Skin tags are common, benign growths of skin that typically appear as small, soft, flesh-colored flaps connected to the body by a narrow stalk. These growths are generally harmless and do not require medical treatment, but many individuals choose to remove them if they become irritated or for cosmetic reasons. While dermatologists offer professional removal methods, many people explore home options, such as the practice of ligation using dental floss. This method aims to resolve the growth by interrupting its blood supply, offering a non-surgical alternative for smaller skin tags.
Understanding the Ligation Mechanism
The underlying principle of using dental floss for removal is called ligation, which is the process of tightly tying off the base of the skin tag. This action causes ischemia, which is the restriction of blood flow to the tissue. Skin tags require a constant supply of blood to deliver oxygen and nutrients for survival.
By applying a ligature, the dental floss acts as a physical barrier, effectively strangulating the narrow stalk, or pedicle, that connects the tag to the body. Once the flow of blood is halted, the cells within the skin tag can no longer sustain themselves. This deprivation causes the tissue to slowly die, a process that leads to the natural detachment of the growth. For this method, a thin, strong material like unwaxed dental floss is often recommended due to its ability to be tied tightly and securely.
Applying the Dental Floss: Step-by-Step
The ligation procedure begins with preparation to minimize the risk of irritation or infection in the area. It is important to first clean the skin tag and the surrounding area thoroughly with soap and water, followed by wiping the site with an antiseptic solution like rubbing alcohol. This step ensures that no surface bacteria are trapped beneath the ligature.
Next, a piece of clean dental floss, roughly six to eight inches long, should be cut. The most important step is to locate the narrow base or stalk of the skin tag, known as the pedicle, and secure the floss as close to the surrounding normal skin as possible. A tight, secure knot should be tied around this base to completely constrict the blood vessel.
It is often helpful to gently pull the skin tag away from the body with sterile tweezers before tightening the knot to ensure the ligature is placed correctly at the base. Once the knot is secure and tight, the excess length of the floss should be trimmed, leaving just enough to confirm the knot remains in place.
Expected Timeline and Outcome
The floss must remain in place continuously until the tag detaches naturally. For most small to medium-sized skin tags, the process of tissue death and detachment typically occurs within three to seven days. Depending on the size of the growth and the effectiveness of the constriction, the full process can occasionally take up to two weeks.
After the floss is secured, the skin tag will begin to exhibit visual changes that indicate the ligation is working. Within the first day, the tag often begins to darken, turning reddish or purplish as the pooled, deoxygenated blood remains trapped. Over the following days, the tissue will shrivel and turn black, eventually resembling a dried raisin.
This darkening and shriveling is the expected sign of successful ischemia. The floss should not be removed during this time, even if the tag appears completely black. If the floss loosens prematurely, it must be retied immediately and tightly to re-establish the necessary constriction. The skin tag will eventually dry out at the base and fall off, leaving a small, healed area of skin underneath.
Situations Requiring Medical Consultation
While ligation can be an effective at-home method for removing small, confirmed skin tags, professional medical consultation is necessary in several situations. A healthcare professional should confirm that the growth is indeed a benign skin tag and not a more suspicious lesion, such as a mole or an early sign of skin cancer. Any growth that is rapidly changing color, shape, or size should never be treated at home and requires immediate medical evaluation.
If the skin tag is larger than the size of a pencil eraser, located in a sensitive area like the eyelids or genitals, or if the procedure causes excessive pain, a professional should be consulted. Furthermore, if any signs of infection develop after the ligature is applied, the floss should be removed and a doctor seen promptly. Signs of a potential infection include increasing redness around the base, excessive swelling, localized heat, or the presence of pus. Attempting home removal on a large or suspicious growth can lead to unnecessary bleeding, scarring, or a delayed diagnosis of a more serious condition.