What is a skin tag?

The skin tags are benign growths, i.e. not harmful, which majorly affects the parts where the skin gets folds. The medical term for skin tag is acrochordons. Some individuals name them as “skin tabs.” It affects 25% of the adult population. The benign growths are either brown or beige. This tag hangs from the skin surface that is connected to the remaining skin by a thin stalk. It becomes very frustrating if the skin tags are present in the part where it rubs against your clothes or jewellery.

Skin tags are not cancers of the skin and do not result in skin cancers.

The skin tags on genital areas are not harmful, but few individuals want to remove it due to their looks, and it is an annoying issue of the skin. They look quite identical to genital warts, i.e. sexually transmitted infections. An individual can have 1 to 100 skin tags on the body. There is a possibility that every person develops skin tags, once in a lifetime. Both females and males are susceptible to the growth of skin tags. Obesity could be a reason that causes the development of skin tags. Few of the skin tags instantly “fall off” while some remain once developed.

The skin tags usually occur with ageing. Skin tags commonly occur in individuals with 60 years and above. One of the factors is heredity, that causes skin tags. Development of skin tags occurs post weight gain or pregnancy.

Initially, the skin tags are as tiny as a flat “pinhead-sized bump.” Majority of the skin tags are small as one-third to one-half of the size of a “pencil eraser.” Few of the skin tags are as big as a “big grape (diameter is 1 cm) or “fig (diameter is 5 cm).”

Symptoms of Genital Skin Tags

They appear as a small “soft bump” on the skin. These tags do not result in pain unless “pulled or aggravated.” Skin tags are attached to the skin surface via a small stalk, unlike genital warts that look flushed against the skin. Unless you are trying to remove the tags, they will not result in bleeding. These tags can cause itching. The appearance of skin tags is in groups or a pattern form on the skin. The colour of the skin tag is quite similar or slightly dark than the skin, so initially, they go unnoticed.

These skin tags only result in cosmetic appearance. The only reason for the removal of skin tags is its aesthetic appearance or looks.

Skin tags either become red, i.e. hemorrhage or black due to twists.

There is skin death of tissues, i.e. necrosis.

The skin tag can drop down from the stalk without any problems or pain. It is a result of skin tag getting twisted on its own from the base of the stalk that affects the flow of blood to the skin tags.

The skin tag can be easily moved back and front. The skin tag can become painful if it is “twisted on the stalk” resulting in the development of blood clot.

Where do the skin tags occur?

The occurrence of skin tags is anywhere on the body protected by skin. These tags occur majorly on the eyelids, armpits, neck, and upper chest, i.e. below the breast, buttock folds, groin folds and genital areas. Plump babies also get skin tags in parts where skin rubs against each other, like “sides of the neck.” Smaller children form skin tags in the “upper eyelid” part, majorly while rubbing the eyes.

There is the development of skin tags in the underarm section due to “friction” and constant rubbing of the skin during sports among children of older age and “preteens.”

Which group is at the target to develop skin tags?

Almost 50% of the population has got skin tags at some point in time in their lives. Skin tags are not inherited and can develop in any individual but majorly seen in adults. They are quite common in middle-aged individuals. Kids also tend to get skin tags, but majorly in areas under the arm and neck parts. Skin tags are seen in obese or overweight individuals.

Causes of Genital Skin tags

Causes are unknown, but skin tags could occur as a result of frustration from clothing or jewellery rubbing against the skin. Genital is a part made up of many folds of skin, and therefore skin tags form there. Genital skin tags are not transmissible to another individual. They are “not contagious.”

Another reason for skin genitals is metabolic syndrome, i.e. overweight or obesity, diabetes. It might also occur in individuals with a family history of skin tags.

Skin tags are seen in pregnant women due to hormonal fluctuations.

Treatment for skin tags is not required unless they are bothering the individual. In-case the skin tags are bothering an individual they can be removed easily during or post-pregnancy by a skin specialist.

Many obese individuals develop a skin condition along with skin tags such as acanthosis nigricans, i.e. on the neck skin or armpits and have higher quantities of fats and sugar.

Diagnosis of Skin Tags

Important to check with the physician if any kind of new bump or mark observed on the genitals. Women can visit a gynaecologist or a general physician for a check-up if the presence of skin tags. Skin tags on the penis are rare, but men can consult a regular physician.

Initially, on the first meet, the physician will ask you questions related to your sex life and family history. If an individual has had a “new sexual partner”, the physician recommends going for STI (Sexually transmitted diseases). The doctor examines the “bumps” to see whether it is harmful or anything else that requires more tests. The physician might recommend for bump removal if not interested.

Is there a requirement to send skin tags for a biopsy?

