Skin tags, medically known as acrochordons, are small, benign growths that frequently prompt questions about their relationship to underlying health conditions, most notably diabetes. While these growths are extremely common and often harmless, their appearance, particularly in large numbers, has been consistently linked in medical literature to certain metabolic disturbances. Understanding the nature of skin tags and their connection to how the body processes sugar and insulin provides important context for overall health screening.
What Skin Tags Are and Where They Appear
Skin tags are small, soft, and usually flesh-colored growths that hang off the skin by a thin stalk (peduncle). They are non-cancerous tumors composed of a core of collagen fibers and blood vessels surrounded by an outer layer of skin tissue (epidermis). They are generally small, typically ranging from one to five millimeters in diameter.
These growths are incredibly common, with estimates suggesting that between 50% and 60% of adults will develop at least one in their lifetime. They often develop in areas where skin rubs against skin or clothing, which is why they are most frequently found in skin folds. Common locations include the neck, armpits (axillae), groin, under the breasts, and on the eyelids.
The friction caused by skin folds is a common physical trigger for their development. They are generally painless unless they become irritated by jewelry or clothing, which can cause them to become sore or bleed. Although they can appear due to genetics or age, their presence in certain patterns can sometimes serve as a visual cue for internal changes.
The Connection to Insulin Resistance and Prediabetes
The appearance of multiple or large skin tags, especially in clusters, has a well-documented correlation with metabolic health, specifically insulin resistance. Insulin resistance is a condition where the body’s cells become less responsive to the hormone insulin. When this happens, the pancreas must produce increasingly higher amounts of insulin to maintain normal blood sugar levels, leading to a state called hyperinsulinemia.
This excess insulin is thought to act as a growth-promoting factor within the skin. High levels of insulin activate receptors in skin cells, which stimulates their proliferation and leads to the formation of the skin tag. This mechanism explains why individuals with impaired glucose metabolism are up to three times more likely to develop multiple skin tags compared to those with normal metabolism.
Insulin resistance is the precursor to prediabetes and Type 2 diabetes, making the sudden or numerous appearance of skin tags a potential early warning sign of metabolic disturbance. The association is also strong with metabolic syndrome, a cluster of conditions that includes abdominal obesity, high blood pressure, and high cholesterol.
When Metabolic Screening is Recommended
While a single skin tag is unlikely to be a cause for concern, their presence, particularly when numerous, warrants a conversation with a healthcare provider about metabolic screening. This is especially true if skin tags appear suddenly or are accompanied by other risk factors for Type 2 diabetes, such as a family history of diabetes, obesity, high blood pressure, or a sedentary lifestyle.
Another dermatological sign that strengthens the case for screening is the presence of acanthosis nigricans, which manifests as dark, thick, velvety patches of skin, most often in the armpits or on the back of the neck. This condition is also directly linked to insulin resistance and frequently co-occurs with skin tags. If a patient presents with multiple skin tags and these other signs, a doctor will likely recommend blood tests to assess glucose control.
Standard screening tests for diabetes and prediabetes include the A1C test, which provides an average of blood sugar levels over the past two to three months, and a fasting plasma glucose test. Identifying insulin resistance or prediabetes early allows for lifestyle changes or medical intervention that can prevent or delay the onset of full Type 2 diabetes.
Professional Skin Tag Removal Methods
For many people, skin tags are a cosmetic annoyance or a source of physical irritation, leading them to seek removal. Professional removal is a quick, in-office procedure that is significantly safer than attempting at-home methods, which carry a high risk of infection and scarring. Removal treats the symptom, not the underlying metabolic condition.
One common method is cryotherapy, which involves applying liquid nitrogen to the skin tag to freeze and destroy the tissue. The tag then shrivels and naturally falls off within a week or two.
Another effective method is surgical excision, where the healthcare provider uses sterile surgical scissors or a scalpel to snip the tag off at its base. This method is often used for larger tags and offers immediate results, sometimes requiring a local anesthetic. Electrocautery, or radiofrequency cautery, uses a small electrical current or heat to burn the tag off, which seals the blood vessels instantly and minimizes bleeding.