Skin tags on the neck are caused primarily by friction, whether from clothing, jewelry, or skin rubbing against itself. But friction alone doesn’t tell the whole story. Hormonal shifts, insulin resistance, weight, age, and possibly even viral infections all play a role in who gets them and how many appear.
These small, soft growths are noncancerous. They typically look like tiny flaps of skin hanging from a narrow stalk, usually between 1 and 5 millimeters across, though some grow to a few centimeters. They’re usually the same color as surrounding skin, though they can darken over time. Nearly half of all adults develop at least one skin tag at some point, and the neck is one of the most common locations.
Friction Is the Primary Trigger
The neck is a high-friction zone. Necklaces, collars, scarves, and lanyards create constant low-grade rubbing against the skin, and that repeated irritation encourages small growths to form. Even without accessories, the natural folds and creases of the neck create areas where skin contacts skin throughout the day, especially during movement.
This is why skin tags cluster in predictable spots: right along the neckline where a shirt collar sits, beneath where a chain rests, or in the creases where the neck meets the jaw or shoulders. If you’ve noticed your skin tags lining up with where a favorite necklace falls, that’s not a coincidence.
Hormones and Pregnancy
Hormonal changes can accelerate skin tag growth significantly. Pregnancy is one of the clearest examples. A 2019 study found a strong positive correlation between levels of leptin, a hormone secreted by fat tissue in both the pregnant person and the fetus, and the number of skin tags that developed. Leptin promotes the growth and multiplication of skin cells, which helps explain why skin tags can appear rapidly during pregnancy.
Estrogen also plays a role. Research has linked elevated estrogen levels to increased skin tag formation, and since estrogen rises dramatically during pregnancy, many women notice new skin tags appearing in the second and third trimesters. These often show up on the neck, under the arms, and beneath the breasts. Some shrink or fall off after delivery as hormone levels normalize, though many remain.
Insulin Resistance and Metabolic Health
Multiple skin tags, particularly on the neck, have been studied as a potential visible marker of metabolic problems. The connection to type 2 diabetes has been examined in several studies with mixed but notable results. One study of 110 patients with skin tags found that 52% had overt diabetes, compared to just 10% of controls without skin tags. Another study found that patients with more than 30 skin tags were at higher risk for diabetes specifically.
The underlying mechanism involves insulin. When the body becomes resistant to insulin, it compensates by producing more. Elevated insulin acts as a growth factor for skin cells, which may stimulate the formation of skin tags. This is why dermatologists sometimes view a cluster of new skin tags, especially on the neck, as a reason to check blood sugar levels. It’s not that skin tags cause diabetes or that having one means you’re diabetic. But a sudden crop of them, particularly combined with other risk factors, can be a useful signal worth investigating.
Age and How Common They Are
Skin tags become dramatically more common with age. In a study of 750 people, researchers tracked the prevalence of skin tags across different decades of life. Among teenagers, about 11% had them. By age 20 to 29, that rose to 28%. By the 40s, more than half of adults (55%) were carrying at least one skin tag, and prevalence plateaued around 59% from age 50 onward.
This pattern makes sense given what drives skin tag formation. Decades of accumulated friction, gradual changes in metabolism, and shifting hormone levels all compound over time. The plateau after 50 suggests there’s a ceiling effect: most people who are prone to them have already developed them by that point.
Genetics and Family History
Some people are simply more prone to skin tags than others, and genetics is part of the reason. If your parents developed skin tags, you’re more likely to as well. In rare cases, skin tags appear as part of a genetic condition called Birt-Hogg-Dubé syndrome, an inherited disorder involving a mutation in what’s believed to be a tumor suppressor gene. People with this condition develop multiple skin growths including skin tags. But for the vast majority of people, the genetic component is subtler: a general family tendency toward skin tags rather than a specific syndrome.
A Possible Viral Connection
One intriguing finding involves human papillomavirus, or HPV. A study published in the British Journal of Dermatology analyzed skin tag tissue from 49 patients and detected HPV DNA (types 6 and 11) in 88% of the samples. This suggests the virus may play a role in triggering or promoting skin tag growth, similar to its known role in other benign growths like laryngeal papillomas. This doesn’t mean skin tags are contagious or that everyone with skin tags has HPV, but it does point to viral activity as one potential contributing factor among many.
Are Neck Skin Tags Dangerous?
Skin tags are benign. It is extremely rare for a skin tag to become precancerous or cancerous. They don’t need to be removed for medical reasons unless they’re causing discomfort, catching on clothing or jewelry, or bleeding from friction. Many people choose to have them removed for cosmetic reasons, and a dermatologist can do this quickly through freezing, snipping, or cauterization.
The one thing worth paying attention to is change. If a skin tag shifts in color, shape, or size, or if it looks different from your other skin tags, it’s worth having a dermatologist examine it. Occasionally, what looks like a skin tag turns out to be a different type of growth. But in the vast majority of cases, a skin tag is nothing more than a harmless nuisance.