What medical specialty removes skin tags from the penis?

Medical Specialties for Removal of Penile Skin Tags

Dermatologists and urologists are the primary specialists who remove skin tags from the penis, with urologists being the preferred choice for genital lesions that may involve deeper penile structures.

Appropriate Medical Specialists

Primary Options:

• Urologists:

  • Specialists in the male genitourinary system
  • Most experienced with penile anatomy and surgical procedures
  • Recommended for skin tags that may involve deeper penile structures 1
  • Can perform both diagnostic evaluation and surgical management 1

• Dermatologists:

  • Experts in skin conditions and dermatologic procedures
  • Well-equipped to diagnose and treat superficial skin lesions
  • Experienced with various removal techniques including cryotherapy, excision, and electrocautery 1, 2

Diagnostic Approach Before Removal

Before removal, it's crucial to ensure the lesion is truly a skin tag and not another condition:

1. Clinical examination to distinguish skin tags from:

   • Pearly penile papules (normal variant)
   • Fordyce spots (normal variant)
   • Condyloma acuminata (genital warts)
   • Molluscum contagiosum
   • Seborrheic keratosis 3, 2

2. Biopsy consideration if there are any suspicious features:

   • Non-healing lesions
   • Ulceration
   • Rapid growth
   • Atypical appearance 1, 2

Removal Techniques

The choice of removal technique depends on:

• Size and location of the skin tag
• Patient preference
• Provider expertise

Common techniques include:

1. Surgical excision:

   • Simple excision with scissors or scalpel
   • Appropriate for larger lesions
   • Provides tissue for histopathological examination if needed 1

2. Cryotherapy:

   • Application of liquid nitrogen
   • Efficacy rates of 63-88% for similar lesions
   • May require multiple treatments 4

3. Electrocautery:

   • Burning the lesion with electrical current
   • Good for small to medium-sized lesions
   • Provides hemostasis during removal 2

4. Ligation:

   • Tying off the base of the skin tag
   • Causes tissue necrosis and eventual separation
   • Can be performed with specialized devices 5

Important Considerations

• Rule out malignancy: Any suspicious lesion should be biopsied to exclude penile intraepithelial neoplasia (PeIN) or squamous cell carcinoma 1

• Underlying conditions: Some skin lesions may be associated with conditions like lichen sclerosus that require additional treatment 1

• Post-procedure care: Proper wound care instructions should be provided to prevent infection and optimize healing 6

• Follow-up: Patients should be advised to return if there are any concerning changes to the surgical site or if new lesions appear 1

Pitfalls to Avoid

• Misdiagnosis: Not all penile lesions are skin tags; misdiagnosis can lead to inappropriate treatment 3, 2

• Overtreatment: Normal variants like pearly penile papules are often mistaken for pathologic conditions and unnecessarily treated 2

• Delayed diagnosis: Failing to recognize premalignant or malignant lesions can lead to disease progression 1

• Inadequate pain control: Genital procedures require appropriate anesthesia due to the sensitivity of the area 6

By consulting the appropriate specialist (urologist or dermatologist) and ensuring proper diagnosis before removal, patients can receive safe and effective treatment for penile skin tags.