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Sep 30, 2021
4 min read

Acrochordon (skin tags): what are they and why do they appear?

Skin tags (acrochordons) are small outgrowths of normal skin. These harmless or benign skin growths can usually be left alone. It’s unclear what causes skin tags, but they seem to be more common in people over age 50 or in those with obesity. Fortunately, it’s relatively easy to remove most skin tags.

chimene richa

Reviewed by Chimene Richa, MD

Written by Andrea Pierce

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Skin tags, also known as acrochordons, are soft bits of extra skin that pop up on the body. Thankfully, skin tags are benign (harmless) growths and don’t need to be removed for health reasons. That said, if they’re bugging you—maybe they’re catching on clothing or jewelry, feel itchy, or unattractive in your view—there are ways to remove them.

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What are skin tags?

Skin tags are usually small pedunculated skin growths—this means they are attached to the body by a thin fleshy stalk called a “peduncle.” They range in color from flesh-toned to darker brown or reddish and tend to be oval-shaped. Skin tags are usually small (1 to 5 millimeters), although larger ones are possible (Pandey, 2021).

Skin tags can appear anywhere but are particularly common in areas where skin rubs against skin, such as around the armpits (axillae), under the breasts, and in the groin area. They’re also common on the neck.

Most of these benign skin growths are painless. But itching and irritation from contact with clothing, rough fabric, or jewelry may bother some people.

Who gets skin tags?

Skin tags are common, especially in adults over age 50 whose skin has naturally lost some of its elasticity over the years—making it less likely to snap back into place. Nearly half of the general population has at least one of these lesions somewhere on the body (Belgam Syed, 2021).

While men and women are equally likely to develop skin tags, certain conditions raise the risk. These include having obesity, diabetes, metabolic syndrome, or a family history of skin tags (Belgam Syed, 2021).

What causes skin tags?

Researchers are still trying to figure out why people get skin tags. While the causes remain hazy and largely unconfirmed, there are several popular theories.

A widely held belief is that skin tags are likely caused by friction, with the irritation of skin rubbing against skin leading to a buildup of extra tissue. This theory may help explain why acrochordons are so common in body folds—and more likely to develop in people with excess weight or obesity, since extra weight likely means having more skin folds (Belgam Syed, 2021).

The development of skin tags has been associated with insulin resistance, a common blood sugar problem. According to this theory, hyperinsulinemia (excess insulin in the bloodstream, which occurs in response to high blood sugar levels) activates receptors for insulin growth factors. These, in turn, trigger the growth of keratinocytes and fibroblasts—the two cell types involved in inflammation, skin repair, and skin regeneration (González-Saldivar, 2017). 

Notably, insulin resistance can develop into prediabetes and eventually type 2 diabetes mellitus—an illness that appears to be associated with skin tags.

Another condition potentially linked to skin tags is human papillomavirus (HPV). Several studies have explored this association, including one small study that reported that, of the 20 people with skin tags examined, 50% of the lesions contained HPV (Dianzani, 2018). Other studies disagree with this finding (Woo, 2020)

Skin tags are common during pregnancy due to hormonal changes, particularly in the second trimester, but they tend to fade away after the pregnancy is over (Goldstein, 2021).

People with the rare inherited disorder, Birt-Hogg-Dube syndrome, tend to have many skin tags along with other skin and medical issues (Belgam Syed, 2021).

What are the treatment options for skin tags?

There’s usually no reason to have a skin tag removed unless the look or feel bothers you. But, if you want it gone, there are treatment options to consider.

Ideally, a dermatologist or specially trained medical professional will perform one of the following procedures after discussing the pros and cons of each approach with you. Things to consider include the size and location of the skin tag and the risk for scarring.

Popular treatments include (Belgam Syed, 2021):

  • Scissor (snip) excision: With this approach, a healthcare provider cuts off small skin tags using small scissors. As long as the skin tag is small, no anesthesia is needed to numb the area beforehand. 
  • Cryosurgery (freezing): Using a probe containing liquid nitrogen, a healthcare provider freezes the skin tag and painlessly removes it with a scalpel. Cryotherapy is considered a very effective way to remove many skin tags in one visit.
  • Shave excision: When the skin tag is on the larger side, a healthcare provider may recommend injecting the base with a local anesthetic and shaving or snipping away the tag.

Most of the time, unless there’s some question about the diagnosis, these procedures don’t involve a biopsy of the tissue and are simple, one-time office visits.

You may have heard about at-home approaches such as over-the-counter products that you apply at home to freeze the skin tag or many natural remedies your grandmother may swear by. However, it’s better to have a dermatologist or other healthcare professional guide you on options when removing a skin tag. This is important to make sure the lesion is an acrochordon (and not something else) and to minimize the risk of bleeding and infection.  

When to reach out to your healthcare provider

For most people, skin tags aren’t worth trying to get removed. But it’s a personal decision. Some simply want them gone because of the way they look or feel, and that’s fine.

Regardless, it’s always wise to pay attention to what’s happening in your body and on your skin. Reach out to your healthcare provider if you notice a skin tag starting to change notably in color or size.

References

  1. Belgam Syed, S. Y., Lipoff, J. B., & Chatterjee, K. (2021). Acrochordon. In: StatPearls [Internet]. [Updated Aug 11, 2021]. Retrieved on Sept. 30, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK448169/
  2. Dianzani, C., Paolini, F., Conforti, C., Silvestre, M., Flagiello, F., & Venuti, A. (2018). Human papillomavirus in skin tags: a case series. Dermatology Practical & Conceptual, 295–296. doi: 10.5826/dpc.0804a08. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30479858/
  3. Goldstein, A. O. (2021). Overview of benign lesions of the skin. In UpToDate. Dellavalle, R.P and Corona, R. (Eds.). Retrieved from https://www.uptodate.com/contents/overview-of-benign-lesions-of-the-skin
  4. González-Saldivar, G., Rodríguez-Gutiérrez, R., Ocampo-Candiani, J., González-González, J. G., & Gómez-Flores, M. (2016). Skin manifestations of insulin resistance: from a biochemical stance to a clinical diagnosis and management. Dermatology and Therapy, 7(1), 37–51. doi: 10.1007/s13555-016-0160-3. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27921251/
  5. Pandey, A. & Sonthalia, S. (2021). Skin tags. [Updated Aug 3, 2021]. In: StatPearls [Internet]. Retrieved on Sept. 30, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK547724/
  6. Woo, Y. R., Jung, Y., & Park, H. J. (2020). Lack of an etiologic role of human papillomavirus in the development of skin tags in the Korean population: a cross-sectional comparative study. Indian Journal of Dermatology, Venereology and Leprology, 86(5), 588–591. doi: 10.4103/ijdvl.IJDVL_1063_19. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32769308/