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Skin tags, formally known as acrochordons, are small pieces of flesh that protrude from your skin.

You’ll know it’s different from a wart or mole because of its pedestal base. Warts are flat on top and go deeper into the skin, but a little ball of skin dangling from the surface is a skin tag.

The prevalence of skin tags seems to increase with age (Banik & Lubach, 1987) and it has been reported that they are markers for colonic polyps (Leavitt, et al. 1983)

What are the causes of skin tags, how are they formed and can you prevent them?

References

Banik, R., & Lubach, D. (1987). Skin tags: localization and frequencies according to sex and age. Dermatology, 174(4), 180-183. doi: 10.1159/000249169 pmid: 3582706

Leavitt, J., Klein, I., Kendricks, F., Gavaler, J., & VanThiel, D. H. (1983). Skin tags: a cutaneous marker for colonic polyps. Annals of internal medicine, 98(6), 928-930. doi: 10.7326/0003-4819-98-6-928 pmid: 6859706

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CAUSES and RISK FACTORS of skin tags

In general, the exact cause and therefore prevention of skin tags is not known (Emedicine). In some cases, skin tags could be associated with the following conditions:

  • Skin aging and skin irritation due to obesity (Emedicine)
  • Diabetes type 2, especially if accompanied with metabolic syndrome (obesity, hyperglycemia, high blood pressure, high cholesterol levels) (PubMed, 2014)
  • Human papillomavirus infection - a sexually transmitted disease (PubMed, 2008)
  • Crohn's disease (PubMed, 2016)
  • Acromegaly or gigantism - increased growth due to increased levels of the growth hormone (PubMed, 2006)
  • Genetic predisposition, Birt-Hogg-Dube syndrome and Nonne-Milroy-Meiges syndrome (PubMed, 2015)

SKIN TAGS AS MARKERS OF COLONIC POLYPS

Studies and reviews that have found no association between skin tags and colonic polyps: PubMed, 1993, PubMed, 1989 and PubMed, 2016.

Some small studies have found some association between skin tags and colonic polyps: Annals of Internal Medicine, 1983, PubMed, 1986. The association may be coincidental, since the prevalence of skin tags can be as high as 46% (Emedicine).

PREVENTION of skin tags can include losing weight (if necessary), avoiding skin irritation, avoiding sexually transmitted diseases and treating eventual underlying disorders.

Skin tags do not likely develop into skin cancers (Stat Pearls).

A dermatologist can REMOVE skin tags if necessary; the growths usually do not recur (University of Missouri).

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Adding to @Jan's answer, to answer the part of the question regarding how skin tags are formed, I have found that according to the American Orthopaedic College of Dermatology (AOCD), the actual cause of acrochordons is unknown, as it is not actually known how they are formed. There are several theories however:

  • Irritation or friction to the skin, caused by skin rubbing on skin may play a role in their formation.
  • Diabetes causing skin tags is thought to be through insulin resistance.
  • The Human Papilloma Virus (HPV) was present in a high percentage of growths in a study of 49 patients with skin tags, suggesting the virus plays a role in development.
  • It is also possible that skin tags are genetic or simply due to normal aging and loss of skin elasticity.

Interestingly the AOCD also mentions that a rare genetic disorder called Birt-Hogg-Dube (BHD) Syndrome is characterised by numerous skin tags along with other symptoms, however looking at the National Organisation for Rare Disorders (NORD) webpage for BHD syndrome, these "skin tags" are known as fibrofolliculomas and appear to be different.

The skin papules known as fibrofolliculomas that are associated with BHD syndrome commonly occur on the scalp, face and neck, but can also be found on the ear lobes and in the oral mucosa. They are generally 2-3mm in size, dome shaped, flesh-colored and are not associated with any pain or discomfort.

Going by the theories mentioned by the AOCD, if skin tags are caused by skin friction, or aging and loss of skin elasticity, maintaining a healthy weight can reduce the numbers as there will be less skin folds to cause skin rubbing, but otherwise, there may be nothing really that can be done to prevent skin tags.

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