Today, we're going to discuss something that many of us might encounter in our lives: skin tags, and what we can do to treat them.

Brief overview of skin tags, their appearance, and prevalence

Skin tags, also known as acrochordons, are small, soft and benign - that is non-cancerous - growths that hang from the surface of the skin by a narrow stalk.

They are typically flesh-colored or slightly darker and are often composed of fibrous tissue and blood vessels inside a layer of skin. There is no risk to leaving them alone but they will not go away on their own and may get bigger in size over time.

Image reproduced from Harvard Medical School Publishing

Skin tags are frequently found in areas where the skin folds and experiences friction, such as the neck, armpits, torso, beneath the breasts, groin, and eyelids. They can become irritated if jewelry or clothing rubs against them.

It's estimated that 50-60% of adults will develop at least one skin tag in their lifetime, with the likelihood increasing after age 40.

Skin tags affect both men and women equally and become more common as people age. While the exact cause of skin tags is unknown, they appear more frequently in people with a family history of skin tags, suggesting a possible genetic component (Pandey and Sonthalia 2022).

You might be surprised to know that skin tags are more common in people with Type 2 diabetes or obesity, along with their associated metabolic profiles (Shah et al. 2014, Crook 2000). What's more, as childhood and teenage obesity rates rise, we're seeing an increase in skin tags among young people too (Pandey and Sonthalia 2022).

Now, for the moms and expecting moms out there, it's worth mentioning that pregnancy can also lead to an increased number of skin tags. And for those young women who aren't pregnant but notice skin tags, they could potentially be an indicator of polycystic ovarian syndrome (Pandey and Sonthalia 2022).

The science behind these associations isn't crystal clear yet, but some studies have found that skin tags might be related to increased epidermal growth factor receptors in the epidermis and higher insulin-like growth factor receptor levels (Shah et al 2014, Koseoglu et al. 2020). These receptors play a role in how our skin grows and function.

A quick note: What are receptors?

Receptors are special proteins found on the surface of cells, and sometimes inside cells, that help our bodies respond to different signals.

Think of receptors like the cell's antennae, that can receive signals and then activate the cells to carry out actions.

Where do the signals come from? These signals can come in the form chemical messengers in the body like hormones, and neurotransmitters

Interestingly, there's also a link between human papillomavirus (HPV) and skin tags. One study even discovered HPV DNA in 88% of skin tags (Crook 2000), although the relationship between the two remains a bit of a mystery.

Unfortunately, there is no proven way to prevent skin tags. But there are ways to treat them. So let’s go over them one by one.

At-home remedies

While there are several over-the-counter (OTC) treatments available for removing skin tags at home, keep in mind that their effectiveness is largely based on anecdotal evidence, not on significant scientific data.

Also, remember that at-home remedies may not be suitable for skin tags in sensitive areas, such as near the eyes or genitals. It's crucial to ensure that you're treating an actual skin tag and not another skin condition like a mole or wart, which may require different treatments or professional evaluation.

Some popular at-home treatments include:

Freeze kits: Also known as cryotherapy kits, these are designed to remove skin tags by freezing them off. OTC freeze kits might not be as potent as the cryotherapy treatments administered by a dermatologist and could require multiple applications.

Ligation bands: Some commercial kits include ligation bands that can be placed around the base of skin tags, cutting off their circulation and causing them to fall off.

Topical creams: Various OTC creams and ointments claim to help remove skin tags and contain ingredients like salicylic acid or tea tree oil.

Professional removal

There are several safe and effective techniques that dermatologists and other medical professionals can use to remove skin tags. These procedures are typically quick, low-risk, and require little to no downtime.

Keep in mind that, unfortunately, skin tag removal is considered cosmetic and usually not covered by insurance. However, professional methods are safer because they minimize the risk of complications like bleeding. Some common professional skin tag removal techniques include:

Cryotherapy: This method involves a dermatologist freezing off the skin tag using liquid nitrogen. It's a quick process that often requires just one treatment but might cause temporary skin discoloration or irritation in the treated area.

Electrocautery: In this procedure, an electric current is used to burn off the skin tags. It's usually quick and relatively painless since the heat also helps seal blood vessels and minimize bleeding. Electrocautery typically leaves minimal scarring and has a low risk of infection. Radiocautery, which uses radio waves to burn off skin tags, is another option.

Surgical removal: A dermatologist may remove the skin tag using sharp scissors or a scalpel. This process is straightforward, resulting in minimal bleeding and scarring.

REFERENCES

Crook MA (2000). “Skin tags and the atherogenic lipid profile.” J Clin Pathol 53: 873-874.

Koseoglu HG, Bozca BC, Bassorgun CI, Sari R, Akbas SH, Karakas AA (2020). “The role of insulin-like growth factor in Acrochordon Etiopathology.” BMC Dermatology 20(14). https://doi.org/10.1186/s12895-020-00111-0.

Harvard Health Publishing Site. “Skin Tags (Acrochordon).” https://www.health.harvard.edu/a_to_z/skin-tags-acrochordon-a-to-z. Accessed April 2023.

Pandey A, Sonthalia S (Updated 2022 Aug 1). “Skin Tags” In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK547724/

Shah R, Jindal A, Patel NM (2014). “Acrochordons as a Cutaneous Sign of Metabolic Syndrome: A Case-Control Study.” Annals of Medical and Health Sciences Research 4(2): 202-205.