Skin Tags (Acrochordon): Symptoms, Causes, risks, Diagnosis, Treatment and Outlook

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A back of a man with skin tags

1Overview

A skin tag or an acrochordon is a small piece of hanging skin that may contain a stalk or a peduncle. They can appear anywhere in the body but they usually form in parts of the skin where there is friction. Mostly, these areas of the skin have creases and folds.

Skin tags are very common and occur after midlife, especially those whose skin is always exposed to the sun. The other names for acrochordon or skin tag are a cutaneous tag, cutaneous papilloma, fibroepithelial polyp, fibroma molluscum, soft fibroma, fibroma pendulum and Templeton skin tags.

Skin tags are not dangerous but they can be removed for cosmetic and aesthetic reasons.

The areas where skin tags mostly appear are the eyelids, under the breasts, armpits, groin area, neck and the upper chest. The skin tags appear to be slightly brownish or flesh-colored, depending on the skin color and type.

Generally, the skin tags are harmless and benign. These tiny pieces of tissues contain blood vessels and a protein called collagen. Both men and women are equally prone to acquiring skin tags but people who are obese, pregnant and those with diabetes are at a higher risk.

2Symptoms

A skin tag usually appears as a soft and small bump on the skin. Eventually, it can grow into a piece of skin attached to the skin, which is usually colored flesh. It can have a stalk and it can be easily moved or wiggled. Though the skin tag is movable, it is usually painless. However, it can become irritated when it’s wiggled often and if the inner stalk is twisted.

3Causes

The exact cause of skin tags is still unclear but it is usually formed when clusters of collagen and blood vessels become trapped in the thick areas of the skin. These pieces of skin are usually seen in areas where the skin is being rubbed like in folds and creases.

Researchers are still unaware of the real cause why skin tags form. However, it is believed to be caused by friction. Friction may lead to the development of skin tags and the growths occur in areas where the skin constantly rubs against other skin or clothing like backpacks, bra straps, and garters.

Skin tags can appear almost anywhere on the body that is covered by skin. The two most common areas, however, are the armpits and the neck. The other common body areas include the eyelids, buttock folds, groin folds and the upper chest.

Since skin tags form in skin folds and creases, friction plays a major role in their development. According to a study, the presence of the human papillomavirus (HPV), may play a pivotal role in the formation and appearance of skin tags.

Another factor is insulin resistance. This is the culprit in type 2 diabetes. Individuals with insulin resistance cannot absorb glucose from food because the cells reject insulin. Insulin is the transport system of blood glucose. The presence of many skin tags may signal insulin resistance, high cholesterol levels, and increased body mass index.

Skin tags are also mostly seen in pregnant women. This is due to the increased levels of pregnancy hormones and increased in weight. In some cases, the presence of multiple skin tags can signal an endocrine problem or an imbalance in the body hormones.

Skin tags may also run in families. People who have diabetes, those who are obese and pregnant are at a greater risk of developing skin tags.

4The risk factors for skin tags include:

  • Severe itching
  • The presence of some forms of human papillomavirus (HPV)
  • Changes in hormones in pregnancy
  • Obesity or being overweight
  • People with diabetes
  • People with sex-oriented imbalance like changes in estrogen and progesterone levels
  • People with close family members who also have skin tags
  • High cholesterol levels
  • Hypertension
  • Insulin resistance
  • Metabolic syndrome
  • Cardiovascular

5Diagnosis

The doctors can detect a skin tag easily by just looking at the lesion. For a skin tag with a characteristic appearance – fleshly-colored, with a stalk and slightly darker than the surrounding skin, there are no further tests needed.

If a person has a skin growth is suspicious, like those that are not wiggled easily, there are bleeding areas and the color is not flesh, you should have it checked. This is to see if the lesion is harmless or it can be a sign of melanoma, the deadliest type of skin cancer.

Skin tags are generally harmless. However, the skin tags may become sources of discomforts. You may consider having them removed if they are affecting the self-esteem or they intervene with wearing clothing and pieces of jewelry. Also, they can be removed if they are taking a toll on one’s self-esteem or they are bleeding.

6Treatment

Since skin tags are generally harmless, removing it is normally for cosmetic reasons. Big ones, particularly in areas where they rub against clothing or other skin, can be removed to reduce irritation.

Small skin tags may rub off their own and most of them are attached to the skin. Mostly, they do not need treatment but if they bother you, you can have them removed.

Skin tags usually do not need treatment, especially if they do not cause any discomfort. However, if the location causes them to rub against clothing or other areas of the skin, removing can be done.

Also, skin tag removal usually does not require the use of anesthesia. However, to make the removal painless, the doctor can use topical anesthetic cream or lidocaine injections to relieve the pain, especially if the skin tag is large or there are multiple ones in one area.

Other procedures like freezing, the skin tags may take a few days before they fall off. Individuals with multiple skin tags may have them pop up again in the same areas.

The doctor may choose from any of the following procedures to remove the skin tag.

Surgery

Cryosurgery – In this procedure, the skin tag is frozen by a probe that contains liquid nitrogen.

Cauterization – In this procedure, the skin tag is burned through a process called electrolysis.

Excision – In excision, the skin tag is removed with a scalpel and usually left to heal on its own. If the incision is big enough, the doctor needs to have the lesion sutured.

Ligation – In this procedure, the skin tag’s blood supply is blocked.

Skin tags should be removed only by licensed doctors and dermatologists. Removing a skin tag should not be done at home due to the risk of infection and possible bleeding.

Medicines

Some drugs can be used to remove the skin tag. Over-the-counter solutions can be used to freeze the skin tag and it will fall off between 7 and ten days. These solutions are similar to those used in removing warts.

Some people may live with the skin tag for years, without feeling any discomfort. Most of these are just removed for aesthetic purposes or of the skin tags cause some degree of pain or discomfort.

There is no evidence that shows that removing a skin tag will cause more to grow.
Also, there is no evidence showing that skin tags can spread to nearby areas.

7Outlook

Skin tags do not usually cause any complication and it can be left there for years without feeling any pain or discomfort. They are benign and harmless.

If you have a skin tag, it may not be a cause for concern. In some individuals, the skin tags are nothing but for others, they can be nuisances. If they do not bother you, let them be. However, if you are uncomfortable with these skin tags, you can have them removed or excised.

However, some skin tags are stubborn and treatments are needed for them to be removed. If they keep on coming back there are some treatment options you can undergo. If the skin tag is ligated, it can last for several weeks before they fall off.

Losing weight can also help obese and overweight people remove skin tags. These skin tags can go away on their own without treatment. Obese people may have skin tags because of some parts of their skin rub against each other. Losing some weight may help reduce the friction, and eventually lead to lesser skin tags in high prone areas.

If you have a skin tag that bleeds, have a different color, forms abnormal borders and change in colors, you may want to have it checked by a doctor or a dermatologist.
These may signal the presence of more serious skin conditions like warts, a viral infection, and skin cancer. Particularly, melanoma appears to be darker and have no distinct border. Melanoma is a serious type of skin cancer. In fact, it’s the deadliest form of skin cancer up to date.

Detecting cancer early is important. If you notice changes in a skin lesion, mole or skin tag, seek medical attention right away. This way, early treatment can be initiated, leading to a good outlook or prognosis in the future. Late diagnosis