Expected Color and Shape Changes in Skin Tags After Ligation
After ligation, a skin tag should progressively darken in color from its baseline (typically skin-colored or hyperpigmented) to dark purple, brown, or black as blood flow is occluded, and the tag should shrivel and eventually fall off within 3-6 days. 1
Mechanism of Color Change
The color transformation occurs due to vascular compromise:
Immediate to early changes (0-3 days): The skin tag will darken as blood flow decreases to the base of the lesion, with successful outcomes directly correlated to achieving decreased blood flow immediately after application and at 2-3 days 1
Progressive ischemic changes: As the tissue becomes ischemic from pressure applied to the base, the tag transitions through darker shades—from its original color to purple, then brown or black as tissue necrosis occurs 1
The degree of blood flow occlusion influences outcome, though complete occlusion is not critical for successful removal 1
Expected Timeline and Shape Changes
The physical transformation follows a predictable pattern:
Days 0-3: The tag begins to shrivel and darken as blood supply is compromised 1
Days 3-6: Complete removal typically occurs, with the desiccated tag falling off 1
Success rates vary by size: Lesions up to 1 mm at the base have 90% successful removal, while those up to 2 mm have 76% success rates 1
Normal vs. Concerning Changes
Expected (normal) changes:
- Progressive darkening from baseline color to dark purple/brown/black
- Gradual shriveling and size reduction
- Minimal discomfort throughout the process 1
Concerning changes requiring evaluation:
- Spreading erythema, warmth, or purulent drainage (suggests infection)
- Severe pain beyond minimal discomfort
- Failure to darken or fall off beyond 6 days