Skin tags are common skin growths that many people develop as they age. They are benign, non-cancerous, and appear as skin-colored or slightly darker bumps connected to the skin by a thin stalk. While often considered a cosmetic concern, their presence, especially when multiple, has been increasingly linked to systemic health issues. This raises the question of whether these growths might serve as visible markers for deeper metabolic changes, such as those leading to diabetes. This article explores the relationship between skin tags and underlying health conditions, focusing on the link to insulin resistance and associated metabolic disorders.
Defining Skin Tags and Non-Systemic Causes
Acrochordons are composed of a fibrovascular core—a bundle of collagen fibers and blood vessels—covered by an outer layer of skin. They commonly range from one to five millimeters and are most frequently found in areas where skin folds or creases occur, such as the neck, armpits, groin, under the breasts, and on the eyelids.
The most frequent non-disease cause of skin tags is mechanical friction, or skin rubbing against skin, clothing, or jewelry. The likelihood of developing these growths increases after the age of 40, affecting nearly half of the general population. Genetic predisposition is also recognized. Pregnancy is another common factor, where hormonal fluctuations and weight gain often lead to the temporary development of new tags.
The Connection to Insulin Resistance and Diabetes
The presence of multiple skin tags is strongly associated with impaired carbohydrate metabolism, particularly Type 2 Diabetes Mellitus. This link stems from the underlying state of insulin resistance that precedes and accompanies diabetes. Insulin resistance occurs when cells do not respond effectively to insulin, forcing the pancreas to produce higher amounts. This results in elevated insulin circulating in the bloodstream (hyperinsulinemia).
Hyperinsulinemia acts as a growth-promoting factor in the skin. The excess insulin stimulates Insulin-like Growth Factor-1 (IGF-1) receptors on skin cells. Activation of these receptors promotes cell proliferation and growth, leading to the formation of the skin tag’s core. Studies indicate that patients with many skin tags (sometimes defined as more than 30) have an increased incidence of impaired glucose tolerance or diabetes.
Skin tags are not a definitive diagnostic tool, but their presence is considered a cutaneous marker for hyperinsulinemia. Individuals with skin tags often have higher fasting insulin levels. The formation of multiple skin tags may be one of the earliest visible indicators that a metabolic problem is developing, potentially years before a formal diabetes diagnosis.
Other Associated Metabolic Conditions
Skin tags are linked to a broader set of conditions that share the underlying problem of insulin resistance, not just Type 2 Diabetes. A significant association is with Metabolic Syndrome, a cluster of risk factors increasing the risk of heart disease and stroke. These factors include abdominal obesity, high blood pressure, abnormal cholesterol levels, and high blood sugar.
Individuals who are overweight or obese frequently develop skin tags, due to both increased mechanical friction and the higher prevalence of insulin resistance. Since obesity is a major component of Metabolic Syndrome, multiple skin tags can alert a physician to the need for a comprehensive metabolic evaluation.
Polycystic Ovary Syndrome (PCOS), a common hormonal disorder in women, is another linked condition. Insulin resistance is a key feature of PCOS, contributing to hormonal imbalances and skin manifestations. The appearance of skin tags in patients with risk factors for PCOS or other components of Metabolic Syndrome signals a potential systemic metabolic imbalance.
Next Steps: Consulting a Professional and Removal Options
If an individual notices a sudden increase in skin tags, especially with symptoms like unexplained weight gain, frequent urination, or increased thirst, consulting a healthcare professional is advisable. A physician will evaluate the tags and may recommend diagnostic tests for underlying metabolic issues, such as an HbA1C test or a fasting glucose test. Evaluation is also important to rule out other skin conditions that resemble skin tags.
While most skin tags are harmless, removal is an option for growths that cause irritation, bleeding, or cosmetic concern. Professional removal methods are quick and safe:
- Cryotherapy, which freezes the tag with liquid nitrogen.
- Surgical excision, which involves snipping the tag with sterile scissors.
- Electrocautery, which uses heat to burn the tag off at the base.
Treating any underlying metabolic condition, such as implementing diet and lifestyle changes to improve insulin sensitivity, is the primary focus for overall health. Managing the metabolic imbalance may also help reduce the formation of new skin tags over time.