What is Skin Tags?
Skin tags, also known as ‘acrochordons,’ are common harmless growths that appear as small, soft bumps on the skin. They are usually safe and not harmful. Research shows that about 50 to 60% of adults may have at least one skin tag in their lifetime, and the chance of getting them increases as we age, particularly after the age of 40. However, it’s important to know that these skin tags are more common in people who are obese, have diabetes, metabolic syndrome (a condition involving high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels), and those who have family members with skin tags. Men and women are equally likely to have skin tags.
Skin tags can start showing up as early as the teenage years but are most commonly seen in later life. However, many studies have reported a rising incidence of skin tags in children and teenagers, which seems to be linked with the global rise in obesity in this age group. Skin tags rarely occur after the age of 70. They often grow in areas of the body where there are skin folds, such as the armpits, neck, eyelids, and groin. Usually, they are the same color as your skin or slightly darker, and they can range in size from 1 and 5 mm up to 1 to 2 centimeters. They are not painful, but they can become irritated and cause discomfort when they rub against clothing or jewelry, sometimes causing them to bleed or itch.
Certain genetic conditions may make people more likely to have skin tags. For instance, people with Birt-Hogg-Dube syndrome (a condition that can increase the risk of skin and lung disease and kidney cancer) and tuberous sclerosis (a disease that causes growth of noncancerous tumors) often have many skin tags, which can form a ‘necklace’ like pattern around the neck. This is referred to as the ‘molluscum pendulum necklace sign.’
What Causes Skin Tags?
Skin tags, also known as acrochordons, have been linked to several health conditions including:
1. Irregular cholesterol and fat levels in your blood
2. Type 2 diabetes
3. Heart diseases
4. Obesity
5. Hereditary factors – meaning it runs in your family
Skin tags are more common in people who are overweight, possibly due to skin rubbing together and getting irritated. Experts think skin tags are part of the normal aging process where the skin loses its elasticity or stretchiness.
Imbalances in hormones, such as increased levels of female hormones progesterone and estrogen or too much human growth hormone, could also lead to the development of skin tags. Some proteins that make cells grow could be risk factors too.
No infections have been reported to cause skin tags but there have been individual cases where certain viruses may be the cause. There have been noticeable associations between the common warts virus (the human papillomavirus or HPV) and skin tags in multiple studies.
Interestingly, lots of research studies have also seen a link between type 2 diabetes and skin tags.
Risk Factors and Frequency for Skin Tags
Acrochordons, also known as skin tags, are commonly found in about 50 to 60% of the population. They occur equally in both males and females. Once developed, a skin tag may grow in size or number as one gets older. By the time people reach their 50s or 60s, nearly two-thirds of them may have skin tags. These growths typically stay there for the rest of their lives.
Signs and Symptoms of Skin Tags
Skin tags, or acrochordons, are small, soft, round bumps that usually hang off the skin on a thin stalk. They vary in size, typically around 0.5 to 2.5 mm in diameter. You can often spot these skin tags easily by simply looking at them, but sometimes a magnifying glass may be necessary for smaller ones. The color of the skin tag can be the same as your skin or it might be darker. More often than not, the darker ones are more common. You’ll usually find these skin tags on the side of the neck, underarms, and groin.
Skin tags can be classified into three general categories depending on their size and appearance:
- Small skin tags: These are tiny raised bumps about 1 to 2 mm in size, most often found on the neck and underarm area.
- Mid-sized skin tags: These either appear alone or in clusters. They are filiform or threadlike in shape, usually about 5 mm long and 2 mm wide, and can be found on various parts of the body.
- Large-sized skin tags: These are larger pendulous lesions that may look bag-like, similar to birthmarks, or like soft fibromas. They are usually found on the lower part of the body, including the groin.
There are also ‘giant’ skin tags, which can cause significant discomfort for patients when they are located in the underarm and genital areas due to their size.
Testing for Skin Tags
If your doctor suspects you might have diabetes, they will conduct several tests. These may include checking your A1c levels (a measure of your average blood glucose over the past 2-3 months), fasting blood glucose levels (blood sugar levels after not eating for at least 8 hours), and postprandial blood glucose levels (blood sugar levels about two hours after you eat). Additionally, to monitor your heart health, they may also check your lipid profile, which includes levels of different types of cholesterol and triglycerides in your blood.
