When should you worry about skin tags?

Skin tags are extremely common, occurring in approximately 50% of adults, but when should you worry about them or look into removal options? We ask a consultant dermatologist for advice.

Despite what the youth-obsessed mass media may tell you, getting older has myriad benefits - not least the feeling that (at long last) one is comfortable in one's own skin. Metaphorically, at least.

The ageing process has its downsides, of course, the majority of them health-related. Skin tags, for example, tend to appear when people are north of their half-century, and are extremely common, occurring in approximately 50% of adults.

The number of these small growths that may develop varies from one to hundreds, and they can also differ in size.

Unsightly and irritating they may be, but, thankfully, skin tags are also painless and non-cancerous - and therefore harmless to everything except (perhaps) your self-esteem.

What are skin tags?

Often suspended on a slender stalk, these smooth, soft, skin-coloured skin lesions are frequently found on the neck, armpits, around the groin, under the breasts and on eyelids, and consist of loose collagen (protein) fibres and blood vessels surrounded by skin.

They can vary in colour and size from a few millimetres up to 5 cm (about 2 in) wide, and unlike, say, warts, are non-contagious.

"Skin tags are benign lesions," says Dr Zainab Laftah, a consultant dermatologist and spokesperson for the British Skin Foundation. "They do not cause any pain or discomfort, unless at sites of friction, where they may become inflamed."

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Research into possible causes

The precise cause of skin tags is unknown. However, because they tend to grow at sites where the skin rubs against itself, they more commonly affect overweight people, who may have excess folds of skin and suffer from skin chafing.

According to a 2008 study in India that analysed 37 skin tags from different parts of the body, the human papillomavirus (HPV) may be a factor, with the results showing HPV DNA in almost 50% of the skin tags examined.

Skin tags affect men and women equally; however, the risk of developing them increases during pregnancy. This is thought to be due to hormonal changes and increased levels of growth factors. In rare cases, multiple tags can be a sign of a hormone imbalance or an endocrine problem.

People with high resistance to insulin (the major factor underlying type 2 diabetes) are also more at risk. This theory was borne out by a 2010 study in Brazil, which found that the presence of multiple skin tags was associated with insulin resistance, a high body mass index (BMI), and high triglycerides.

Can I remove skin tags myself?

In general, skin tags don’t require treatment, and smaller ones may simply rub off on their own. However, you may consider having them removed for either cosmetic reasons or if they snag on clothing or jewellery.

A range of removal products and techniques is available on the high street and online, but, according to Laftah, there are significant risks associated with trying to remove skin tags yourself.

"Removal, particularly of large skin tags, should not be attempted at home due to the risks of infection and bleeding," she says. "There is also a risk of scarring and recurrence."

Some removal kits aim to cut off the supply of blood to the base of the tag with a tiny band, a process called ligation. The idea is that, without a supply of blood, the cells will die and the tag will fall off, usually within 10 days.

Kits containing cream and an applicator are also available. Some recommend cleaning the skin with an alcohol wipe and filing down the tag before applying the cream, to ensure it is fully absorbed. The cream may cause a mild stinging sensation; the tags should fall off within 2-3 weeks.

Certain skin tag removal products also contain liquid nitrogen. The patient should avoid spraying these on to surrounding skin and may want to apply petroleum jelly around the tag for protection. Several applications may be necessary before the growth falls away (again, usually within 10 days).

Surgical removal procedures

Remember: you should always seek expert medical advice if you are concerned about a skin tag or any other skin lesion.

If you have decided to have a skin tag removed, several straightforward procedures are available, but be aware that this is regarded as cosmetic surgery, and is rarely available through the NHS.

"Skin tags are easily treated with common removal procedures such as cauterisation (burnt off), cryotherapy (frozen off) or excision (cut out)," says Laftah. "These procedures should be carried out by a trained medical professional. The potential risks include infection, bleeding, scarring and recurrence.

"It is advisable to see your GP or a dermatologist if a skin tag starts to increase in size, becomes painful and/or bleeds, or you suddenly develop multiple skin tags."

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