“I want to remove my skin tags, but what options are available?”
“What does skin tag surgery involve? Is it painful?”
“I have a growth that looks like a skin tag — but is it really one?”
Are you concerned about a growth that may be a skin tag?
Skin tags are benign skin growths. However, if left untreated they may increase in number or grow larger over time, so we encourage you to consult a clinic.
This page covers the following information about skin tags:
- Causes of skin tags
- How to distinguish them from other conditions
- Symptoms
- Treatment options
We hope this information helps you address your skin tag concerns.
What Are Skin Tags? Benign Growths Common on the Neck and Underarms
Skin tags are benign growths that commonly appear on the neck, underarms, and similar areas [1,2,18].
Medically known as “acrochordons” or “skin tags,” they are among the most common benign skin tumors seen in adults over middle age [2,10].
The growths are typically 1–3 mm in size and appear as raised bumps on the skin. They start small but may gradually enlarge over time, sometimes developing a pedunculated (hanging) shape.
The number of skin tags tends to increase with age, making them more noticeable over time.
Skin tags most commonly appear after age 30 and are more prevalent in women and individuals with obesity [2,19].
Epidemiological studies report that approximately 46% of adults over 50 are affected, with women developing them at roughly 1.5 times the rate of men [2,19].
Individuals with a body mass index (BMI) of 25 or above have an approximately 2–3 times higher risk of developing skin tags [11,20].
Causes of Skin Tags
Skin tags are thought to be related to the four factors listed below, though their exact cause is not fully understood [1,2].
Recent research has revealed that skin tags are not simply a consequence of aging; they are strongly associated with metabolic disorders such as insulin resistance and diabetes [3,5,8,9].
Individuals with diabetes are reported to develop skin tags at approximately 3–4 times the rate of those without the condition [8,20].
- UV exposure
- Skin aging
- Friction
- Obesity
Skin tags are not caused by a virus, so they cannot be transmitted from person to person or spread to nearby skin [1,16,17].
Some studies have explored a possible link with human papillomavirus (HPV), but large-scale investigations have not established a clear association [16,17].
Skin Tags as Markers of Endocrine and Metabolic Disease
From a dermatological perspective, skin tags are not merely a cosmetic concern — they are increasingly recognized as a cutaneous manifestation of systemic internal conditions [3,4,6].
When multiple skin tags are present, screening for metabolic disorders such as diabetes, dyslipidemia, and insulin resistance syndrome is recommended [4,6,12].
Diagnosing Skin Tags: How to Distinguish Them from Malignant Tumors
Diagnosis is made through visual inspection and palpation.
They commonly appear in multiples on the neck, cervical region, and underarms as small growths approximately 2 mm in size, ranging from skin-colored to light brown. Smaller lesions are also referred to as skin tags or acrochordons.
They are soft and may grow into a pedunculated, polyp-like shape over time.
The following features can help distinguish skin tags from malignant tumors [1,25,26].
Dermoscopy examination shows that skin tags display uniform coloration and a consistent vascular pattern, which is useful for differentiating them from conditions such as malignant melanoma [26].
For any suspicious lesion, a definitive diagnosis by tissue biopsy is always required [25].
| Skin Tag | Malignant Tumor | |
|---|---|---|
| Size | 1–3 mm | More likely malignant if over 5 cm |
| Shape | Symmetrical | Asymmetrical |
| Border | Well-defined | Poorly defined |
| Surrounding area | Flat and smooth | Irregular |
| Ulceration / Necrosis | Absent | Present |
| Rate of growth | Slow and gradual | Rapid |
※ The differential diagnostic criteria above are based on international dermatology society guidelines [25,26].
In the table, “ulceration” refers to tissue loss extending into the deeper layers of the skin, while “necrosis” refers to the partial death of tissue.
Skin tags and malignant tumors differ in many ways, including size and shape. Distinguishing between them on your own is not straightforward. If you have any concerns about a diagnosis, we encourage you to consult a clinic at an early stage.
Classification of Skin Tags
Skin tags are often classified by size as follows [1,18].
This classification is important for determining the treatment approach. For small acrochordons, simple excision or laser treatment is generally chosen, while surgical excision is typically indicated for larger skin tags [7,24].
- Smaller lesions: referred to as skin tags or acrochordons
- Larger lesions: referred to as soft fibromas (molluscum fibrosum)
- Very large, pendulous lesions: referred to as pedunculated soft fibromas
Soft fibromas and skin tags tend to protrude from the skin, whereas acrochordons are relatively flat. Shape can therefore be a useful reference point when distinguishing between skin tags and acrochordons.
