Clipping Those Gnarly Skin Tags

Although benign and easily removed, skin tags often accompany diabetes.

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Skin tags (aka acrochordon) are gnarly bits of flesh which serve no purpose other than to annoy us and blemish our beautiful skin. One population study tagged 48 percent of the population as carriers of these lesions. People who are overweight are particularly susceptible to the formation of skin tags. Skin tags increase in frequency through your 50s, and as many as 59 percent of septuagenarians (people in their 70s) have them.

Although most insurers refuse to cover the cost, skin tags can be easily removed by a primary care physician in an outpatient setting. However, skin tags often accompany a far more serious problem: type 2 diabetes.

What Are Skin Tags?

Skin tags are usually small and typically located on the neck and armpit area; however, they can call other parts of the body home including the back, trunk, abdomen, and various skin folds. Although the occasional "tagzilla" might rear its ugly pedunculated head, skin tags are either dark or flesh colored and no larger than 5 mm. Skin tags are usually painless but can become irritated if they were to catch on clothing or jewelry. Skin tags come in three flavors:

  • small bumps about 1 or 2 mm in width and height
  • thread-like lesions about 2 mm in length
  • bag-like (pedunculated) lesions that occur on the lower back

Nobody knows why skin tags form, but hormones, growth factors, and infection may all play a part.

Although skin tags can be confused with warts, neurofibromas or nevi (moles), most physicians are quick to identify these unsightly little skin stickers. Very rarely are skin tags cancerous, and the vast majority of them require no biopsy.

Skin Tag Removal

Many people want their skin tags gone because they look bad or irritate them in some way.

Here are some ways that skin tags are removed:

  • Small skin tags can be snipped off with a pair of iris scissors—no lidocaine or local anesthesia needed.
  • Larger skin tags can be shaved off (shave excision) after application of local anesthesia.
  • Skin tags can be frozen off using cryotherapy. For example, a physician can dip the tip of a pair of forceps in liquid nitrogen and grab the lesion until it turns white. If you have a lot of skin tags, this quicker option works well.
  • Electrodesiccation involves the use of electrical current to dry out the skin tag and can be used for small skin tags which are too small to be grabbed with forceps.
  • A more experimental means of removal involves application of skin patch which was found 65 percent effective in one case series.

Should a removed skin tag bleed, a cotton tip applicator impregnated with aluminum chloride can be applied in order to stop the bleeding.

Diabetes and Skin Tags

In and of themselves, skin tags are benign. However, skin tags can be indicative of type 2 diabetes, a much more sinister and insidious condition.

If you're overweight, have skin tags and haven't seen a physician in some time, you may want to see a primary care physician to not only remove your skin tags but also, more importantly, to test (and treat) you for diabetes. 

In one Taiwanese study, 313 residents aged 65 and older at a veterans home were surveyed for various skin changes associated with diabetes. Of those with diabetes, 22.9 percent had skin tags versus 14 percent who had skin tags and no diabetes.

More generally, various other skin changes are associated with diabetes including chronic ulcers and acanthosis nigricans or darkened and thickened skin around the neck, thighs, and vulva. 

On a final note, although you may figure that removing skin tags is as simple as grabbing a pair of scissors from the cupboard drawer, it isn't. First, the removal of skin tags should be performed by a trained health care professional who can do so in a sterile environment. Second, skin tags often accompany diabetes, a much more serious problem which requires medical attention.


Article titled "High prevalence of cutaneous manifestations in the elderly with diabetes mellitus: an institution-based cross-sectional study in Taiwan" by HW Tseng and co-authors published in JEADV in 2014.

Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr.. Chapter 157. Skin Tag. In: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr.. eds. The Color Atlas of Family Medicine, 2e. New York, NY: McGraw-Hill; 2013.

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