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Benign soft tissue growths removed quickly with snip excision or cryotherapy.
Skin tags are common, harmless skin growths that appear to hang off the surface of the skin. These soft, flesh-coloured lesions are also known by various medical terms, including acrochordon, papilloma, fibroepithelial polyp, soft fibroma, and pedunculated growths, indicating their attachment to the skin by a stalk-like structure. In some cases, they can take on a thread-like appearance, referred to as filiform.
Both men and women are susceptible to developing skin tags, particularly as they age. These growths can vary in size from a mere millimetre to several centimetres and often appear in areas where skin folds and friction occur, such as the neck, armpits, and groin.
Structurally, skin tags consist of loosely arranged collagen fibres and blood vessels enveloped by a layer of epidermis that may be thickened or thinned. Despite their harmless nature, they can sometimes be mistaken for other skin conditions, which underscores the importance of accurate identification, particularly for individuals who are concerned about the appearance of new skin growths.
The exact cause of skin tags remains unclear, though several factors are believed to contribute to their formation. Friction and irritation from skin rubbing together are thought to be primary triggers, which is why they frequently occur in areas of skin folds.
The following factors are associated with a higher likelihood of developing skin tags:
Skin tags typically present as small, soft, flesh-coloured or slightly pigmented protrusions attached to the skin by a narrow stalk. They are most commonly found in areas where skin folds create friction, including the neck, armpits, groin, eyelids, and beneath the breasts. Their size can range from a single millimetre to several centimetres in diameter.
In most cases, skin tags cause no pain or discomfort. However, irritation may occur when they are repeatedly rubbed by clothing, jewellery, or shaving. In rare instances, a skin tag may become twisted on its stalk, causing localised discomfort or a change in colour due to reduced blood supply.
Skin tags are typically diagnosed through visual examination by a dermatologist. Their characteristic appearance, including the soft texture, pedunculated attachment, and common locations, usually allows for straightforward identification. However, skin tags can sometimes resemble other conditions such as seborrhoeic keratoses, viral warts, or molluscum contagiosum. A dermatologist is best positioned to provide an accurate diagnosis and to rule out other skin conditions.
If there is any uncertainty regarding the nature of a growth, a biopsy may be performed to confirm the diagnosis through histological examination.
Skin tags are medically harmless and do not require treatment. However, removal is often sought for cosmetic reasons or when a tag becomes irritated by clothing or jewellery. Several effective removal methods are available, and a dermatologist can recommend the most appropriate approach based on the size, location, and number of skin tags present.
Cryotherapy: Cryotherapy involves freezing the skin tag with liquid nitrogen, causing it to fall off after a period of time. It is a commonly used and well-tolerated technique.
Surgical excision: Snip excision, often performed with scissors or a scalpel, provides an immediate solution and is suitable for skin tags of varying sizes.
Electrosurgery: Electrosurgery, also known as diathermy, uses high-frequency electrical currents to remove the tag while minimising bleeding.
Ligation: Ligation involves tying a suture around the base of the skin tag to cut off its blood supply, leading to its eventual detachment over a period of days.
Although skin tags are benign, a dermatologist should be consulted when a new skin growth appears that is unfamiliar or has an atypical appearance. Any growth that bleeds, changes rapidly in size or colour, or causes persistent discomfort warrants professional evaluation to rule out other conditions.
Individuals with multiple skin tags, particularly those with associated metabolic risk factors such as obesity or type 2 diabetes, may benefit from a broader assessment. Dr. Maksym Breslavets at the Centre for Medical and Surgical Dermatology is available to assess skin tag presentations and advise on the most appropriate course of management.
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