Cutaneous skin tag

A cutaneous skin tag is a small, noncancerous growth that hangs from the skin. It is usually attached by a thin piece of tissue called a stalk. Skin tags are often soft and flesh-coloured, although they can be darker than the surrounding skin.

They commonly develop in areas where skin rubs against skin, jewellery, or clothing. Typical locations include the neck, armpits, groin, under the breasts, and around the eyelids. A person may have one skin tag or many.

Skin tags are harmless and do not usually need treatment. They matter mainly because they can catch on clothing, become irritated, affect vision when near an eyelid, or cause concern about their appearance.

Several other skin growths can resemble a skin tag. These include moles, warts, and some skin cancers. A new or changing growth should not automatically be assumed to be a skin tag, especially if it has unusual colour, rapid growth, an irregular shape, or repeated bleeding.

Most skin tags cause no symptoms. They are often noticed while washing, dressing, shaving, or looking in a mirror.

A typical skin tag is:

• Soft and easy to move
• Smooth or slightly wrinkled
• Flesh-coloured, brown, or occasionally darker
• Attached to the skin by a narrow stalk
• A few millimetres across, although some become larger

Skin tags can become sore when they rub against a collar, bra strap, waistband, or jewellery. Shaving may cut them and cause bleeding. A tag on an eyelid can sometimes interfere with vision or irritate the eye.

Occasionally, a skin tag twists on its stalk. This can interrupt its blood supply, causing it to become painful, swollen, dark red, purple, or black. The tag may eventually dry up and fall off, but a painful or suddenly dark growth should be assessed if its identity is uncertain.

Skin tags do not normally cause a rash, pus, a spreading area of redness, or ongoing pain. Those features may point to irritation, infection, or another skin condition.

The exact process that causes skin tags is not fully understood. Friction is thought to contribute, which helps explain why tags often appear in skin folds and areas where clothing rubs.

They become more common with age and may run in families. Hormonal and body changes during pregnancy can also make skin tags more likely to develop.

Skin tags are associated with overweight and obesity, probably because skin folds create more areas of friction. Research has also found associations with insulin resistance, type 2 diabetes, and metabolic syndrome. Insulin resistance means the body does not respond to insulin as effectively as expected. An association does not mean that every person with skin tags has diabetes or that a skin tag causes diabetes.

Skin tags are not caused by poor hygiene. They are not contagious, and they cannot be passed to another person through touch, towels, sexual contact, or shared spaces.

A healthcare professional can usually identify a skin tag by examining it. The location, soft texture, shape, and narrow stalk often make the diagnosis clear. Blood tests and scans are not normally needed.

A magnifying instrument called a dermatoscope may be used to examine details beneath the skin's surface. This can help distinguish a skin tag from a mole, wart, or another growth.

If the appearance is unusual or the diagnosis remains uncertain, the growth may be removed and sent for a biopsy. During a biopsy, a laboratory examines the tissue under a microscope. This can confirm what the growth is and check for abnormal cells.

Having several skin tags does not automatically mean that testing for diabetes is needed. A clinician may consider routine metabolic screening based on the overall picture, including age, weight, family history, symptoms, and other risk factors.

A skin tag that is not painful or troublesome can usually be left alone. It does not need treatment to prevent cancer, because a confirmed skin tag is benign, meaning noncancerous.

Removal may be considered if a tag repeatedly catches, bleeds, becomes irritated, affects vision, or causes significant concern about appearance. Depending on its size and location, a trained healthcare professional may remove it by:

• Cutting it off with sterile surgical scissors or a blade
• Freezing it with liquid nitrogen, called cryotherapy
• Sealing and removing it with heat or electrical energy

Local anaesthetic may be used to numb the area, especially for a larger tag. Small tags may be treated without it. Minor discomfort, a small wound, or brief bleeding can occur. Healing time depends on the method, size, and location.

Removal may leave a small scar or an area that is lighter or darker than the surrounding skin. Freezing can sometimes require more than one treatment. Removing one tag does not prevent new tags from developing elsewhere.

Home removal is not recommended. Cutting or burning a growth can cause heavy bleeding, infection, scarring, and injury to nearby tissue. Products marketed for warts or skin tags can damage normal skin and should not be used near the eyes or other sensitive areas. Home treatment can also delay assessment of a growth that is not actually a skin tag.

