Skin Polyp (Skin Tag)

Overview

Skin polyps, commonly known as skin tags or acrochordons, are small, benign growths that hang from the skin by a thin stalk called a peduncle. These harmless growths are extremely common, affecting approximately 46% of the general population, with prevalence increasing with age. While they can appear anywhere on the body, skin tags most frequently develop in areas where skin rubs against skin or clothing.

These soft, flesh-colored or slightly darker growths typically measure between 2-5 millimeters in diameter, though some can grow larger, occasionally reaching up to 5 centimeters. Skin tags are composed of loose collagen fibers and blood vessels surrounded by skin. They are considered a type of benign tumor, meaning they are non-cancerous and do not pose any health risks.

Although skin tags are harmless and painless in most cases, they can become irritated when caught on clothing, jewelry, or during shaving. Many people choose to have them removed for cosmetic reasons or when they cause discomfort. The medical term "acrochordon" comes from the Greek words "akron" (extremity) and "chorde" (cord), describing their characteristic appearance as small pieces of skin attached by a narrow stalk.

Symptoms of Skin Polyps

Skin polyps are typically asymptomatic, meaning they don't cause symptoms beyond their physical presence. However, their appearance and associated features can vary considerably.

Primary Characteristics

Associated Symptoms

Physical Characteristics

• Size: Usually 2-5mm, but can grow up to 5cm
• Color: Flesh-colored, brown, or slightly darker than surrounding skin
• Texture: Soft and smooth, sometimes wrinkled
• Shape: Round or oval, attached by a thin stalk
• Number: Can occur singly or in groups
• Location: Most common in skin folds and areas of friction

Common Locations

• Neck and upper chest
• Underarms (axillae)
• Groin and genital area
• Eyelids
• Under breasts
• Buttock folds

Causes of Skin Polyps

The exact cause of skin polyps isn't fully understood, but research has identified several factors that contribute to their development. They appear to result from a combination of genetic predisposition, friction, and metabolic factors.

Primary Mechanisms

Friction and Skin Rubbing

The most widely accepted theory is that skin tags develop in response to repeated friction. This explains why they commonly appear in skin folds and areas where skin rubs against skin or clothing. The constant irritation may trigger the overgrowth of skin cells, leading to tag formation.

Collagen and Blood Vessel Clusters

Histologically, skin tags consist of:

• Loose collagen fibers
• Blood vessels
• Epidermis (outer skin layer)
• Sometimes fat cells

Contributing Factors

Hormonal Changes

Hormonal fluctuations appear to play a role in skin tag development:

• Pregnancy: Increased estrogen and progesterone levels
• Growth hormones: May stimulate skin cell proliferation
• Sex hormones: Changes during puberty or menopause

Insulin Resistance

Studies have shown a strong association between skin tags and insulin resistance. The presence of multiple skin tags may indicate:

• Prediabetes or type 2 diabetes
• Metabolic syndrome
• Hyperinsulinemia

Genetic Predisposition

Skin tags often run in families, suggesting a hereditary component. Certain genetic conditions associated with increased skin tag formation include:

• Birt-Hogg-Dubé syndrome
• Polycystic ovary syndrome (PCOS)
• Acromegaly

Associated Medical Conditions

Several conditions are associated with increased skin tag formation:

• Obesity: Increased skin folds and friction
• Diabetes: Insulin resistance and metabolic changes
• Human papillomavirus (HPV): Some studies suggest a possible link
• Dyslipidemia: Abnormal lipid levels
• Hypertension: Often coexists with metabolic syndrome

Risk Factors

While skin tags can affect anyone, certain factors significantly increase the likelihood of developing them.

Age

Skin tags become increasingly common with age:

• Rare in children and young adults
• Prevalence increases after age 40
• Peak incidence in the 5th and 6th decades of life
• Affect up to 59% of adults by age 70

Weight and Body Composition

• Obesity: Higher BMI correlates with increased skin tag formation
• Weight gain: Rapid weight changes increase risk
• Increased skin folds: More areas of friction

Medical Conditions

• Diabetes mellitus
• Insulin resistance
• Metabolic syndrome
• Polycystic ovary syndrome
• Cardiovascular disease

Hormonal Factors

• Pregnancy: Especially second and third trimesters
• Menopause: Hormonal changes
• Endocrine disorders: Growth hormone excess

Lifestyle Factors

• Tight clothing causing friction
• Jewelry rubbing against skin
• Poor glycemic control
• Sedentary lifestyle

Genetic Predisposition

• Family history of skin tags
• Certain ethnic groups (higher prevalence in some populations)
• Genetic syndromes

Diagnosis

Skin polyps are typically diagnosed through visual examination alone. Their characteristic appearance makes them easy to identify, though occasionally they may need to be differentiated from other skin conditions.

