From the Guidelines
For a bothersome skin tag, the primary care physician should not recommend excision, especially if the patient has a history of Crohn's disease, due to the high rate of postoperative complications, including poor wound healing and subsequent proctectomy, as reported in the american gastroenterological association medical position statement 1. When considering treatment for a skin tag, the primary care physician should prioritize methods that minimize the risk of complications and promote optimal healing.
- The most common methods for removal include snipping the skin tag off with sterile scissors after numbing the area with lidocaine (1-2% solution), freezing it with liquid nitrogen cryotherapy, or burning it off using electrocautery.
- These procedures are quick, usually taking just a few minutes, and cause minimal discomfort.
- After removal, the physician may apply aluminum chloride solution to stop any minor bleeding and recommend keeping the area clean with gentle soap and water until healed, typically 3-7 days.
- Over-the-counter antibiotic ointment like Bacitracin or Neosporin may be suggested to prevent infection. However, it is essential to consider the patient's medical history and the potential risks associated with excision, as highlighted in the study 1, to determine the best course of treatment. In general, skin tags are benign growths consisting of loose collagen fibers and blood vessels covered by skin, often occurring in areas where skin rubs against skin or clothing. While home remedies exist, professional removal is safer and more effective, especially for larger tags or those in sensitive areas. If the skin tag appears unusual in color, size, or is painful, the physician may recommend sending the removed tissue for pathological examination to rule out other conditions.
From the Research
Treatment Options for Bothersome Skin Tags
- Cryotherapy: a highly effective treatment for benign skin problems, including skin tags, with minimal side effects such as hypopigmentation and depigmentation 2, 3
- Electrosurgery: a suitable option for removing skin tags, with high patient and physician satisfaction rates 2
- Excision with ethyl chloride spray anesthesia: a painless and comfortable method for skin tag excision, using micro-scissor and micro-forceps 4
- Mechanical device: a novel medical device that applies pressure to the base of a skin tag, leading to its removal within 3-6 days, with minimal discomfort and excellent cosmetic outcome 5
- Snip-excision: a simple and effective method for removing skin tags, often used in combination with other treatments 6
Considerations for Treatment
- Patient satisfaction and comfort: ethyl chloride spray anesthesia and mechanical device have been shown to be comfortable and painless options for skin tag removal 4, 5
- Lesion size and location: cryotherapy and electrosurgery may be more suitable for larger or more sensitive areas 2, 3
- Potential side effects: hypopigmentation, depigmentation, and scarring are possible side effects of cryotherapy and electrosurgery, while excision with ethyl chloride spray anesthesia and mechanical device have minimal side effects 4, 5, 2, 3