The appearance of new growths on the skin can often cause confusion, especially between common types like skin tags and warts. Skin tags (acrochordons) and warts (verrucae) are fundamentally different conditions, stemming from distinct origins and physical makeup. Understanding these core distinctions is the first step in correctly identifying and managing these two common skin lesions.
Fundamental Causes and Origins
Warts are caused by an infection with the Human Papillomavirus (HPV), which stimulates excess growth of keratin, a hard protein in the skin. This viral trigger means warts are infectious and require a break in the skin barrier for the virus to gain entry. Different strains of HPV are responsible for various types of warts, such as common warts on the hands or plantar warts on the feet.
Skin tags are benign growths of loose collagen fibers and blood vessels surrounded by skin. Their formation is primarily linked to mechanical friction, where skin repeatedly rubs against skin or clothing. This explains their common appearance in skin folds like the neck, armpits, and groin. Skin tags are also associated with aging, weight gain, hormonal changes like pregnancy, and underlying conditions such as insulin resistance or Type 2 diabetes.
Distinctive Physical Characteristics
Skin tags are typically soft, pliable, and smooth to the touch. They have a pedunculated appearance, meaning they are attached to the skin by a thin stalk (peduncle), allowing them to hang off the surface. Their coloration usually matches the surrounding skin tone or is only slightly darker.
Warts, conversely, have a distinctly rough, granular, and firm surface, sometimes likened to a cauliflower texture. They generally have a broad base and are raised or dome-shaped, growing into the skin rather than hanging from it. A telltale sign is the presence of tiny black or dark red dots within the lesion, which are actually clotted capillaries. Warts are most common on the hands, fingers, and soles of the feet.
Nature, Contagion, and Potential Health Implications
Skin tags are non-contagious and cannot be spread from person to person or across the body. They are considered benign and pose no significant health risk. Discomfort from a skin tag is generally due to irritation, bleeding, or inflammation caused by being snagged on jewelry or clothing.
Warts, due to their viral origin, are contagious and spread through direct skin-to-skin contact or indirectly via contaminated surfaces. They can also auto-inoculate, meaning a person can spread the infection to different parts of their own body. While most skin warts are harmless, some types of HPV are associated with long-term health concerns, such as specific strains that cause anal or genital warts. The main concern with common warts is their potential to cause pain, especially plantar warts on the foot, or to spread and multiply.
Different Approaches to Removal and Treatment
The differences in cause dictate distinct strategies for professional removal and treatment. Skin tags are an overgrowth of normal skin tissue, so their removal is typically a straightforward, elective procedure focused on physical elimination. Common methods include simple excision (snipping the tag off with sterile scissors), cauterization (using heat to burn the growth away), and cryotherapy (freezing the tissue with liquid nitrogen).
Wart treatment is more complex because it must address the underlying viral infection. Topical treatments often involve salicylic acid, which gradually dissolves the layers of the wart. Professional treatments aim to destroy the infected tissue, commonly using cryotherapy to freeze the wart or electrosurgery to burn it. For persistent warts, laser therapy may be used to target the blood vessels supplying the growth.