Tying off a skin tag to stop its blood supply also carries risks, particularly if the growth is large, broad-based, infected, or incorrectly identified. Professional assessment is safer when removal is wanted.

Skin tags themselves rarely cause medical complications. The most common problems come from repeated rubbing, twisting, shaving, or attempts at removal.

Possible complications include:

• Irritation, tenderness, or inflammation
• Bleeding after the surface is cut or torn
• Twisting that interrupts the tag's blood supply
• Infection after injury or unsterile removal
• Scarring or skin-colour changes after treatment

The main diagnostic risk is mistaking another type of growth for a skin tag. Skin cancers do not normally arise from an ordinary skin tag, but a cancerous or precancerous growth may occasionally resemble one. Changes such as rapid enlargement, an irregular border, several colours, an open sore, or repeated unexplained bleeding need assessment.

There is no reliable way to prevent every skin tag. Age, inherited tendency, pregnancy, and other biological factors cannot be changed.

Reducing repeated friction may help limit irritation and could reduce some new tags, although this is not guaranteed. Comfortable clothing, well-fitting undergarments, and avoiding jewellery that repeatedly catches the skin may help.

Weight management may reduce skin-fold friction for some people, but it cannot guarantee that skin tags will stop forming. Skin tags should not be treated as proof that a person needs to lose weight.

Routine skin care and washing do not prevent skin tags. They are not caused by dirt or inadequate hygiene.

A skin tag may remain the same size for years, grow slowly, or become irritated from time to time. Some fall off after twisting or losing their blood supply, but many remain unless they are removed.

Skin tags do not spread from one area to another like an infection. However, new tags may develop over months or years because the factors that encourage them can continue. This is not the same as a removed tag growing back, although a new one may appear close to the previous site.

Most people can work, exercise, bathe, and have close contact with others without restrictions. A tag can be covered with clothing if that makes it less likely to catch, but adhesive dressings may irritate the surrounding skin if used continuously.

It can be useful to notice how a skin growth normally looks. A photograph with the date may help track change, especially in a place that is difficult to see. Avoid repeatedly squeezing or picking at it.

After professional removal, follow the wound-care instructions provided. Temporary soreness and a small scab may occur. Seek advice if the area becomes increasingly painful, hot, swollen, or produces pus.

Arrange a routine appointment if a skin growth is new and its identity is uncertain, or if it is causing repeated irritation. Assessment is also appropriate if removal is wanted because it catches on clothing, affects vision, or causes distress.

Make a prompt appointment if a presumed skin tag:

• Grows quickly or changes noticeably
• Has an irregular shape or several colours
• Becomes persistently painful
• Develops an open sore
• Bleeds repeatedly without being caught or cut
• Feels firm or has a broad base rather than a soft stalk

Get urgent medical help if bleeding continues despite firm, steady pressure with clean gauze or cloth. Urgent assessment is also appropriate for spreading redness, worsening swelling, pus, fever, or severe pain after injury or attempted removal.

A skin tag is not usually an emergency. Sudden collapse, breathing difficulty, or other unrelated severe symptoms should be handled as emergencies in the usual way rather than attributed to a skin tag.

Are skin tags cancerous?

A confirmed skin tag is noncancerous and does not normally turn into skin cancer. However, not every hanging or raised growth is a skin tag. A changing, irregular, ulcerated, or repeatedly bleeding growth should be examined.

Why am I suddenly getting lots of skin tags?

New tags may appear with age, pregnancy, weight changes, increased skin friction, or an inherited tendency. Multiple tags are also associated with insulin resistance, but they do not confirm diabetes. A clinician can consider whether routine testing is appropriate based on other risk factors.

Can I cut a skin tag off myself?

This is not recommended. It may bleed more than expected, become infected, or leave a scar. More importantly, a growth that looks like a skin tag may be something else. Removal near the eye, genitals, or major blood vessels is particularly risky.

Will a skin tag grow back after removal?

A completely removed tag usually does not grow back. New tags can appear in the same general area or elsewhere, so removal is not a permanent way to prevent all future skin tags.

Are skin tags contagious?

No. They are not caused by an infection and cannot be passed through touching, sex, shared towels, or swimming pools.

Do skin tags mean I have diabetes?

No. Skin tags can occur in people with or without diabetes. Multiple skin tags have been linked with insulin resistance in some studies, but diagnosis of diabetes requires appropriate blood testing and consideration of other health factors.