Medical Edge Newspaper Column

Skin Tags Best Dealt With By Medical Provider

June 27, 2008
Dear Mayo Clinic:
I frequently have patients in my pharmacy asking about skin tags. After ruling out malignancy, and other than excision, are there treatments that patients may be able to apply themselves in the home setting?

Answer:
People who have skin tags should not attempt home remedies. The treatments for skin tags are simple and often effective, but to avoid unnecessary health risks, they should be performed under the guidance of a physician.

Skin tags are small noncancerous (benign) skin growths. Usually, they are flesh-colored bumps of tissue connected to the skin's surface by a narrow stalk, although the color, texture, size and width of the base can vary.

Skin tags are frequently located on the neck, underarms, eyelids or within body folds, such as under the breasts or in the groin area. Friction can cause these growths. Common locations are areas where skin rubs on skin or against clothing.

Skin tags occur in almost half the population, most commonly in middle age. Most skin tags have no symptoms unless irritation results from repeated contact with jewelry or clothing, for example.

Although skin tags are harmless, some people choose treatment because of irritation or cosmetic concerns. Skin specialists (dermatologists) or family practice or internal medicine physicians usually diagnose and treat skin tags. Occasionally, an eye specialist (ophthalmologist) may need to remove a tag located very close to the eyelid.

A physician should make the diagnosis because other skin disorders can look like a skin tag. These include benign conditions such as moles, warts and seborrheic keratoses, as well as malignant skin cancers including melanomas. If a lesion looks suspicious, a physician may remove it for examination under a microscope by a pathologist to rule out malignancy.

The presence of multiple skin tags can signal an underlying hormonal or endocrine syndrome, such as polycystic ovary syndrome or acromegaly — another reason medical evaluation is always recommended prior to treatment.

Medical treatments for a benign skin tag include removal with surgical scissors, freezing with liquid nitrogen and electrical burning (cautery). If the skin tag is large or has a broad base, surgical removal is an option. Small tags are usually removed easily without anesthesia. Larger growths may require local anesthesia. For multiple tags, applying an anesthetic cream before the procedure may help.

Using surgical scissors offers immediate removal, but there's potential for minor bleeding. Freezing or burning the tag usually involves a short time before it falls off, and skin discoloration is a risk. With all treatment options, repeat treatments may be necessary if the tag doesn't fall off, if it grows back, or if new tags grow elsewhere.

Again, people should not self-treat skin tags. The most common home remedy is tying off the small tag stalk with a piece of thread or dental floss and allowing the tag to fall off over several days. Sometimes painful, this treatment attempts to constrict blood supply to the tag and cause it to die. Another typical home remedy is applying caustic salves, such as acids, over time. But, potentially, surrounding tissue can also be destroyed, causing discoloration, scarring or infection. Removal with scissors at home can cause bleeding and infection from contaminated scissors or contamination of the open wound.

The best medical advice for skin tags is to have a physician make the diagnosis and evaluation, as well as guide treatment.

— Katherine Lim, M.D., Dermatology, Mayo Clinic, Arizona