Overview

Skin tags, medically known as acrochordons, are common, harmless, soft skin growths that hang off the skin's surface. They are typically small, flesh-colored, or slightly darker, and can appear in various parts of the body, particularly in areas where skin rubs against skin or clothing. Skin tags are benign and non-cancerous, posing no medical danger, though some people may choose to have them removed for cosmetic reasons or if they cause irritation. Skin tags are especially prevalent in adults and tend to increase in number with age.

Causes

The exact cause of skin tags is not fully understood, but several contributing factors are recognized. They are primarily associated with skin friction and certain health conditions. Common causes and risk factors include:

• Friction: Skin tags frequently develop in areas where skin folds or rubs together, such as the neck, armpits, groin, and eyelids.
• Age: Skin tags are more common in middle-aged and older adults.
• Obesity: Overweight individuals are more prone to skin tags due to increased skin folds and friction.
• Pregnancy: Hormonal changes during pregnancy may trigger the formation of skin tags, especially around the neck and underarms.
• Genetics: A family history of skin tags increases the likelihood of developing them.
• Diabetes and insulin resistance: Skin tags are more commonly observed in people with type 2 diabetes and metabolic syndrome.
• Human papillomavirus (HPV): Some studies have found a possible link between HPV and skin tag development.

Symptoms

Skin tags are usually easy to recognize by their distinct appearance. Typical features include:

• Appearance: Small, soft, smooth, or slightly wrinkled growths that are either skin-colored or slightly darker.
• Shape: Often attached to the skin by a narrow stalk called a peduncle, giving them a hanging appearance.
• Size: Can vary from a few millimeters to several centimeters in diameter, though most are small.
• Location: Commonly found on the neck, armpits, groin, eyelids, under the breasts, and sometimes on the trunk.
• Painless: Skin tags are typically painless but may become irritated or sore if rubbed frequently or snagged by jewelry or clothing.
• No systemic symptoms: Skin tags do not cause fever, fatigue, or any internal health issues.

Diagnosis

Diagnosis of skin tags is straightforward and based on physical examination. Healthcare providers can usually identify them without any special tests:

• Clinical examination: Visual and tactile inspection is sufficient to diagnose skin tags.
• Differential diagnosis: Doctors may ensure the growth is not a wart, mole, or other skin lesion like seborrheic keratosis.
• Biopsy: Rarely, if a skin tag appears unusual or changes in color, size, or shape, a biopsy may be performed to rule out other skin conditions.

Routine laboratory tests are not needed for the diagnosis of skin tags.

Treatment

Since skin tags are benign, treatment is usually not necessary unless they cause discomfort or cosmetic concerns. Treatment options include:

• Observation: No treatment is required if the skin tags are asymptomatic and not bothersome.
• Cryotherapy: Freezing the skin tag with liquid nitrogen, causing it to fall off after a few days.
• Excision: Cutting the skin tag off using sterile scissors or a scalpel under local anesthesia, commonly done in clinical settings.
• Electrosurgery: Burning the skin tag off using electric current.
• Ligation: Tying off the skin tag at its base with a surgical thread or band to cut off blood supply, leading to natural detachment.
• Avoiding home remedies: Over-the-counter removal kits exist, but it is generally advisable to have skin tags removed by a healthcare professional to avoid infection or scarring.

Prognosis

The prognosis for skin tags is excellent since they are harmless and non-cancerous. Key points about prognosis include:

• No health risks: Skin tags do not pose any risk of turning into cancer or causing internal problems.
• Recurrence: While removed skin tags do not grow back, new ones can develop over time, especially if risk factors like obesity or friction persist.
• Simple removal: Removal procedures are quick, minimally invasive, and usually leave little to no scarring when performed properly.
• Cosmetic improvement: Many people opt for removal due to cosmetic reasons and are generally satisfied with the results.

With proper skin care and maintenance of a healthy weight, the recurrence of skin tags may be minimized, though they are considered a normal part of skin aging for many people.