Clinical Examination

A healthcare provider will examine the growth, looking for typical features:

• Pedunculated (hanging) appearance
• Soft, flesh-colored texture
• Location in typical areas (skin folds)
• Absence of suspicious features

Differential Diagnosis

Conditions that may resemble skin tags include:

• Neurofibromas: Softer, may be associated with café-au-lait spots
• Seborrheic keratoses: Usually flatter, waxy appearance
• Melanocytic nevi (moles): Typically flat or slightly raised, pigmented
• Warts: Rougher texture, caused by HPV
• Molluscum contagiosum: Pearl-like with central dimple
• Basal cell carcinoma: Rare, but important to rule out

When Further Testing is Needed

Additional evaluation may be necessary if:

• The growth has atypical features
• Rapid growth or changes in appearance
• Bleeding or ulceration
• Multiple colors within the lesion
• Irregular borders
• Size greater than 5cm

Diagnostic Procedures

Dermoscopy

A non-invasive technique using magnification to examine skin lesions more closely. Can help differentiate skin tags from other conditions.

Biopsy

Rarely needed, but may be performed if:

• Diagnosis is uncertain
• Suspicious features present
• Patient requests confirmation
• Legal or insurance requirements

Associated Screening

For patients with multiple skin tags, screening for associated conditions may be recommended:

• Blood glucose testing for diabetes
• Lipid profile
• Insulin levels
• Hormonal evaluation if indicated

Treatment Options

Skin polyps don't require treatment unless they cause discomfort, become irritated, or are cosmetically bothersome. When removal is desired, several safe and effective options are available.

Professional Removal Methods

Cryotherapy (Freezing)

Liquid nitrogen is applied to freeze the skin tag:

• Quick procedure (seconds)
• May require 1-2 treatments
• Minimal scarring
• Slight stinging sensation during treatment
• Tag falls off within 10-14 days

Surgical Excision

Cutting off the skin tag with sterile scissors or scalpel:

• Immediate removal
• Local anesthetic may be used
• Minimal bleeding
• Allows for histological examination if needed
• Small risk of scarring

Electrocautery

Using electrical current to burn off the tag:

• Simultaneous removal and cauterization
• Minimal bleeding
• Good for multiple tags
• May leave temporary discoloration

Ligation

Tying off the blood supply with surgical thread:

• Gradual process (7-10 days)
• Tag darkens and falls off
• Suitable for larger tags with clear stalks
• Can be done at home under guidance

Post-Removal Care

• Keep area clean and dry
• Apply antibiotic ointment as directed
• Cover with bandage if clothing rubs area
• Watch for signs of infection
• Avoid sun exposure to prevent hyperpigmentation

What Not to Do

Avoid these unsafe removal methods:

• Cutting with non-sterile tools: Risk of infection
• Burning at home: Can cause severe burns
• Harsh chemicals: May damage surrounding skin
• Nail clippers: Uncontrolled cutting, bleeding risk

Natural Approaches

While effectiveness varies, some people try:

• Tea tree oil application
• Apple cider vinegar
• Vitamin E oil
• Garlic extract

Note: Scientific evidence for these methods is limited.

Cost Considerations

• Often considered cosmetic (not covered by insurance)
• Prices vary by method and location
• Multiple tags may be removed in one session
• Some dermatologists offer package deals

Prevention

While skin tags cannot always be prevented, certain measures may reduce their formation or minimize risk factors.

Weight Management

• Maintain healthy body weight
• Reduce skin fold friction
• Regular exercise
• Balanced diet

Reduce Friction

• Wear properly fitting clothing
• Choose breathable fabrics
• Use powder in skin folds
• Avoid tight jewelry
• Keep skin folds dry

Metabolic Health

• Control blood sugar levels
• Manage insulin resistance
• Regular health screenings
• Address metabolic syndrome

Skin Care

• Keep skin clean and dry
• Moisturize to prevent irritation
• Gentle exfoliation
• Avoid harsh chemicals

During Pregnancy

• Maintain appropriate weight gain
• Wear supportive, comfortable clothing
• Keep skin folds clean and dry
• Note: Many pregnancy-related tags resolve postpartum

When to See a Doctor

While skin tags are benign, certain situations warrant medical evaluation.

Seek Medical Attention If:

• Rapid growth or change in appearance
• Bleeding without trauma
• Pain or tenderness
• Signs of infection (redness, warmth, pus)
• Multiple colors within the growth
• Irregular or asymmetric shape
• Ulceration or crusting

Consider Removal If:

• Frequent irritation from clothing or jewelry
• Located in areas prone to injury (shaving areas)
• Cosmetic concerns
• Catching on objects
• Large size causing discomfort

Screening Recommendations

If you have multiple skin tags, discuss screening for:

• Diabetes or prediabetes
• Metabolic syndrome
• Hormonal imbalances
• Cardiovascular risk factors

Special Populations

• Diabetics: Monitor for changes, as healing may be slower
• Immunocompromised: Higher infection risk with removal
• Blood thinners: Increased bleeding risk
• Keloid formers: Risk of excessive scarring

Related Conditions

Several conditions may be associated with or mistaken for skin polyps.

Frequently Asked Questions