Mr. Thompson is a 47-year-old male that came to the office for his annual skin cancer screening. He has no significant past medical history. He has not noticed any moles that are changing shape or color or any lesions that have been bleeding or not healing, which would be signs of skin cancer. He does mention that he has growths under his armpits and neck that don’t bother him but his wife would like them examined and removed if possible.
On the physical exam, I notice that he has a few seborrheic keratoses and angiomas on his trunk (see Part 1 and Part 2 of What are these things growing on me?) and a few benign moles. Around his axilla and neck, he has approximately 10 (2-4mm) soft flesh colored fleshy pedunculated papules (growths on a stalk).
Skin tags or the medical term, acrochordons are one of the most common benign growth on the skin of patients in a dermatology office. Although acne and actinic keratosis (precancerous lesions) are the two most commons reasons to visit the dermatologist, skin tags are a very common complaint during skin exams. They are fleshy benign growths that can grow anywhere but most commonly in the armpits, eyelids, groin, neck and skin folds.
They are more common in obese patients have been associated with Type 2 Diabetes and pregnancy. A person may have 1 to 100 skin tags and they are in 50% of all patients and more commons as you get older. They appear equally among mem and women. The cause of skin tags is unclear though, growth hormones and weight probably play a role in their development.
Even though they are benign (harmless), they can often be irritated under the armpit with clothing and jewelry. They do not need to be treated so removal is not often covered by insurance unless they are suspicious for a skin cancer or other lesion. It is not advisable to try to remove these by yourself as skin tags should be examined by a dermatologist to differentiate them from a basal cell carcinoma, wart, mole, melanoma or cyst. They should also be removed with a sterile procedure. Typically, the area is anesthetized with local anesthesia and shave with a small blade or cut with a surgical scissor. They will be sent to the lab if they are suspicious for a skin cancer.
There are no effective creams or OTC meds to get rid of skin tags and no known preventative measures to take other than a healthy lifestyle to prevent obesity and diabetes. I tell my patients that if they can find the cure and cause for skin tags, they will make a fortune.
In the office, Mr. Thompson decided to go ahead with the removal of his skin tags. The areas were numbed and removed without any complications. He lives by the motto, “Happy wife. Happy life,” and went home a happy patient.