Laser Removal Of Skin Tags

What are skin tags?

Skin tags are small, soft, benign, skin colored or hyperpigmented growths that are typically connected to the underlying skin by a thin stalk (peduncle). These skin tags typically occur in sites where clothing rubs against the skin or where there is skin-to-skin friction in areas of skin folds, such as the eye lids, underarms, neck, upper chest (particularly beneath the breasts in women) and groin. They may appear as surface nodules or papillomas in areas of skin folds.

A skin tag is medically termed an acrochordon. Sometimes skin tags are also called soft fibromas, fibro-epithelial polyps (FEP), fibroma pendulans and pedunculated fibromas. At times, skin tags are inappropriately called soft warts though they do not represent true warts.

Most skin tags vary in size from 2 - 5 mm in diameter, although larger skin tags may develop up to a diameter of to 2-5 cm.

Types of skin tags:

Three types of skin tags are normally described as follows:

  1. Small, furrowed papules of approximately 1-2 mm in width and height, located mostly on the neck and the axillae.

  2. Single or multiple filiform lesions of approximately 2 mm in width and 5 mm in length occurring elsewhere on the body.

  3. Large, pedunculated tumour or nevoid, bag-like, soft fibromas that occur on the lower part of the trunk.

  4. Giant skin tags may produce considerable discomfort to patients when located in the axillae and genital regions.

Localisation of skin tags

Skin tags are most frequently found on/below the eye lids, the face, neck, sub-axillary zones (arm pits), trunk, abdomen, back and groin.

 

Skin tags may occur at unusual sites of the body, e.g. on the penis, vaginal labia, in the fold between the buttocks, on the waist, etc.

Genetic/familial predisposition to skin tags

Skin tags are not present at birth and their frequency increases with age. However, skin tags can sometimes be seen in children. These skin tags tend to increase with age and are most common in middle-aged and older individuals. Skin tags can be observed in about 25% of adults. Studies have shown a genetic and/or familial predisposition to the development of skin tags.Therefore, skin tags can manifest themselves in families. 

 

These tumors are usually asymptomatic, and they do not become painful unless inflamed or irritated. Patients may complain of pruritus or discomfort when a skin tag is snagged by jewelry or clothing.

Association of health disorders to skin tags

Multiple skin tags are often associated with:

  1. Type 2 Diabetes Mellitus (Insulin Resistance) A study of 118 research subjects with acrochordon reported an incidence of 40.6% of either overt type 2 diabetes mellitus or impaired glucose tolerance. Reports exist suggesting that the mechanism is through the effect of insulin and glucose starvation. The previous study showed no correlation between the location, size, colour, or number of acrochordons with impairment of glucose tolerance.

  2. Obesity: increased skin-to-skin contact and friction make skin tags more common in overweight or obese people. 

  3. Significantly High Serum Cholesterol Level

  4. Significantly High Low-Density Lipoprotein (LDL) Level

  5. Elevated Triglyceride Level

  6. Elevated High-Sensitive C-Reactive Protein

  7. Impaired Carbohydrate or Lipid Metabolism

  8. Liver Enzyme Abnormalities

  9. Hypertension

  10. Crohn's Disease peri-anal (around the anal opening) skin tags are common in people with Crohn's disease.

  11. Pregnancy: hormonal changes caused by pregnancy can also stimulate skin tags' growth, especially during the second trimester of pregnancy.

  12. Acanthosis Nigricans

  13. Birt-Hogg-Dube (BHD) Syndrome: Acrochordons associated with fibrofolliculomas and trichodiscomas have been described as components of BHD syndrome, an autosomal dominant disorder.

  14. Human Papillomavirus (HPV) Infections: Human papillomavirus (HPV) types 6/11 DNA were found in a high percentage of skin tag biopsy samples obtained from 49 white patients. According to the authors of the study, the viral infection should be considered as a pathogenic cofactor.

  15. Tumours Of The Gastro-Intestinal Tract & Kidneys: Skin tags have been reported to accompany other neoplasms, especially tumours of the gastrointestinal tract and kidneys. Neoplasms are suggested to produce and release growth factors that cause acrochordon growth into the circulation. The results of a recent study refute the theory that an association of acrochordons and colonic polyps actually exists.

