Yes, PCOS can cause skin tags, though the link is indirect. The real driver is insulin resistance, which affects up to 70% of women with PCOS. When insulin levels stay chronically high, the hormone acts as a growth signal that triggers excess skin cell production, leading to the small, soft growths known as skin tags. Studies estimate that roughly 9% to 16% of women with PCOS develop them.
How High Insulin Triggers Skin Tags
Skin tags aren’t caused by PCOS itself but by the metabolic environment PCOS creates. The key player is hyperinsulinemia, the state of having persistently elevated insulin in your blood. In PCOS, your cells become less responsive to insulin, so your pancreas compensates by pumping out more of it. That extra insulin doesn’t just regulate blood sugar. It also activates growth factor receptors on two types of skin cells: keratinocytes (the cells forming your outer skin layer) and fibroblasts (the cells producing connective tissue underneath).
Specifically, excess insulin increases circulating levels of a compound called IGF-1, which binds to receptors on both cell types and tells them to multiply. At the same time, it suppresses a protein that normally keeps cell growth in check. The result is a small overgrowth of both skin layers, forming a soft, fleshy bump that hangs from a narrow stalk. This is why skin tags are considered a visible marker of insulin resistance, not just a cosmetic nuisance.
Where They Typically Appear
Skin tags in women with PCOS show up in the same places they do in anyone else: areas where skin folds and rubs against itself. The neck and armpits are the most common locations by far. The groin, under the breasts, and around the eyelids are also frequent sites. Tags in these areas tend to be small, just 1 to 2 millimeters, though larger pedunculated growths can develop in the groin or armpit and cause discomfort from friction with clothing.
The Link to Body Weight
Research consistently shows that skin tags in PCOS are closely tied to weight. In one clinical study of women with the condition, skin tags appeared almost exclusively in those who were overweight or obese, a finding that reached strong statistical significance. This makes sense biologically: higher body fat reduces your cells’ sensitivity to insulin, forcing the pancreas to produce even more of it. The more insulin circulating, the stronger the growth signal reaching your skin cells. Women with PCOS who are at a healthy weight can still develop skin tags, but it’s far less common.
Skin Tags and Acanthosis Nigricans
If you have PCOS-related skin tags, you may also notice patches of darkened, velvety skin in the same areas, particularly the neck, armpits, and groin folds. This is acanthosis nigricans, and it develops through the exact same insulin-driven mechanism. Both conditions are triggered by IGF-1 stimulating skin cell overgrowth, and both are considered visible flags for insulin resistance. In clinical settings, the presence of either one prompts screening for metabolic problems like type 2 diabetes and abnormal cholesterol levels. Having both together strengthens that signal considerably.
Removal and Prevention
Skin tags are benign and don’t need to be removed for medical reasons. But if they’re bothersome, cosmetically unwanted, or irritated by jewelry or clothing, a dermatologist can remove them quickly. Small tags are typically snipped, frozen with liquid nitrogen, or cauterized in a single office visit. The procedure is minor and healing takes a few days to a week depending on the location and size.
The catch is that removal doesn’t address the underlying cause. If insulin levels remain high, new skin tags will likely form in the same friction-prone areas. This is why managing the metabolic side of PCOS matters more than removing individual tags. Weight loss of even 5% to 10% of body weight can meaningfully improve insulin sensitivity. Dietary changes that reduce blood sugar spikes, regular physical activity, and in some cases medications that improve insulin function all help lower the growth signals reaching your skin. Women who successfully reduce their insulin resistance often notice that new skin tags stop appearing, even if existing ones don’t shrink on their own.
What Skin Tags Tell You About Your PCOS
Skin tags are one of the less common skin features of PCOS compared to acne, excess hair growth, or hair thinning. But their presence carries a specific message: your insulin resistance is likely significant enough to be driving visible changes in your body. They’re not part of the formal diagnostic criteria for PCOS, but they serve as a practical, no-cost clue that your metabolic health deserves closer attention. If you’re developing skin tags in your 20s or 30s, especially alongside darkened skin folds, it’s worth having your fasting insulin and blood sugar levels checked rather than treating the tags as a purely cosmetic issue.