Skin tags

A skin tag (acrochordon) is a small, soft, skin-coloured or slightly darker growth that hangs from the skin on a narrow stalk. They are benign, very common, and harmless.

Skin tags typically appear where skin rubs against skin or clothing: the neck, underarms, under the breasts, the groin, and the eyelids. They range from a couple of millimetres to around a centimetre.

Why they form

• Friction - the common factor in most sites where they appear
• Age - they become more common from middle age onwards
• Genetics - they run in families
• Weight - more skin-on-skin contact means more friction
• Pregnancy - hormonal change and skin stretching; some resolve afterwards
• Insulin resistance and type 2 diabetes - multiple skin tags appearing in a short period can be worth mentioning to your GP

Reasons people have them removed

• They catch on clothing, jewellery or a razor, and become sore or bleed
• They are rubbed by a bra strap, collar or waistband
• They sit on the eyelid and are irritating
• Appearance

Removal is elective. There is no medical requirement to remove a skin tag that is not bothering you.

Assessment first

Skin tags are usually recognisable, but several other lesions can resemble one - benign moles, seborrhoeic keratoses, neurofibromas, and occasionally a skin cancer presenting as a raised lump. A lesion that is pigmented, firm, growing, ulcerated or bleeding without being caught on anything is examined properly before any decision about removal.

Where a lesion is not clearly a simple skin tag, it is excised and sent to pathology rather than destroyed - because burning or freezing leaves nothing to test.

How skin tags are removed

All methods are performed under local anaesthetic where needed, at our Malvern East clinic.

Radiofrequency (electrosurgery)

The most common method for skin tags. High-frequency energy removes the tag at its base and seals the small vessel in the stalk, so bleeding is minimal. No stitches. See electrosurgery.

Snip excision

The tag is cut off at the base with fine surgical scissors. Quick, and suitable for tags on a thin stalk.

Cryotherapy

Liquid nitrogen freezes the tag, which then darkens and falls off over one to two weeks. Suitable for some sites, though it carries a higher chance of leaving a pale mark. See cryotherapy.

Multiple tags can usually be treated in one appointment. Most people return to normal activity immediately.

Why not to remove one at home

Cutting, tying off with thread, or using an over-the-counter freezing or acid product carries real problems:

• A lesion that was not a skin tag goes undiagnosed
• Infection from unsterile instruments
• Bleeding that is harder to stop than expected
• Incomplete removal and regrowth
• A worse scar than a clean removal would have left
• Chemical burns to surrounding skin from acid preparations

Skin tags near the eye should never be treated at home.

Aftercare

• Keep the site clean and dry; follow any dressing instructions
• Do not pick at the scab - let it separate on its own
• Avoid friction on the area while it heals: loose clothing, no tight straps
• Protect the site from sun, and use sunscreen once healed
• Watch for increasing redness, swelling, pain or discharge and contact us if they occur

Healing generally takes one to two weeks.

What results are realistic

The treated tag is gone. Most sites heal with little visible mark, though a small flat pale or pink patch can remain.

Removal does not stop new skin tags forming elsewhere, because the causes - friction, genetics, age - are unchanged. Some people have them removed periodically. Individual results vary.

Risks

• A small scar or mark at the site
• Changes in pigmentation, lighter or darker, sometimes persistent
• Bleeding
• Infection
• Incomplete removal or regrowth at the site
• New skin tags elsewhere
• Discomfort during and after the procedure
• Missed diagnosis where a lesion is destroyed rather than examined

See risks and complications.

Cost

Cost depends on the number of tags and the method. As at September 2024 and including GST, a consultation with a Cosmetic Doctor is $150. Removal for cosmetic reasons is not covered by Medicare; removal of a lesion that is medically indicated may attract a rebate.

Booking

Me Clinic, 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511, or use the online consultation form.

Related: skin lesions, seborrhoeic warts, mole removal, all skin conditions.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.