Skin tags, known medically as acrochordons, are common, small, and benign growths. They are soft, flesh-colored or slightly brown protrusions connected to the skin by a thin stalk called a peduncle. Estimates suggest that between 46% and 60% of the adult population will develop at least one skin tag. While these growths are harmless and non-cancerous, many seek removal due to irritation from clothing or for cosmetic reasons. The main concern is whether the growth will reappear after treatment.
Understanding Skin Tags
Acrochordons are classified as fibroepithelial polyps, which are benign tumors composed of normal skin elements. A skin tag consists of a fibrovascular core, including collagen fibers, blood vessels, and sometimes fat cells, covered by the epidermis (outer layer of skin). They are typically small, ranging from 1 to 5 millimeters, though they can occasionally grow up to several centimeters.
These soft growths most often occur in areas where skin folds or creases exist, leading to skin-on-skin rubbing or friction with clothing. Common locations include the neck, armpits, groin, under the breasts, and on the eyelids. While usually painless, a skin tag can become irritated, inflamed, or bleed if snagged by jewelry or clothing.
Factors That Cause Skin Tag Formation
The primary theory for skin tag development centers on mechanical friction, explaining why they are found in skin folds. Constant rubbing irritates the area and stimulates skin cells (keratinocytes and fibroblasts) to overgrow and form the protrusion. This physical irritation is considered a major local trigger.
Beyond friction, skin tags are associated with several systemic health conditions, suggesting a metabolic component. A link exists with insulin resistance, a precursor to Type 2 diabetes and a feature of metabolic syndrome. High levels of insulin and insulin-like growth factor (IGF-1) stimulate the growth of skin cells and increase collagen production, leading to skin tag formation.
Obesity is another risk factor, as excess body weight increases the number and size of skin folds, thereby increasing friction. Genetic predisposition also plays a role; individuals with a family history of skin tags are more likely to develop them. Hormonal changes, such as those during pregnancy, can also increase the likelihood of new growths, possibly due to elevated levels of estrogen and progesterone.
Do Skin Tags Recur After Removal?
The answer to whether a skin tag grows back depends on the definition of “recurrence.” The specific, individual skin tag that has been professionally removed will not regrow. Once the lesion’s tissue is excised, cauterized, or frozen, the cells that made up that growth are permanently destroyed.
However, individuals prone to developing skin tags may observe new growths appearing in the same general area or elsewhere. This is because the underlying causal factors, such as persistent skin friction, genetic susceptibility, or metabolic issues like insulin resistance, have not been addressed. The removed tag is gone, but the conditions that created it still exist, setting the stage for a new fibroepithelial polyp to form nearby.
The likelihood of new tags forming is higher if contributing factors like obesity or hormonal imbalance continue. If a skin tag is not completely destroyed during removal, a small remnant of tissue could lead to the formation of a new lesion. Therefore, a thorough removal procedure performed by a medical professional is important to minimize the chance of new growths developing at the exact site.
Professional Removal Techniques
Dermatologists use several safe and effective methods to ensure the complete removal of skin tags, preventing regrowth of the original lesion. These procedures are typically performed in an office setting and aim to destroy the entire fibrovascular core and stalk. Attempting home removal is not recommended due to the risk of infection, scarring, and incomplete treatment.
Cryotherapy
Cryotherapy involves applying liquid nitrogen to the skin tag. The intense cold freezes the tissue, causing the cells to die; the tag eventually scabs over and falls off within one to three weeks. This technique is quick and ideal for small to medium-sized lesions.
Cauterization and Excision
Cauterization, also known as electrosurgery, uses a heated probe or electric current to burn off the skin tag at its base. The heat immediately destroys the tissue and helps control bleeding, making it a precise removal method. For larger or thicker skin tags, surgical excision is used, where the growth is cut away with a sterile scalpel or surgical scissors. This method ensures complete removal and is performed after applying a local anesthetic.