Epidemiology and Incidence of Skin Tags
Skin tags are extremely common in middle-aged and older adults, occurring in approximately 46% of people over the age of 50 [2].
Women are affected roughly 1.5 times more often than men, and the risk is 2–3 times higher in individuals with obesity [2,11,19].
The most common site is the neck (approximately 70%), followed by the axillae and groin [2,15].
Association Between Skin Tags and Metabolic Disease
Skin tags are not merely a cosmetic concern — they are clinically important as a cutaneous manifestation of metabolic disorders such as diabetes and insulin resistance [3,5,8,9].
Among patients with multiple skin tags, the prevalence of diabetes is reported to be 3–4 times higher than in the general population [8,20], and the co-occurrence of dyslipidemia is approximately twice as high [4,12].
For this reason, internal medicine screening is recommended for patients with multiple skin tags [6,14].
Diagnosis and Dermoscopic Findings of Skin Tags
Skin tags can generally be diagnosed by visual inspection and palpation alone, but dermoscopy allows for more detailed examination [26].
Typical dermoscopic features include uniform light-brown coloration, an arborizing vascular pattern, and a smooth surface — findings that are useful in differentiating skin tags from malignant melanoma and similar conditions [26].
For suspicious or rapidly changing lesions, a definitive diagnosis by tissue biopsy is necessary [25].
Treatment Options and Prognosis
The choice of treatment for skin tags depends on the size and number of lesions [24,27].
For small lesions (2 mm or less), electrocautery or cryotherapy with liquid nitrogen is used; for medium-sized lesions (2–5 mm), scissor excision is indicated; and for large lesions (5 mm or more), surgical excision is typically performed [24,27].
With appropriate treatment, the recurrence rate is reported to be 5% or less, and patient satisfaction with cosmetic outcomes is generally high [27].
Skin Tags, Diabetes, and Insulin Resistance
Skin tags are recognized as a clinically significant cutaneous finding not only in dermatology but also in the field of endocrinology and metabolic medicine [3,5,8].
Symptoms of Skin Tags
Skin tags are generally painless, though larger ones may become uncomfortable due to friction. Infection or inflammation is uncommon.
Many people have lived with skin tags on their back, abdomen, neck, or thighs for years without realizing how straightforward treatment can be — and those who do seek treatment are often very pleased with the results.
When multiple skin tags are clustered on the neck or similar areas, a physician can often remove several in the same session, with careful attention to cosmetic outcome.
Occasionally a skin tag may develop a mushroom-like stalk, but as these are benign growths, there is no urgent need for treatment.
Two Treatment Options for Skin Tags — Removable with Dermatological Procedures
As skin tags are generally benign, our clinic treats them through surgical excision, scissor removal, or high-frequency (radiofrequency) excision as appropriate [7,24,27].
International dermatological surgery guidelines recommend electrocautery for small lesions, scissor excision for medium-sized lesions, and surgical excision for large lesions [24,27].
Below, we explain the following two treatment approaches in more detail.
- Surgery
- CO2 laser (carbon dioxide laser)
While cryotherapy with liquid nitrogen is another option, it carries a risk of burns and post-inflammatory hyperpigmentation and is therefore not routinely performed at our clinic.
Surgery
Surgery involves removing the skin tag with a scalpel under local anesthesia.
It is indicated for larger skin tags or when there is a possibility that the lesion may be malignant.
Our clinic aims to complete procedures as efficiently as possible — some cases can be completed in under five minutes. Surgical treatment at our clinic is covered by health insurance, so please feel free to contact us with any questions.
CO2 Laser (Carbon Dioxide Laser)
CO2 laser treatment removes skin tags by directing a laser that reacts with water to ablate the skin surface.
It may be a suitable option when skin tags are numerous or have proven difficult to treat by other means.
Compared with scalpel-based treatment, healing tends to be faster and scarring is less likely, as the deeper dermal layer is preserved. Although skin tissue is ablated, bleeding is minimal.
Following CO2 laser treatment, sun protection is important to prevent UV exposure to the treated area.
For detailed information about our CO2 laser treatment, please also visit the page below.
Wart and Mole Removal with CO2 Laser — Features, Pricing, and Precautions
Our Approach to Treatment
At our clinic, we use ultra-fine needles to minimize discomfort during local anesthesia injections.
When suturing is required, we take great care to minimize the appearance of any scarring.
