Skin Tags - Appalachian Spring Dermatology

What are skin tags? Skin tags are the common name for the pedunculated, or floppy growths that commonly occur around the neck, in the underarm area, in the groin area, and under the breasts. When examined under a microscope, what we commonly call a skin tag could actually be an Acrochordon, fibroepithelial polyp, seborrheic keratosis, or intradermal nevus.

These growths have many other common names including warts and moles. They are not true warts in most cases, because they are not caused by the virus Human Papilloma Virus (HPV). However, some skin tags can get infected with the wart virus when we pick at them. These growths are not true moles in most cases either. The medical term for a true mole is a nevus, which is a growth of the pigmented cells in the skin. Some larger skin tags are intradermal nevi, a type of true mole, but most skin tags are not moles

Why do people get skin tags? There are many old wives tales about why these lesions grow and ways to treat them. Most lesions do not occur for any specific reason, however they do tend to occur more in areas of friction and moisture. In some rare cases, sudden onset of a large number of skin tags, especially in children, can be an early sign of insulin overload and diabetes. These lesions do tend to be more common with increasing obesity. However, all obese patients do not have skin tags, and many thin people have skin tags as well.

How are skin tags removed? Many people remove these lesions at home by cutting them off, twisting them, or tying a string around them. These methods do have some value; however, the lesions do tend to bleed a lot when cut off. Most other home remedies work well for some people, so feel free to try them at your own risk.

In the office, Dr. Rosenberger removes these lesions using a few different methods.

Electrodessication – Best for small lesions. In this method Dr Rosenberger will cauterize these lesions and the lesions will fall off at home. Lesions are not numbed prior to this treatment.

Cryosurgery – Best for flatter, broader lesions and for those who have a variety of other lesions such as irritated seborrheic keratoses as well. These lesions will fall off at home. Lesions are not numbed prior to this treatment.

Scissor snip – Best for larger, pedunculated lesions. Lesions are anesthetized (numbed) using a needle in most cases. Lesions can be removed without anesthesia as well. Lesions are snipped off using scissors, and bleeding is stopped with cautery. When removing these lesions, Dr. Rosenberger puts all of the skin tags in one bottle and has them analyzed by pathology to make sure the lesions are just irritated, not cancerous. Dr. Rosenberger did find a skin cancer growing inside one of the lesions in the underarm of a patient this way in the past.

Once removed, will the skin tags grow back? Many people ask me if the skin tags will just grow back. Usually, the same lesions do not grow back, but patients develop a whole new “crop” of lesions in time.

Will removing my skin tags leave a scar? Yes, Dr. Rosenberger always says that anytime you remove something from the skin, there is a 100% risk of a scar. Now, that scar should be microscopic and barely noticeably, but it will be there. The biggest problem with removing skin tags is they do take a while to heal, and there is often some temporary discoloration. Dr. Rosenberger prefers to remove skin tags in the fall and winter. They heal better and faster in cooler months, and it gives time for the discoloration to fade.

Will insurance cover removal of my skin tags?

Unfortunately, many insurance companies consider the removal of these lesions cosmetic unless specific lesions are particularly red, irritated, rubbing on clothing, growing rapidly, or suspicious in some other way. If you would like to check to see if your insurance company will pay for these lesions to be removed, you will need the following procedure code, CPT – 11200 – Removal of up to 15 skin tags by any method. It is very rare for insurance to cover the removal of skin tags. If your insurance does not consider the removal of skin tags to be a covered service, Dr. Rosenberger charges a reasonable per lesion fee in addition to the charge for the office visit evaluation.

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