The presence of multiple skin tags, medically known as acrochordons, is recognized as a possible outward sign of an underlying metabolic issue. While these small, soft growths are benign, their appearance in increasing numbers can be a physical manifestation of insulin resistance and the resulting state of hyperinsulinemia. This connection suggests that skin tags are a visible cue that warrants a closer look at one’s overall metabolic health. Understanding this relationship helps individuals move toward proactive wellness and earlier detection of potential health challenges.
What Skin Tags Are and Why They Form
Skin tags, or acrochordons, are small, non-cancerous growths that appear as soft, flesh-colored or slightly darker bumps extending from the skin’s surface by a thin stalk. They are composed of loose collagen fibers and blood vessels covered by an outer layer of skin. Skin tags are common, with estimates suggesting that nearly half of all adults will develop at least one in their lifetime.
These growths typically form in areas where skin folds or rubs against itself, such as the neck, armpits, groin, and under the breasts. This constant mechanical friction is a primary non-metabolic cause, as the repeated rubbing triggers the overgrowth of the outer skin layers. Genetics and aging are also contributing factors, with prevalence increasing after the age of 40 and a tendency to run in families. However, when skin tags appear in large numbers, a different biological mechanism is often at play.
Defining Insulin Resistance
Insulin resistance (IR) is a metabolic condition where the body’s cells—specifically in the liver, muscle, and adipose tissue—do not respond effectively to the hormone insulin. Insulin’s primary function is to move glucose (sugar) from the bloodstream into cells to be used for energy. When cells become resistant, glucose is unable to enter them efficiently, causing blood sugar levels to remain elevated.
To overcome this resistance, the pancreas attempts to compensate by producing and releasing progressively larger amounts of insulin. This overproduction leads to hyperinsulinemia, meaning there are abnormally high levels of insulin circulating in the blood. Hyperinsulinemia is often considered the foundation of metabolic syndrome, a cluster of conditions that includes high blood pressure and abnormal cholesterol levels. This state can persist for years before high blood sugar levels fully manifest as prediabetes or Type 2 diabetes.
The Biological Connection Between Insulin and Skin Growth
The link between insulin resistance and skin tags is not through high blood sugar, but through the chronic state of hyperinsulinemia. Insulin is not exclusively a glucose-regulating hormone; it is also a powerful anabolic, or growth-promoting, hormone. The elevated insulin levels resulting from resistance begin to influence growth factors in the skin.
Specifically, the high concentration of insulin in the bloodstream activates receptors for Insulin-like Growth Factor 1 (IGF-1), which are present on skin cells like keratinocytes and fibroblasts. Although insulin and IGF-1 are distinct, their receptors share structural similarities, allowing insulin to bind to and stimulate the IGF-1 receptor when concentrations are sufficiently high. This stimulation triggers a signal cascade that promotes rapid cellular proliferation in the skin’s outer and connective layers.
This excessive growth stimulation causes the localized skin tissue to multiply and form the small, pedunculated growths characteristic of skin tags. Skin tags are essentially a physical result of systemic growth factor stimulation driven by chronic hyperinsulinemia. The presence of numerous skin tags, particularly more than eight, can be considered a clinical marker that strongly suggests underlying insulin resistance and a pre-diabetic status.
Testing for Insulin Resistance and Management Strategies
For individuals with multiple skin tags, testing for insulin resistance provides a clearer picture of their metabolic health. While the gold standard for measuring IR is a complex research procedure, several practical clinical tests are used to assess the condition. Common diagnostic methods include a fasting plasma glucose test, which checks blood sugar after an eight-hour fast, or a Hemoglobin A1C test, which provides an average of blood glucose over the preceding two to three months.
A more direct assessment involves measuring fasting insulin levels, which, when combined with fasting glucose, allows for the calculation of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). A high HOMA-IR value or a significantly elevated fasting insulin level strongly suggests insulin resistance. The most effective management strategy focuses on reversing the underlying IR, which can prevent the development of new skin tags and improve overall health.
Management primarily involves targeted lifestyle changes to increase insulin sensitivity. Adopting a low-glycemic, whole-foods diet and reducing the intake of added sugars can significantly reduce the demand for insulin. Increasing physical activity, especially combining aerobic exercise with resistance training, helps muscle cells become more responsive to insulin. Addressing the root cause through these strategies is the most comprehensive approach, providing benefits that extend far beyond the skin.