Multiple skin tags located close together can often be removed in a single session, allowing for a treatment approach that pays close attention to cosmetic results.
Our physicians assess the location and size of each lesion and determine the most appropriate treatment method.
Using plastic surgery instruments, we perform procedures with minimal incisions — including scissor excision, incision with suturing, or high-frequency (radiofrequency) excision — chosen to achieve the best possible outcome.
We approach every treatment with care and attention to detail, and we welcome you to entrust your skin tag treatment to our clinic.
Treatment Fees for Skin Tags
For skin tag treatment, all aspects of care — including consultation, examinations, surgery, and pathological testing — are covered by health insurance. Public assistance programs and other subsidies are also accepted.
Our fees for skin tag treatment are as follows.
- Exposed areas: approximately ¥5,000–¥15,000
- Non-exposed areas: approximately ¥4,000–¥10,000
For full pricing details, please refer to our skin tag surgery fee schedule.
Please note that CO2 laser treatment is not covered by health insurance.
Frequently Asked Questions About Skin Tags
Here we answer some of the most common questions about skin tags.
Skin tags are not caused by a virus, so there is no risk of passing them to others [1,16,17].
Large-scale studies have also ruled out a clear link with human papillomavirus (HPV), and skin tags are not infectious in any way [16,17].
Skin tags typically appear on the neck and underarms, whereas viral warts most commonly develop on the fingers, soles of the feet, face, and arms — not on the neck.
Growths appearing on the neck or underarms are therefore unlikely to be viral warts. That said, some types of viral warts can enlarge over time.
Rather than assuming a growth is a skin tag, we recommend consulting a clinic for a proper assessment.
Skin tags are benign growths. If you are not bothered by their appearance, leaving them untreated is generally not a significant concern.
However, you should not attempt to remove them yourself. If the growth turns out to be a viral wart rather than a skin tag, there is a risk that it could spread to the surrounding skin.Attempting self-treatment increases the risk of worsening the condition.
There are creams and products marketed for wart removal, but many lack clear scientific evidence.
For effective management of skin tags, we encourage you to consider consulting a clinic.
The costs of skin tag surgery are fully covered by health insurance [7,24].
Consultation, examinations, and pathological testing are also covered. Surgical treatment is recognized as a standard procedure in domestic dermatology clinical guidelines [13].
The specific treatment and associated costs may vary depending on the location and size of the lesion, so please ask during your consultation for detailed information.
CO2 laser treatment for cosmetic purposes is not covered by health insurance.
During skin tag surgery, local anesthesia is used, so discomfort during the procedure is generally minimal.
You may feel some discomfort during the local anesthesia injection; however, our clinic uses ultra-fine needles to help minimize this.
Some patients do experience mild discomfort after the procedure once the anesthesia wears off.
Individual responses vary, so if you have any concerns, please feel free to discuss them during your consultation.
Most over-the-counter wart removal products are designed for viral warts.
Skin tags are not viral warts, so these products are not intended for this type of growth.
Some over-the-counter products should not be used on seborrheic keratoses (age spots), so correctly identifying the type of growth is important.
To avoid mistaking a skin tag for a seborrheic keratosis — or vice versa — we encourage you to consult a clinic.
6 Features of Our Clinic That Patients Appreciate
Team-Based Care — Under the supervision of board-certified plastic surgeons, our clinic brings together specialists from multiple disciplines including plastic surgery, dermatology, and orthopedics.
Attention to Comfort — Our specialist physicians select from a broad range of treatment methods, aiming to minimize discomfort throughout the process.
Careful Scarring Outcomes — We perform surgical removal with meticulous care to avoid damage to the surrounding skin.
Insurance-Covered Treatment Available — Surgical excision with a scalpel is fully covered by health insurance at our clinic.
No Hospitalization Required — Same-Day Surgery Available — From consultation to procedure, the process is smooth and efficient. Same-day surgery is available.
Convenient Location — Our clinics are located within easy walking distance of major terminal stations in central Tokyo.
Many of our patients come to us with the following concerns.
Do any of these sound familiar?
Those who want to remove raised skin growths on the neck, underarms, or similar areas
Busy professionals who cannot set aside a large block of time for treatment
Women who care deeply about achieving aesthetically pleasing results after surgery
We carefully assess the condition of each patient’s skin and recommend treatment options that aim to minimize scarring as much as possible. Our physicians bring broad knowledge and clinical experience to every procedure — please feel free to consult us.
References
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