There’s also something called a Body Mass Index (BMI), which is a measure calculated from your height and weight. Your doctor will make a note of your BMI and track it over time. This information helps your doctor to understand better your overall health condition and guide any necessary treatment decisions.
Treatment Options for Skin Tags
Skin tags are small, usually harmless growths on the skin. They can be treated in various ways, all of which involve removing them. One common method is using a tool that uses heat to burn the skin tag off – typical in a doctor’s office. Other methods include:
– Trimming off with a surgical scissors
– Using a heated tool to burn off the tag
– Freezing it off
Some smaller skin tags can be removed using special types of lasers. Depending on the size and the location of the tag, a local anesthetic may be applied or injected to reduce any discomfort. Once the skin tag is removed, the tiny wound usually heals on its own.
In general, removal techniques like trimming, heating, or freezing are the most common practice. However, many doctors prefer using the heating tool due to its precision and convenience.
Despite being typically low-risk, there can be some risks associated with skin tag removal. The skin may bleed when the tag is removed. So, during the procedure, the doctor needs to apply pressure and monitor the patient carefully. In some cases, silver nitrate or an electrical device might be used to stop the bleeding.
Very rarely, a patient might experience heavy bleeding or an infection after the procedure. The likelihood of complications can be reduced if the doctor is aware of all the medications and supplements the patient is taking, as some can affect bleeding and clotting times.
It’s essential for patients to follow directions on how to take care of the area where the skin tag was removed – this will help prevent infections. It’s also important not to try to remove skin tags at home. Without the right technique and a sterile environment, the risk of excessive bleeding and infection increases.
What else can Skin Tags be?
Several skin conditions can sometimes look like skin tags. These include:
- Changes in the skin seen in neurofibromatosis type 1
- Genital warts
- Moles, also known as melanocytic nevi
- Non-genital warts
- A rare pre-cancerous growth known as a fibroepithelial tumor or Pinkus tumor
- A rare skin condition called seborrheic keratosis
Surgical Treatment of Skin Tags
Skin tags are generally not harmful. Most of the time, once they have been removed, lab tests on the tissue confirm that they are non-threatening.
What to expect with Skin Tags
A skin tag is a small growth that can become larger if it is constantly rubbed by clothes or folds in your skin. However, regardless of size, the internal structure of these skin tags does not change. Most importantly, these skin tags pose an extremely low – or even no – risk of turning cancerous.
Possible Complications When Diagnosed with Skin Tags
A skin tag can sometimes twist and become inflamed. This can be especially problematic for individuals who are overweight; they are at an elevated risk of inflammation.
Here are the potential complications that could arise when removing a skin tag:
- Improper removal could lead to scarring.
- Normal skin tissue could inadvertently be removed during the process, changing the appearance of the skin. Because of this, you should reach out to an experienced clinician.
- The area where the skin tag was removed could experience mild irritation or a specific type of skin inflammation known as irritant dermatitis.
- In rare cases, if a nerve growth within the skin tag is cut during removal it can result in something called a neuroma. This condition might cause chronic pain for several weeks or potentially even months.
Recovery from Skin Tags
Using the right moisturizers can assist in the growth of new skin and also lower the chance of developing irritant dermatitis, a condition that causes skin to become red, itchy, and inflamed.
Preventing Skin Tags
Skin tags are harmless skin growths, but they can sometimes indicate the presence of type 2 diabetes or obesity. For this reason, it’s important to keep a healthy body weight and ensure your blood sugar levels are stable. People with type 2 diabetes should be under the care of a hormone specialist, known as an endocrinologist, to help manage their blood sugar levels properly.
If you have skin tags around your neck, it’s best to avoid wearing necklaces or other neck jewelry. This helps prevent irritating your skin or causing injuries because of friction.
Additionally, try not to wear tight or synthetic clothing as they can rub and cause friction on the skin tags. It’s just another way to avoid further irritation.
