Ask the Pharmacist

Q) I have a skin tag on my neck. Is that a big deal and is there anything I can do about it?

A) A skin tag is a small, soft piece of hanging skin that is typically attached to our “normal” underlying skin by a thin stalk (known as a peduncle). Like many other medical conditions, skin tags go by a number of other names including calling them an acrochordon, a cutaneous papilloma, a cutaneous tag, soft warts and Templeton skin tags amongst others. Whatever their name, there is no doubt that they are very common.

While they are not present at birth, their frequency increases with age to the point that they can be found on approximately 25% of adults. They seem to affect men and women equally and most commonly first show up after midlife.

Skin tags are benign meaning that they are an unusual growth on the body but they are in no way related to cancer. They are believed to be caused by friction between adjacent areas of skin or between clothing and skin. While they may be found anywhere on the body, the most typical sites are the underarms, the upper chest (particularly just under a female’s breast), the folds in the groin, the neck and the eyelids.

There is a genetic predisposition to the development of skin tags but this certainly does not mean that just because your father has them that you will be fated to as well. They are also more commonly seen in those of us who are overweight (not surprising as that leads to more friction with clothes and skin folds), are pregnant (not so much do to the increased weight but rather this is more related to the hormonal changes going on), diabetics (who are more prone to a condition called acanthosis nigricans which is associated with skin tag formation), those with high blood pressure or high cholesterol and in those with Crohn’s disease where skin tags around the anal opening are quite common.

The appearance of skin tags can be varied. Usually they are flesh coloured but might appear brown in those with lighter skin tones. Their size can vary from 1mm to the size of a grape and they may be either smooth or wrinkled. While they all attach to the skin via a stalk, very tiny skin tags may look just like a “bump” on the skin. Sometimes their colouring will change to red or black if their blood supply is altered. They are almost always painless and usually only bleed if they caught on something and are torn. Their presence does not require a visit to the doctor as they are not usually a sign of an underlying medical condition nor are they dangerous. As such, the only reason to show them to a doctor is to distinguish them from other types of benign growths (such as a mole or a wart. Note skin cancer does not look like a skin tag) or to get their aid in removing the tag if its appearance disturbs you.

That being said, a physician’s help is not always necessary as they may rub off or fall off spontaneously. The classic do-it-yourself intervention involves tying dental floss around the base of the tag which cuts off the circulation and causes it to fall off within a few days to weeks. It may be necessary to re-tighten the string every few days to increase the odds of success.

There are also over the counter solutions available at most pharmacies that freeze the skin tag causing them to fall off in 7 to 10 days. The feedback I have received from an admittedly limited number of my patients who have used these products is that they are not particularly effective although they are safe to try.

Other home remedies that have less evidence supporting their usefulness include applying tea tree oil or apple cider vinegar to a cotton ball and leaving it on the skin tag for 10 minutes, three times a day. Some report success by dipping a Q-Tip in iodine and smearing it on the skin tag followed by covering it with a bandage and repeating this process twice a day.

If professional help is sought, your physician may use a medical procedure to remove the tags such as cauterization (burned off using electrolysis), ligation (whereby its blood supply is stopped), cryosurgery (where it’s frozen off using liquid nitrogen) or excision (where it is cut out with a sterile scalpel).

The long and short of this is that skin tags are not a valid reason to work yourself into a “knot”. They are just a growth that undoubtedly you notice far more than any of your acquaintances.