Acrochordons, commonly known as skin tags, are small, benign growths of the skin that typically appear in areas where the skin folds, such as the neck, armpits, and groin. While they are generally harmless and often attributed to friction, the presence of multiple skin tags can signal an underlying metabolic change. This finding has a proven association with insulin resistance, a condition where the body’s cells become less responsive to the hormone insulin. This connection reveals how the body’s internal chemistry, specifically its handling of sugar, can physically manifest on the skin.
The Biological Connection Between Skin Tags and Insulin Resistance
When cells resist the action of insulin, the pancreas attempts to overcome this resistance by producing and releasing large amounts of the hormone, a state known as hyperinsulinemia. This sustained high level of circulating insulin is the primary driver for the formation of acrochordons.
Insulin is recognized not only for regulating blood sugar but also as a growth-promoting hormone. Elevated insulin levels interact with specific receptors on skin cells, particularly the insulin-like growth factor 1 (IGF-1) receptors on keratinocytes and fibroblasts. This interaction stimulates the proliferation and growth of these skin cells, leading to the physical formation of skin tags.
This physiological process explains why skin tags often appear in clusters and in friction-prone areas. The combination of hyperinsulinemia acting as a growth stimulant and mechanical irritation accelerates the development of these growths. Studies show a strong correlation between the presence of multiple skin tags and metabolic disturbance. The presence of skin tags is considered a visible marker of impaired carbohydrate metabolism.
Other Cutaneous Manifestations of Insulin Resistance
Skin tags are not the only dermatologic sign suggesting insulin resistance; several other conditions are strongly associated with this metabolic state. The most recognized is Acanthosis Nigricans (AN), which presents as dark, velvety, and thickened patches of skin. These patches are most commonly observed in the folds of the skin, such as the neck, armpits, and groin.
Similar to skin tags, the darkening and thickening seen in Acanthosis Nigricans are caused by the overstimulation of skin cells by high levels of insulin and IGF-1. This promotes the proliferation of keratinocytes and increases the production of the pigment melanin, resulting in characteristic hyperpigmentation. The appearance of AN is often a more overt sign of hyperinsulinemia and may serve as an early indicator of metabolic dysfunction.
Insulin resistance is also a component of metabolic syndrome, which can present with other dermatologic findings. In women, hyperinsulinemia can contribute to hormonal imbalances that manifest as hirsutism, the growth of excess coarse hair in a male-like pattern. Impaired immune function and elevated blood sugar levels can also increase susceptibility to certain skin infections, particularly recurrent fungal infections.
Next Steps: Screening and Medical Consultation
If the appearance of skin tags, especially in clusters or alongside other cutaneous signs, raises suspicion of insulin resistance, the next step is to consult with a healthcare provider. A primary care physician or an endocrinologist can evaluate the metabolic status. While a dermatologist can confirm the benign nature of the skin tags, the underlying cause requires systemic investigation.
The diagnosis of insulin resistance or prediabetes relies on specific blood tests that assess how the body processes glucose and insulin.
Diagnostic Tests for Insulin Resistance
- The Fasting Plasma Glucose test measures blood sugar levels after an overnight fast.
- The Hemoglobin A1c (HbA1c) test provides an average of blood sugar levels over the preceding two to three months, offering a view of long-term glucose control.
- The Oral Glucose Tolerance Test (OGTT) tracks blood sugar levels before and after consuming a standardized sugary drink to evaluate the body’s response.
- A fasting insulin level can be measured to assess the degree of hyperinsulinemia, often used in formulas like the HOMA-IR to estimate the level of insulin resistance.
Addressing the Underlying Cause: Managing Insulin Resistance
The most effective way to address skin tags linked to insulin resistance is not through cosmetic removal but by managing the underlying metabolic condition. Improving insulin sensitivity can help prevent the formation of new skin tags. Lifestyle modifications form the foundation of any strategy to manage insulin resistance.
Dietary changes focus on reducing the intake of refined carbohydrates and sugars, which cause rapid spikes in blood glucose. Adopting a diet rich in whole foods, lean proteins, and fiber supports stable blood sugar levels and decreases the demand on the pancreas to produce excessive insulin.
Regular physical activity is essential for improving insulin sensitivity. Exercise helps muscles absorb glucose more efficiently, reducing the amount of insulin the body needs to produce. Aiming for consistent moderate-intensity activity, such as brisk walking, allows for better glucose uptake. Achieving a moderate weight loss, particularly a loss of 5 to 10 percent of body weight, can significantly enhance insulin responsiveness and improve metabolic health.