What are Skin Tags? How to Remove them?

Have you ever noticed those small and soft skin tags hanging somewhere on your parent's or grandparents' skin? Ever wondered how or why skin-tags appear on some people? Can it be treated or removed? Let's find out. 

What are skin tags? 

Skin tags are small pieces of soft skin hanging on the body that may have a peduncle or stalk. They are made of blood vessels and collagen surrounded by an outer layer of skin.

In other words, they are skin-related growth noticeable as soft protrusions of heaped-up skin. Usually benign, that is noncancerous, by nature, skin tags are also designated by other terms such as 'acrochordon,' 'cutaneous papilloma,'' cutaneous tag,' 'fibroepithelial polyp,'' fibroma molluscum,'' fibroma pendulum,'' soft fibroma,' and 'Templeton skin tags.'

These skin-tags are generally the skin color but can also be brown to dark brown and even black if it gets twisted and the blood flow is constricted. These are often elongated and attached to a fleshy stalk with a generally 1–5 mm size but rarely can grow up to 1 –2 cm in size.

Skin-tags usually appear on the eyelids, armpits, under the breasts, groin, upper chest, and neck. They are benign, noncancerous tumors of the skin. They consist of a lump of fibers and ducts, nerve cells, fat cells, and a covering or epidermis.

Skin tags are generally smooth and uneven lumps of skin (but can also be wrinkly and asymmetrical). Even though they are painless, it might be painful when skin tags get caught in mesh fabric clothing or jewelry like fine chain necklaces. The constant friction between skin tags and garments may even cause bleeding and subsequent infection.

Causes of Skin-tags

The exact causes of why skin tags appear are not clear. However, the following reasons are speculated:

According to a study conducted by the Indian Journal of Dermatology, published in 2011, skin tags are related to obesity and not diabetes. However, skin tags can be an early sign of insulin resistance. Insulin resistance is a condition where the human body does not normally react to the amount of insulin produced. This, in turn, leads the pancreas to produce more insulin until it becomes exhausted and cannot keep up with the body's demands. As a result of the level of blood sugar in the body
begins to rise.

In the study, 245 nondiabetics (123 males and 122 females) and 276 people with diabetes (122 males and 154 females) were included after recording all the parameters of the subjects like age, sex, body mass index (BMI), relevant habits, skin tags color, size, and number in different anatomical sites.

The study results showed that the mean number of skin tags is more common among obese than non-obese participants, and the number increased significantly with age irrespective of sex. Moreover, the study also revealed that only BMI was significantly associated with skin tags.

The association of diabetes with skin tags was non-significant. So it can be concluded that diabetes is not a factor responsible for having skin tags. Hence, obesity is a factor for having skin tags.

Patients with metabolic syndrome(Mets) and a family history of skin tags or genetic disorders are also equally vulnerable to having skin tags on their skin. It can also be seen in large numbers in patients diagnosed with Birt-Hogg-Dube (BHD) syndrome and tuberous sclerosis.

Hormonal imbalances like an increase in female sex hormones and human growth hormones may also lead to skin tags' development.

Although there might be various reasons for skin tags' appearance in an individual, it has been observed that there is an increasing incidence of skin tags in both adults and children. Even though skin tags are not contagious, it is not uncommon for various family members to have them, suggesting they can be genetic.

It is still unclear why there is an increasing incidence, but according to a study in 2008, the human papillomavirus (HPV) may be a factor in the development of skin tags. It is also speculated that it may happen due to collagen and blood vessels trapped inside the thicker pieces of skin. 

When Does it Appear? 

It is estimated that almost 50% of adults develop a skin tag in their lifetime, men and women alike, mostly among people suffering from obesity. Skin tags are usually common during the adult stage (the early '40s) but can appear in the teenage phase. But it is very rare to appear after the seventh decade of life. Old people, pregnant women, obese people are more at risk of developing skin tags.

Should You Be Worried? 

Skin tags are usually stagnant little lumps on the skin with no pain at all. It is no cause for any worry or health concern. But if you experience pain and notice the size to increase, ulcerate, bleed, or any change of color on it, then it is time for you to have the doctor checked it once. Moreover, if you want to remove the skin tag for cosmetic reasons solely, you need to consult a dermatologist. There might be a good chance that you may bleed a lot and catch an infection if you try to remove it without consulting a doctor first. 

Treatment 

Skin tags may be removed normally due to aesthetic or cosmetic reasons. They are also removed when they irritate due to friction with garments or jewelry. And it is also risky to shave with a sharp blade while there is a skin tag on the spot where you're shaving. 

As published in Medical NewsToday, the following procedures can remove skin tags: 

• Cauterization: The protrusion can be burned off through electrolysis. Electrolysis is a hair removal technique that destroys the hair growth center through chemical or heat energy. 
  
• Cryosurgery: Cryosurgery involves the use of extremely cold temperatures to destroy abnormal tissue growths. A skin tag is frozen off using a probe containing liquid nitrogen.  
  
• Ligation: The blood supply to the skin tag base is interrupted through the use of skin tag removal patches or bands. As a result, the cell units die, and the protrusion falls off. 
  
• Excision: Excision involves removing the tissue through which the skin tag grew through the use of a scalpel or laser. 
  

However, these procedures are risky and should not be attempted at home to avoid any risk of bleeding and infection. Skin tag removal should be done strictly by a dermatologist, a skin specialist, or a similarly trained medical professional. One should be even more cautious when removing skin tags on delicate areas such as the eyelid, especially those near the eyelid margin. It would be better to consult an eye doctor or ophthalmologist first.

Surgery is what doctors might go with when the skin tag is considerably bigger. Although the surgery is a minor one and safe, the patient may experience heavy bleeding and risk developing an infection in extremely rare cases.

However, very small tags can be removed using over-the-counter products such as skin tag removal patches that cut off the blood supply to the base of the skin tag or skin tag removal creams, making the skin tags fall off within a few weeks of use. However, their efficacy isn't always reliable. There are also certain medications that can be used for the removal of skin tags. But it should be used under the doctor's supervision only. These medications dry up the skin tag, and it eventually falls off after 7 to 10 days.

Although there are natural remedies suggested on the internet like apple cider vinegar, tea tree oil, etc., there is no scientific evidence to prove their efficacy in treating skin tags.

Lastly, even though skin tags are generally benign, it is still very much possible for a cancerous growth to be mistaken for a skin tag. Skin tags generally stay small, while skin cancers can grow large and can often bleed and ulcerate. So it is very important to have your doctor check if there is any growth that bleeds or has a different color.