Skin Tag - Western SummaryWestern Medicine Summary

Western Medicine

Western Summary

Skin tags are also called acrochordons or fibroepithelial polyps. They are present in nearly 50% of the population and are benign growths that develop over skin creases such as around the neck, eyelids, armpits, under the breasts, and the groin.[2] They are usually harmless unless they are irritated when rubbed or scratched by jewelry, shaving, or clothing.

Symptoms

Skin tags are fleshy and soft projections of skin with a narrow stalk. Skin tags are typically small, like the size of a grain of rice, but some can be over 10 cm in diameter.[1] Irritated skin tags can cause itching, pain, bleeding and occasionally become infected.

Causes

Skin tags develop due to many factors: 

  • Friction: Since skin tags tend to form over areas with frequent rubbing such as skin folds, it is believed that they form and grow because of friction.[3] 
  • Metabolic diseases: Skin tags are more common in middle-aged, overweight, and diabetic adults. Skin tag development is closely associated with metabolic syndrome,[4] where sugar and fat metabolism is abnormal.[5] Along the same line, insulin resistance is associated with colon polyps, diabetes and obesity. This may explain why people with skin tags are also more likely to have colon polyps.[6] 
  • Hormones: Hormones, such as estrogen, may cause skin tag formation,[7] which may explain why they are more common in pregnant women.[8] 
  • Genetics: There is likely a genetic cause to skin tags since they are more prevalent in relatives.[9] Every once in awhile, skin tags can be associated with polycystic ovarian syndrome,[10] and other genetic syndromes, such as acromegaly[11] and Birt-Hogg-Dube syndrome.[12]

Treatments

Skin tags are benign and do not require medical treatment unless they are irritated, or when cosmetics is a concern. There are no creams that have been shown to eliminate skin tags. There are several treatments that can be useful and should be discussed with a medical provider:[3,13]

  • Cryotherapy: This treatment involves freezing the skin tags with liquid nitrogen. 
  • Cautery: The skin tag can be directly burned. This leaves a small wound that will heal with a small scar in the area of treatment. 
  • Scissor based removal: This skin tag can be clipped off with scissors after the skin is numbed. This leaves behind a small wound that will heal on its own.
  • Ligation (tying off the base): A suture or copper wire is tied around the stalk of the skin tag to shut off the blood supply. This should only be performed after consulting with a licensed medical provider.

Diet/Exercise: Healthy diet, exercise and weight loss can be helpful in reducing skin tag formation and growth.[8] There are no specific diets that have been shown to reverse skin tags after they have formed.

1.    Ilango N, Jacob J, Gupta AK, et al. Acrochordon--a rare giant variant. Dermatol Surg.2009;35(11):1804-1805; PMID: 19732115.

2.    Banik R, Lubach D. Skin tags: localization and frequencies according to sex and age. Dermatologica.1987;174(4):180-183; PMID: 3582706.

3.    Allegue F, Fachal C, Perez-Perez L. Friction induced skin tags. Dermatol Online J.2008;14(3):18; PMID: 18627719.

4.    Akpinar F, Dervis E. Association between acrochordons and the components of metabolic syndrome. Eur J Dermatol.2012;22(1):106-110; PMID: 22063265.

5.    Shah R, Jindal A, Patel N. Acrochordons as a cutaneous sign of metabolic syndrome: a case-control study. Ann Med Health Sci Res.2014;4(2):202-205; PMID: 24761238.

6.    Oran M, Erfan G, Mete R, et al. Association of colon adenomas and skin tags: coincidence or coexistence? Eur Rev Med Pharmacol Sci.2014;18(7):1073-1077; PMID: 24763889.

7.    El Safoury O, Rashid L, Ibrahim M. A study of androgen and estrogen receptors alpha, beta in skin tags. Indian J Dermatol.2010;55(1):20-24; PMID: 20418971.

8.    Kumari R, Jaisankar TJ, Thappa DM. A clinical study of skin changes in pregnancy. Indian J Dermatol Venereol Leprol.2007;73(2):141; PMID: 17458033.

9.    Rasi A, Soltani-Arabshahi R, Shahbazi N. Skin tag as a cutaneous marker for impaired carbohydrate metabolism: a case-control study. Int J Dermatol.2007;46(11):1155-1159; PMID: 17988334.

10.    Lowenstein EJ. Diagnosis and management of the dermatologic manifestations of the polycystic ovary syndrome. Dermatol Ther.2006;19(4):210-223; PMID: 17004997.

11.    Ben-Shlomo A, Melmed S. Skin manifestations in acromegaly. Clin Dermatol.2006;24(4):256-259; PMID: 16828406.

12.    Palmirotta R, Savonarola A, Ludovici G, et al. Association between Birt Hogg Dube syndrome and cancer predisposition. Anticancer Res.2010;30(3):751-757; PMID: 20392993.

13.    Schwartz RA. Acrochordon Treatment & Management. Medscape.com. Updated August 18, 2015. Accessed January 18, 2016.