John R. Tkach, M.D.
300 North Willson, Suite 203B
Bozeman, MT 59715
(406) 587-5442

Skin Tags (Acrochordons)

Patient Information Sheet

What are skin tags, how do you treat them, and what is their significance?

Skin tags are little outward growths of skin. They commonly occur on the sides of the neck and under the arms and less often under the breasts or in the groin area. The tendency to get them is inherited. They are not due to anything you are doing wrong. As of January 2010, they are not a sign of anything wrong although they have incorrectly been blamed as precursor signs associated with bowel cancer, diabetes, and due to overweight. I do not know of any way to prevent new skin tags from appearing.

Treatment Options

  1. Do nothing: This is not a bad choice except that skin tags tend to grow larger. It is easier to treat them when they are small.
  2. Freeze with liquid nitrogen: Over the past 20 years, I have found that, most of the time, this is the best treatment for skin tags. Most of the time, one treatment is enough. Sometimes skin tags are stubborn and require several treatment visits.
  3. Scissor excision: This is a treatment commonly used by many dermatologists. I do not use this treatment as much as I used to. With scissors, it is not possible to cut as closely to the skin surface as I would like. The tiny stalk of skin tag left behind tends to continue growing. Liquid nitrogen is better because it gets right down flush with the surface of the skin. Another problem with cutting skin tags off with scissors is that it leaves a little open surgical wound that could get infected. However, the risk is small.
  4. Electrodesiccation: buzzing the skin tag with electricity remotely like using a spark coil on a car. This treatment is also commonly used. It is more painful than the other treatments. It may be a little more likely to produce a scar, although the risk is small.
  5. Scalpel excision: Giant skin tags, over 1cm, are too big for simple treatment and may require excision and suture. It is a minor procedure.

Each doctor has a favorite way of treating skin tags. Mine is freezing with liquid nitrogen. However, I am not inflexible about this. If you would prefer to try one of the other forms of treatment, just let me know. With any form of treatment, recurrences are common.

Skin Tags Are Not Related to Intestinal Polyps.

The average American has a 5% risk of developing bowel cancer in a 70-year life span. Early detection and treatment are the best approach. Bowel cancer may develop from skin-tag-like growths called "polyps" in the bowel. But it is hard to see inside the bowel. Understandably, family doctors, internists, and surgeons are grateful for easily recognized clues.

Long ago, there was a notion that skin tags were an external sign of colon polyps and that people with skin tags should have a bowel examination. This idea arose from a study by Leavitt and others in 1983. Over the next six years considerable controversy developed about the real significance of skin tags.

If you have skin tags, should you seek an examination for colon polyps or colon cancer? In February 1992, I performed a computerized medical literature search to see what had become of this controversy. Between 1988 and 1992, there were three good studies that showed that skin tags are NOT a sign of colon polyps. From 1988 to 1992, there were no new studies supporting an association between these two.

So, what should you do? Having skin tags appears not to be justification for asking you to have a bowel examination. I do have some specific suggestions. If you are over 45 years old, you should have a flexible sigmoidoscopic examination at least every 5 years or at intervals suggested by your doctor. Some doctors say once a year, and some say even every six months. If anyone in your family has had bowel cancer, it is more urgent that you have this study done. The simple office rectal exam in which the doctor puts on a glove and feels the rectum with one finger is simple, safe, and useful. I suggest that people over 45 years old have it done about once a year.

The information provided in these patient information sheets is offered for general informational and educational purposes only; it is not offered as and does not constitute medical advice. In no way are any of the materials presented meant to be a substitute for professional medical care or attention by a qualified practitioner, nor should they be construed as such.

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