a doctor might recommend a biopsy to confirm the diagnosis and rule out other conditions.

4. What other conditions might look like skin tags?

Several skin conditions can resemble skin tags, including:

• Moles (dermal nevus)
• Warts, including genital warts
• Seborrheic keratosis ("barnacles")
• Neurofibromas (nerve-related growths)

5. When should I consider skin tag removal?

Removal might be appropriate when skin tags:

• Become repeatedly irritated
• Catch on clothing or jewellery
• Cause emotional distress
• Affect appearance in visible areas

6. Is skin tag removal painful?

Professional removal procedures typically cause minimal discomfort. Doctors often use local anaesthesia for larger tags or sensitive areas, ensuring a comfortable experience during the removal process.

7. Can skin tags disappear naturally?

While skin tags occasionally fall off on their own, this is relatively rare. Most skin tags remain stable once formed and typically require professional removal if they become bothersome.

Dr. Bhavana Nukala

MBBS, MD (DVL)
CARE Hospitals, Banjara Hills, Hyderabad

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+91 406 810 6585