  16. People with multiple skin tags should be encouraged to reduce their weight, stop smoking, practice healthy dietary habits and lead a healthy lifestyle as well as treat their respective health disorders.

 

Laser Removal Of Skin Tags

How good and effective is laser removal of skin tags?

Laser removal is the most effective way to get rid of skin tags without pain, without any side effects and with rapid skin healing.

 

How are skin tags usually removed with a laser?

Skin tags are removed in an outpatient facility without any pain under local anaesthesia with the use of a high power laser, such as a CO2 or an Erbium YAG laser. The skin tags are practically "vaporized" out without burning the skin. 

 

Most patients experience only mild discomfort after the treatment. After laser removal of skin tags, normally no scarring occurs. There are no side effects after the laser removal of skin tags.

 

How long does the treatment take?

Treatment may take 10-15 minutes till an hour or more, depending on the number and location of the skin tags. 

 

Is there any bleeding with laser removal of skin tags?

With laser treatment of skin tags, there is absolutely no bleeding.

 

How many treatment sessions are needed?

Normally only one laser treatment session is required for the full liquidation of all skin tags present in any body region.

 

Skin Tags Don’t Grow Back Again:

Laser technologies used for skin tags' removal are extremely precise due to which the treatment efficacy is high. Once the skin tag is removed, it does not not grow back. However, there is no way one can prevent new skin tags from developing with a certain number of years. 

 

Does laser removal of skin tags leave scars after treatment?

Laser works on the surface, removing skin tags (with or without a stalk) from the surface of your skin. It does not kill underlying skin cells. Thus, the skin regenerates quickly without leaving any scars. However, scar formation may rarely happen only in the case of an abnormal skin reaction due to hypersensibility or an an existing allergy. If any scar ever happen to occur, it may be removed in a second treatment after one month by performing laser skin resurfacing, especially if it is on the face or neck. 

 

Is laser treatment the best choice?

People struggle with the unsightly look of skin tags and want them gone as fast as possible. If you’re looking for convenience and quick removal, laser treatment remains your best choice.

 

How is the healing process after laser removal of skin tags?

For the most part, healing after laser skin tag removal is quick, easy, and relatively painless. Most people can expect to be fully healed in about 7-14 days after treatment.

 

Recovery Plan Following Treatment:

The wound spots created by the laser removal of skin tags are regularly treated with the application of an ointment medicated with an antibiotic & healing agents, and corresponding medico-aesthetic natural products until their complete healing and the normalisation of the skin in these spots.

 

The patient will be given post-treatment instructions for keeping the skin safe and for creating the best conditions for its healing. These will include keeping the treated areas clean, sun protection, heat protection, nutritional advices, skin moisturization, and so on. 

 

References:

  1. Adams BB, Mutasim DF. Elastic tissue in fibroepithelial polyps. Am J Dermatopathol. 1999 Oct. 21(5):446-8. [Medline].

  2. Kawasaki H, Sawamura D, Nakazawa H, Hattori N, Goto M, Sato-Matsumura KC, et al. Detection of 1733insC mutations in an Asian family with Birt-Hogg-Dube syndrome. Br J Dermatol. 2005 Jan. 152(1):142-5. [Medline].

  3. Dianzani C, Calvieri S, Pierangeli A, Imperi M, Bucci M, Degener AM. The detection of human papillomavirus DNA in skin tags. Br J Dermatol. 1998 Apr. 138(4):649-51. [Medline].

  4. Tamega Ade A, Aranha AM, Guiotoku MM, Miot LD, Miot HA. [Association between skin tags and insulin resistance]. An Bras Dermatol. 2010 Feb. 85(1):25-31. [Medline].

  5. Emir L, Ak H, Karabulut A, Ozer E, Erol D. A huge unusual mass on the penile skin: acrochordon. Int Urol Nephrol. 2004. 36(4):563-5. [Medline].

  6. Peña KB, Parada DD. Lymphedematous fibroepithelial polyp of the glans penis non-associated with condom catheter use. APMIS. 2008 Mar. 116(3):215-8. [Medline].

