Skin Tags (Acrochordons)

Skin tags look like tiny bits of "hanging" skin

A skin tag is a tiny, benign, outpouching of skin that is typically connected to the underlying skin by a thin stalk. Skin tags look like tiny bits of "hanging" skin and typically occur in sites where clothing rubs against the skin or where there is skin-to-skin friction, such as the underarms, neck, upper chest, and groin.

Skin tags are not present at birth and their frequency increases with age. Skin tags can be observed in about 25% of adults. Studies have shown a genetic predisposition to the development of skin tags. Therefore, skin tags can run in families.

The medical term for a skin tag is an acrochordon. Other terms that have been used to refer to skin tags include soft warts (although they do not represent true warts), soft fibromas, fibroepithelial polyps (FEP), fibroma pendulans, and pedunculated fibroma.

Skin tags are more common in overweight or obese people

In many cases, skin tags are believed to develop due to friction between adjacent areas of skin or between clothing and skin. Common sites for skin tags include the following:

• Underarms
• Upper chest (particularly beneath the breasts in women)
• Neck
• Eyelids
• Groin folds

Because of the increased skin-to-skin contact and friction, skin tags are more common in overweight or obese people. Although skin tags can sometimes be seen in children, they tend to increase with age and are most common in middle-aged and older individuals.

Studies have suggested an inherited susceptibility to the development of skin tags. In people with Crohn's disease, skin tags around the anal opening (perianal skin tags) are common. The hormonal changes of pregnancy can also stimulate the growth of skin tags, particularly during the second trimester of pregnancy.

Skin tags are not cancerous. Reports of skin cancers arising from skin tags are extremely rare.

Skin tags are typically flesh-colored or may appear brown in light-skinned individuals. They may be smooth or wrinkled and range in size from very tiny (1 mm) to approximately the size of a grape. Although it is usually possible to recognize a stalk that attaches the skin tag to the underlying skin, very small skin tags may appear as raised bumps on the skin.

If a skin tag is twisted on its blood supply it may turn red or black. Skin tags may bleed if caught on clothing or are otherwise torn.

Skin tags are not typically painful and are not associated with any particular skin conditions or symptoms. However, people who are prone to diabetes and have a skin condition called acanthosis nigricans often have associated skin tags, suggesting that factors which make one prone to diabetes may be operative in the development of skin tags.

Skin tags typically do not require medical treatment unless they are irritating to the patient or if removal for cosmetic reasons is contemplated.

The diagnosis of skin tags is made by observation as skin tags usually have a very characteristic appearance.

Laboratory tests or other diagnostic studies are not required. However, your doctor may recommend that a skin tag be excised and sent to a pathologist for microscopic diagnosis to rule out other conditions of the skin that appear similar in appearance to skin tags. Certain types of moles (nevi), benign skin growths (such as seborrheic keratosis), and warts can sometimes resemble skin tags. It is very rare for skin cancer to resemble a skin tag.

Treatment of skin tags is only indicated if they are disturbing to the patient. Treatment involves surgical removal of the skin tags.

Self-treatments are sometimes used, including tying off the small tag stalk with a piece of thread or dental floss and allowing the tag to fall off over several days.

Removal of the skin tags by a healthcare practitioner is the established treatment for skin tags that are irritating or pose cosmetic problems.

Medications have no role in the treatment of skin tags.

Removal of skin tags can be accomplished by cutting with a blade or scissors, freezing with liquid nitrogen, or using electrocautery (burning). Removal is done in the doctor's office.

Local anesthesia (such as with injections or lidocaine or application of a topical anesthesia cream) may be indicated before the removal of larger skin tags. Tiny skin tags can typically be removed without anesthesia.

Removal of skin tags is curative, although the individual may develop more skin tags at a later time.

It is not possible to completely prevent the development of skin tags, although weight loss may be helpful in this regard.

Skin tag removal is curative, but individuals who tend to develop skin tags will likely develop more over time. Further procedures may be necessary should removal of future skin tags be desired.