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Ask the doctor: Why have I so many skin tags and can I get rid of them?

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Skin tags tend to occur more frequently in people who are overweight or suffer from diabetes

Skin tags tend to occur more frequently in people who are overweight or suffer from diabetes

Skin tags tend to occur more frequently in people who are overweight or suffer from diabetes

I have a lot of skin tags, mainly on my upper torso and around my armpits and I was wondering if there was any treatment available? Also, what exactly are they and am I going to get more as I age? I am a 42-year-old woman.

A benign outgrowth of normal skin that appears to sit on a pedunculated ‘stalk’ is known as an acrochordon or skin tag. An estimated 50pc of adults have skin tags. They increase in frequency as we age. They can occur for the first time during pregnancy but often regress a few months after pregnancy. They are more commonly seen in people who suffer with obesity and/or diabetes.

Skin tags have a tendency to occur at sites of friction such as under the breast, in the armpit, the neck or groin regions. It is important to distinguish skin tags from other similar looking skin lesions like a neurofibroma, which is usually larger and firmer or a pedunculated dermal naevus (mole).

Often your GP, a consultant dermatologist or plastic surgeon will remove skin tags. It’s a very straightforward procedure. Usually it is requested for cosmetic reasons or due to frequent irritation of the lesion. The exact skin tag is unlikely to recur after treatment, but you may see new skin tags form in the general area. Local anaesthetic injections may be required depending on the size of the lesion and one of three techniques may be used:

1. Removal with forceps and fine-grade scissors.

2. Cryotherapy with liquid nitrogen.

3. Electrodesiccation when an electrode tip is applied directly to the lesion.

I thought I might mention other commonly seen benign skin lesions. Lipomas are the most common soft tissue tumour. A lipoma consists of mature fat cells enclosed in a thin fibrous capsule. They are soft, painless and superficial, meaning they occur in the outer subcutaneous tissue and can occur on any part of the body, but are frequently found on the upper extremities and trunk. They vary in size from 1 centimetre to >10 centimetres. Ultrasound examination is useful in diagnosis and helps to rule out other causes for the soft tissue swelling.

Epidermal (or epidermoid) cysts are also commonly found benign skin lesions. They tend to occur at the base of the ears, the face or the trunk. This type of cyst may occur for no reason or may arise from the implantation of the follicular epithelium in the skin as a result of trauma or from a comedone (large spot). They range in size from a few millimetres to several centimetres and can occur anywhere on the body.

They appear as a skin-coloured dermal (often fluctuant) nodule. If an epidermal cyst becomes inflamed or infected it can cause intense pain, swelling with redness and can sometimes spontaneously rupture. Unfortunately there is no way to predict if the cyst will remain stable over time or progressively enlarge and cause trouble. When surgically removed they can leave a significant scar and even have a tendency to recur.

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Lastly, a solar lentigo or ‘liver spot’ is a benign pigmented macule that results from increased activity of epidermal melanocytes. Multiple spots are called lentigines and can grow slowly over many years or can appear suddenly. They commonly occur with aging, especially in people over 40 years old and look like tan/brown/black spots typically in sun-exposed areas such as the face, shoulders, arms or back of your hands. Chemical peels, topical bleaching creams or intense pulse light laser can help to remove solar lentigo but subsequent sun exposure may result in recurrence.

Dr Jennifer Grant is a GP with Beacon HealthCheck


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