Overview

Skin tags (acrochordons) are small soft benign skin growths hanging off the skin by thin stalks. Very common, affecting up to 46% of adults. While medically harmless, they can be cosmetically bothersome or irritated by friction. In Kuwait and the GCC, their association with obesity, diabetes, and metabolic syndrome makes multiple skin tags a clinically relevant finding.

Symptoms

• Small (2-5mm) soft flesh-coloured or brownish growths on thin stalks
• Most common on neck, armpits, groin folds, eyelids, and under breasts
• Painless unless twisted, irritated, or rubbed by clothing or jewellery

Causes & Risk Factors

• Skin friction in folds; overweight and obesity
• Insulin resistance and type 2 diabetes — multiple skin tags may be a marker
• Pregnancy, genetics, and advancing age

Complications

• Benign — never become cancerous
• Multiple tags may signal underlying insulin resistance or diabetes requiring investigation

Diagnosis

Clinical diagnosis. Any unusual, rapidly growing, bleeding, or changing growth should be biopsied. Patients with multiple tags should be screened for insulin resistance and diabetes.

Treatment

• No treatment needed if small and asymptomatic
• Removal options (all in clinic under local anaesthetic): cryotherapy, electrocautery, surgical snipping, ligation
• Do not attempt to cut off skin tags at home — risk of bleeding and infection

Prevention

• Maintain healthy body weight to reduce skin fold friction
• Manage blood sugar levels
• Have metabolic markers checked if multiple tags develop

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