Skin tags

Skin tags are small 2-6mm wide, 10-20mm high, flesh coloured, benign growths of the skin that can develop on the neck, underarms, around the eyes and the inner upper legs. Skin tags are not dangerous and has no real medical importance.

They can be unsightly and bothersome in the neck area and irritating in the underarm and groin area. When skin tags are damaged from shaving, rubbing or some other mechanical irritation, they can become red and painful, or even bleed. If the blood supply to the skin tag is damaged they can turn alarmingly black, but will eventually fall off.

Anyone can develop skin tags, but weight gain, a genetic tendency, Syndrome X, pregnancy and diabetes are predisposing factors. The medical name for skin tags are fibroepithelial polyps or Acrochordons. They are also known as “vleismoesies” and “muistepels” in Afrikaans. “Vleismoesie” translates roughly to “meaty mole” and “muistepel” translates roughly to “mouse nipple”.

Dermatosis Papulosis Nigra is a similar growth to skin tags, but they are darkly pigmented and occur on the face of people with dark skin.

Skin tags are easily removed with shave excision, nipping them off with a special pair of curved scissors, freezing them with liquid nitrogen, or with light cautery. Flat skin tags can be removed with light liquid nitrogen therapy or preferably light cautery, which is more accurate. The elevated ones are removed with curved scissors, shave excision or light cryotherapy, depending on the size of the skin tag.

Liquid nitrogen does not require any local anaesthetic, but the surgical options and cautery most often do. To minimize discomfort a patient can have a numbing ointment applied for two hours, before the procedure. The bigger skin tags can then be further numbed with a local anaesthetic injection.

These procedures can result in scarring or excessive pigmentation if not done with the correct intensity. I will therefore, in some patients, initially remove only one or two skin tags to first test a patients healing response. If the patient is happy with the result, we can then remove the remaining skin tags.

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