Tiny skin tags, without the tissue, can be removed and sent for biopsy or any examination under the microscope.

Sometimes, there is a requirement of the skin tags, i.e. more prominent or atypical growths; to be sent for an examination under the microscope for confirming it to be skin tags.

Treatment for Genital Skin tags

There are many home remedies used for treating skin tags such as tea tree oil, baking soda, apple cider vinegar, castor oil to loosen the skin tag stalk. These remedies make the skin tags lose from the stalk, which becomes easy to remove them off.

It also becomes essential to be completely aware that the home remedy used are proper and appropriate as we are dealing with skin that is sensitive. If using a home remedy to remove the genital skin tags, it could sometimes cause a chemical burn if not appropriately treated.

Essential to have a conversation with the physician for the removal of skin tags. A gynaecologist, dermatologist or general physician can help with the removal of the skin tags in their clinic. To avoid any discomfort during the removal of skin tags, they apply local anaesthesia. For rapid catch hold-of, the skin tags the physician uses forceps dipped in liquid nitrogen for removal from the body, known as cryotherapy, i.e. “removal by freezing.” Other possible methods of treatment include surgical excision, i.e. scalpel used for removing and “cauterization” (way of burning used for removal of skin tags).

Not possible to remove all skin tags together and need to re-visit the physician again for a repeat of the treatment. Removal of skin tags is an “out=patient” method which requires almost nil time for recovery. This method includes minimal risk and susceptibility to infections is minimal. There are chances of skin tags occurring again, in-case of skin rubbing against each other.

Does the removal of skin tags cause them to grow again?

There are no such studies to show that removal of skin tags result in “more tags to grow” further. The skin tags do not “seed” or grow after removing them. In actual, some individuals are highly susceptible to the development of skin tags, and new growths occur timely. Some people exclude the skin tags on a yearly or quarterly, i.e. at appropriate intervals.

Are the skin tags a tumour?

Skin tags are harmless or benign growth. Skin tags are generally not “cancerous” and do not develop cancer if not treated. It is sporadic that skin tags result in cancer or pre-cancerous.

Are skin tags contagious?

There is no research to prove that skin tags are transmissible.

How does skin tag appear under a microscope?

Under a microscope, the skin is stained with a stain called Hematoxylin and eosin (H& E). Below the microscope, there is a spherical tissue in a coloured form that’s connected to a tiny stalk. The outer purple layer, i.e. epidermis “overlies” the dermis, i.e. pink colour. The epidermis layer, i.e. external layer results in excess growth, i.e. hyperplasia and “encloses an underlying layer of skin” termed as the dermis, in this, the collagen fibres appear to be loose and enlarged. Generally, in the skin tags, there is no presence of hair, moles, or other structures of the skin.

Most of the times, skin tags are damaged. Few times the skin tags are sent for observation under the microscope by a “pathologist” who does the diagnosis and checks whether there is any sign or symptom of skin cancer. In-case of no proper growth of skin, i.e. more significant, bleeds or different presentation, there is a requirement of pathological examination to check for skin cancers or irregular cell growth or development.

Skin tags are “mimic” by some of the other diseases that are seborrhea Keratoses, moles, warts, cysts, milia, neurofibromas and nevus lipomatous.

Is there a need to worry when removing the skin tag by shaving?

Skin tags get removed many times while “shaving off” during hair removal, i.e. underarms either via wax or razor. Shaving removes the harmless skin tag. Sometimes a skin tag causes bleeding and requires pressure to be applied for another 10-15 minutes to stop it. Shaving the skin tags results in skin infection, which is quite rare.

Skin tags vs Wart

As we know, genital skin tags are round, tender growths of the skin that grow on the stalk. They look tiny and like a deflated balloon. They can aggravate if rubbing against clothes or jewellery but they are not benign or contagious.

Whereas, Genital warts are wounds or bumps present on the surface of the skin, either flat or elevated. They look similar to a cauliflower. Eve n genital warts are not that harmful or contagious but are a result of an infection.

Genital skin tags are soft and bend when pressed. The growth of skin tags are quite rapid, but no further growth post in the early developmental stages. There is not much change observed with time. Skin tags develop on pubis or labia.

Warts are a result of HPV, i.e. Human Papillomavirus and are transmissible whereas skin tags are not similar to skin warts (not contagious).

Outlook for Genital Skin Tags

There is no reason for concern to have a skin tag. If having multiple skin tags in the genital areas, they do not cause any problem and not a sign or symptom of a problem in deep.

Essential to confirm the skin tag by a physician, so no further serious problems. In-case the skin tag “bothers” you, and they need to be removed by the physician, i.e. simple and a “low-risk elective procedure.”

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