From the Guidelines
Skin tags can be safely removed in primary care settings through several methods, including snipping with sterile scissors, cryotherapy with liquid nitrogen, electrocautery, or ligation with a suture or thread. The most common approaches for removal include:
- Snipping with sterile scissors after cleaning the area and applying local anesthesia (1% lidocaine with epinephrine)
- Cryotherapy with liquid nitrogen for about 10-30 seconds until the skin tag turns white
- Electrocautery using heat to burn off the skin tag after local anesthesia
- Ligation involving tying off the base of the skin tag with sterile suture material or dental floss, cutting off blood supply until it falls off in 5-10 days. Post-procedure care includes keeping the area clean, applying petroleum jelly or antibiotic ointment, and watching for signs of infection (redness, warmth, increasing pain, pus) 1.
However, it's essential to note that the provided evidence primarily focuses on actinic keratosis rather than skin tags. Despite this, the general principle of managing skin lesions in primary care can be applied, emphasizing the importance of proper diagnosis and treatment. When considering removal, it's crucial to assess the size and number of skin tags, as multiple or very large skin tags may require referral to dermatology. Patients should be informed that minor bleeding, scabbing, and temporary discoloration are normal. Insurance coverage varies, as skin tag removal is often considered cosmetic unless the tags are symptomatic (painful, bleeding, or interfering with daily activities).
In primary care settings, healthcare professionals can play a significant role in diagnosing and treating skin conditions, including skin tags, by providing guidance on prevention, self-care, and when to seek specialist care 1.
From the Research
Skin Tag Removal Methods
- Cutaneous cryotherapy is a treatment method for benign skin lesions, including skin tags 2
- This method uses liquid nitrogen as the freezing agent, with a boiling point of -196 degrees C 2
- Carbon dioxide snow, with a temperature of -79 degrees C, can be used as an alternative to liquid nitrogen 2
Treatment Considerations
- Complications from cutaneous cryotherapy are infrequent when the correct technique is used 2
- Local anaesthetic is usually not necessary for this treatment method 2
- The treatment can be used to remove various types of benign skin lesions, including solar and seborrhoeic keratoses, viral warts, and skin tags 2