Skin tags (acrochordons) are common, benign skin growths that appear as small, soft flaps. They are composed of collagen fibers and blood vessels and typically form where skin folds or rubs against itself, such as the neck, armpits, and groin. While harmless, their presence can be bothersome, leading many people to seek affordable at-home removal devices. These products, often marketed as pens or kits, offer a simple alternative to professional dermatological care.
Understanding Removal Pen Mechanisms
At-home removal devices employ several different mechanisms designed to destroy the tissue of the skin tag. One common approach is ligation, which uses a small band or thread to tightly wrap around the base of the growth. This action physically cuts off the blood supply to the skin tag, leading to tissue death and causing the growth to shrivel and eventually fall off over several days.
Other devices utilize a form of cryotherapy, which involves applying a freezing agent to the skin tag. These pens typically contain a cold substance, such as dimethyl ether and propane, which aims to freeze the tissue, causing cellular destruction. The goal is for the frozen tissue to blister and detach after a period of approximately one to two weeks.
A third method involves electrocautery or plasma technology, often seen in “mole removal pens.” These handheld devices deliver a high-frequency electrical current or plasma arc to the skin tag, cauterizing and burning the tissue. This process is intended to dehydrate and destroy the lesion, allowing it to scab over and fall away.
The Critical Issue of Self-Diagnosis
The primary danger of using any at-home removal method is not the device itself, but the risk of misdiagnosis. Many serious skin conditions can closely resemble a benign skin tag to the untrained eye. For instance, early-stage skin cancers like nodular melanoma or basal cell carcinoma can sometimes appear as small, flesh-colored bumps or polyps.
Attempting to remove a lesion without professional confirmation means a potentially malignant growth is not properly evaluated. If a cancerous lesion is only partially removed or destroyed, the remaining cells can continue to grow and potentially spread without detection. This results in a significant delay in receiving life-saving treatment, which is the most consequential risk.
Furthermore, governmental agencies have expressed concerns regarding the lack of regulatory oversight for these consumer products. The U.S. Food and Drug Administration (FDA) has issued warnings against using unapproved over-the-counter products for mole and skin tag removal. There are currently no FDA-approved drug products for the removal of these lesions. The agency notes that using these unapproved products may lead to permanent injury, scarring, and delayed diagnosis of serious conditions.
Specific Risks and Adverse Outcomes
Physical complications resulting from improper home use are often severe. The use of non-sterile instruments or environments significantly increases the risk of bacterial infection at the site of removal. Since many skin tags occur in warm, moist areas like the armpits or groin, the risk of developing a serious secondary infection is compounded when the skin barrier is compromised.
The methods themselves can cause extensive damage to the surrounding healthy skin tissue. Caustic chemical agents, such as those containing high concentrations of salicylic acid or Sanguinaria canadensis (bloodroot), are present in some kits and can cause chemical burns, severe pain, and ulceration. At-home cryotherapy kits often contain a less powerful freezing agent than professional liquid nitrogen, leading to incomplete removal and repeated applications that increase skin irritation.
Both heat and cold methods carry a substantial risk of permanent scarring or changes in skin color. Improperly applied heat from electrocautery pens can leave behind noticeable burn scars, while freezing can result in hypopigmentation (lightening) or hyperpigmentation (darkening) of the skin, which is a particular risk for individuals with darker skin tones. Using these devices near sensitive areas, such as the face or eyelids, is especially dangerous and has led to reports of serious injuries including permanent disfigurement.
When to Consult a Dermatologist
A professional evaluation is necessary before attempting to remove any skin growth, especially if the lesion exhibits specific characteristics. You should consult a dermatologist if the skin tag is rapidly changing in size, color, or shape, begins to bleed spontaneously, or becomes painful. Any lesion that is unusually large or has an irregular border should also be seen by a professional to rule out malignancy.
Removal of lesions located in highly sensitive areas, such as the eyelids, genitals, or near the mouth, should only be performed in a clinical setting. Dermatologists use safe, sterile, and precise techniques tailored to the specific lesion. Professional methods include surgical excision (snip removal), which removes the tag with sterile scissors or a scalpel, or electrodessication, which uses a controlled electric current to burn and dry out the tissue.
Cryotherapy in a medical setting is performed using concentrated liquid nitrogen, which ensures accurate freezing depth and minimizes damage to the surrounding skin. These controlled procedures greatly reduce the risk of infection, excessive bleeding, and permanent scarring, providing a safer and more effective alternative to at-home devices.