  7. Kassinove A, Raam R. Acrochordon of the labia. J Emerg Med. 2013 May. 44(5):e361-2. [Medline].

  8. Singh N, Thappa DM, Jaisankar TJ, Habeebullah S. Pattern of non-venereal dermatoses of female external genitalia in South India. Dermatol Online J. 2008 Jan 15. 14(1):1. [Medline].

  9. Eads TJ, Chuang TY, Fabre VC, Farmer ER, Hood AF. The utility of submitting fibroepithelial polyps for histological examination. Arch Dermatol. 1996 Dec. 132(12):1459-62. [Medline].

  10. Gorpelioglu C, Erdal E, Ardicoglu Y, Adam B, Sarifakioglu E. Serum leptin, atherogenic lipids and glucose levels in patients with skin tags. Indian J Dermatol. 2009. 54:20-22. [Medline].

  11. Boza JC, Trindade EN, Peruzzo J, Sachett L, Rech L, Cestari TF. Skin manifestations of obesity: a comparative study. J Eur Acad Dermatol Venereol. 2011 Sep 20. [Medline].

  12. Akp?nar F, Derv?s E. Association between acrochordons and the components of metabolic syndrome. Eur J Dermatol. 2011 Nov 7. [Medline].

  13. Hui ES, Yip BH, Tsang KW, Lai FT, Kung K, Wong SY. Association between multiple skin tags and metabolic syndrome: A multicentre cross-sectional study in primary care. Diabetes Metab. 2016 Apr. 42 (2):126-9. [Medline].

  14. Senel E, Salmanoglu M, Solmazgül E, Berçik Inal B. Acrochordons as a cutaneous sign of impaired carbohydrate metabolism, hyperlipidemia, liver enzyme abnormalities and hypertension: a case-control study. J Eur Acad Dermatol Venereol. 2011 Dec 21. [Medline].

  15. Wali V, Wali VV. Assessment of Various Biochemical Parameters and BMI in Patients with Skin Tags. J Clin Diagn Res. 2016 Jan. 10 (1):BC09-11. [Medline].

  16. Garg S, Baveja S. Giant Acrochordon of Labia Majora: An Uncommon Manifestation of a Common Disease. J Cutan Aesthet Surg. 2015 Apr-Jun. 8 (2):119-20. [Medline].

  17. Ozkol HU, Bulut G, Gumus S, Calka O. Ulcerated giant labial acrochordon in a child. Indian Dermatol Online J. 2015 Jan-Feb. 6 (1):60-1. [Medline].

  18. Alkhalili E, Prapasiri S, Russell J. Giant acrochordon of the axilla. BMJ Case Rep. 2015 Jul 3. 2015:[Medline].

  19. Dianzani C, Calvieri S, Pierangeli A, Imperi M, Bucci M, Degener AM. The detection of human papillomavirus DNA in skin tags. Br J Dermatol. 1998 Apr. 138(4):649-51. [Medline].

  20. Levine N. Brown patches, skin tags on axilla. Are this patient's velvety plaques related to his obesity and diabetes?. Geriatrics. 1996 Oct. 51(10):27. [Medline].

  21. Thappa DM. Skin tags as markers of diabetes mellitus: an epidemiological study in India. J Dermatol. 1995 Oct. 22(10):729-31. [Medline].

  22. Goyal A, Raina S, Kaushal SS, Mahajan V, Sharma NL. Pattern of cutaneous manifestations in diabetes mellitus. Indian J Dermatol. 2010. 55(1):39-41. [Medline]. [Full Text].

  23. Mathur SK, Bhargava P. Insulin resistance and skin tags. Dermatology. 1997. 195(2):184. [Medline].

  24. Baldo A, De Natale F, Parisi A, Lo Presti M. Un singolare fibroma pendulo. Chronica Dermatologica (Roma). 1995. 5:719-23.

  25. Bord A, Valsky DV, Yagel S. Prenatal sonographic diagnosis of congenital perineal skin tag: case report and review of the literature. Prenat Diagn. 2006 Nov. 26(11):1065-7. [Medline]

 

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