Skin Polyp (Skin Tag)

What is a skin polyp?

In medicine, a polyp is any growth that sticks out from a surface on a stalk. When this happens on the skin, the usual cause is a skin tag, also called an acrochordon or fibroepithelial polyp. So yes: a skin tag is a type of polyp, and "skin polyp" and "skin tag" usually mean the same thing.

Under a microscope a skin polyp is a fold of normal skin covering a loose core of collagen fibers, fat cells and small blood vessels. It contains no abnormal cells.

Typical features:

• soft and squashy, easily moved
• attached by a thin stalk (a peduncle), though small ones can be almost flat
• flesh-colored or slightly darker brown
• from 1 mm up to about 1 cm, occasionally larger
• painless unless twisted or irritated

Skin polyp vs internal polyps

The polyps people hear about in the colon, nose, uterus or vocal cords are different growths in mucous membranes. Some colon polyps can turn into cancer, which is why they are removed. Skin polyps carry no such risk, and having skin tags does not mean you have polyps elsewhere. A few older studies suggested a link with colonic polyps, but this has not held up and skin tags are not a reason for a colonoscopy.

Why skin polyps form

The exact cause is unknown. The strongest triggers are friction and hormones:

• Skin rubbing on skin or clothing, which is why they cluster in folds, the neck and under bra straps
• Excess weight, which creates more skin folds
• Insulin resistance and type 2 diabetes: high insulin levels stimulate skin cell growth. Many skin tags appearing along with dark, velvety patches (acanthosis nigricans) is a recognized marker of insulin resistance
• Pregnancy, due to hormonal changes. Some shrink after birth
• Age: they become common after 40
• Family tendency
• Rare genetic conditions such as Birt-Hogg-Dubé syndrome, in which many small facial growths can look like skin tags

Skin polyps are not contagious and are not caused by a virus.

Skin polyp or something else?

Most skin polyps are easy to recognize, but a few other growths look similar. A doctor can usually tell them apart by looking, sometimes with a dermatoscope (a lighted magnifier).

A growth that is changing, bleeding, crusting or unusually colored should be examined, and may be sent to a lab after removal to confirm what it is.

How to treat a skin polyp

Treatment is optional and done for comfort or appearance. Because it is considered cosmetic, health insurance often covers removal only when a tag is symptomatic, for example repeatedly bleeding or irritated.

Removal by a doctor

These are quick office procedures, usually with a little local anesthetic:

• Snip excision: the stalk is cut with sterile scissors or a scalpel. It is fast, and the tissue can be sent for testing.
• Cryotherapy: liquid nitrogen freezes the tag, which falls off in 1 to 2 weeks. It can leave a pale mark on darker skin.
• Electrocautery: a heated wire burns through the stalk and seals the vessels.
• Ligation: a suture is tied around the base so the tag loses its blood supply and drops off.

Small tags may bleed briefly. Healing takes 1 to 2 weeks and usually leaves little or no scar.

Home removal: proceed with caution

Dermatologists generally advise against cutting off skin polyps yourself. Bleeding can be surprisingly heavy, and infection or scarring can follow. Over-the-counter freezing kits and removal bands exist, but they are less reliable than office treatment and should never be used on the eyelids, genitals or a growth you are unsure about. Creams and products sold online with claims of dissolving tags have little evidence and can burn the skin. Do not use them on anything that might not be a skin tag, because treating a skin cancer at home can delay diagnosis.

After removal

New skin polyps may form in the same areas, because the underlying tendency remains. Losing weight and improving blood sugar control may reduce how many appear.

Complications

Skin polyps rarely cause problems. Possible issues include:

• Irritation and bleeding when caught on clothing, a razor or jewelry
• Twisting (torsion): the stalk twists, cutting off the blood supply. The tag turns dark red, purple or black and may hurt, then usually shrivels and falls off by itself over days. This is not dangerous, but have it checked if you are unsure
• Infection after injury, which is uncommon

Frequently asked questions

What are skin polyps?

Skin polyps are small, soft, benign growths that hang from the skin on a narrow stalk. They are the same as skin tags (acrochordons) and are made of normal skin, collagen, fat and small blood vessels. They are very common, especially in skin folds, and are harmless.

Is a skin tag a polyp?

Yes. A polyp is any growth on a stalk, and a skin tag is a polyp of the skin. Doctors call it a fibroepithelial polyp or acrochordon. It is unrelated to colon or nasal polyps and does not carry a cancer risk.

What is the difference between a polyp and a skin tag?

On the skin, there is essentially none: skin tags are skin polyps. The difference matters inside the body. Polyps in the colon, uterus or nose are growths of mucous membrane, and some colon polyps can become cancerous. Skin tags cannot.

How do you treat a skin polyp?

Most need no treatment. If one bothers you, a doctor can remove it in minutes by snipping it off, freezing it with liquid nitrogen, burning it with cautery or tying it off. Avoid cutting it yourself, as it can bleed heavily and become infected.

Can skin polyps be cancerous?

Skin polyps themselves are benign and do not turn into cancer. Occasionally a skin cancer or other growth can look like a tag. See a doctor about any growth that changes quickly, bleeds, crusts, is firm or has an unusual color.

Why am I getting so many skin tags?

The most common reasons are friction in skin folds, excess weight, insulin resistance or type 2 diabetes, pregnancy and family tendency. If many appear quickly, especially with dark, velvety skin in the neck or armpits, ask your doctor to check your blood sugar.