A skin tag, medically known as an acrochordon, is a common, soft, and benign skin growth that typically appears in areas where skin folds or friction occurs, such as the neck, armpits, or groin. These growths are usually flesh-colored or slightly darker, ranging in size from a grain of rice to several millimeters, and are characteristically attached to the skin by a thin stalk called a peduncle. This article explores the practice of using floss for ligation, a method some people attempt at home, but it should not be considered a substitute for professional medical advice.
Identifying Skin Tags and Understanding the Method
Skin tags are composed of loosely arranged collagen fibers and blood vessels covered by an epidermis. They are soft to the touch and movable, differing significantly from other skin lesions like warts or moles, which may be firmer or flat. The presence of a slender stalk, or peduncle, is a distinguishing feature of a skin tag, making it suitable for removal methods that target this attachment point.
The home method of removal using floss is a form of ligation, which means tying off the base of the growth. The principle behind this technique is to restrict the blood flow to the skin tag by applying tight pressure to its peduncle. Deprived of its blood supply, the tissue of the skin tag will begin to necrose, causing it to darken, shrink, and eventually detach from the skin. This process generally takes several days to a week, depending on the size of the tag and the tightness of the ligation.
Step-by-Step Guide to Floss Ligation
Before attempting this method, the skin around the tag and the hands performing the procedure must be thoroughly cleaned with soap and water to minimize the risk of introducing bacteria. A small length of plain, unwaxed, and unflavored dental floss is recommended due to its thinness compared to household thread. Flavored or waxed floss should be avoided as the chemicals or coatings could potentially irritate the skin.
The next step involves carefully isolating the skin tag by gently pulling it away from the surrounding skin. The floss must then be looped around the peduncle, aiming to place the ligature as close to the surrounding normal skin as possible. A surgical or square knot should be tied, ensuring it is snug enough to compress the stalk completely and cut off circulation. The knot should be extremely tight but should not cause immediate, sharp pain or tear the skin at the base.
The excess floss should be trimmed, leaving enough length to check the knot periodically, and the remaining ligature must be left in place. The skin tag is expected to change color over the following days, typically progressing from its original color to a darker purple, then black, as the tissue dies. Once the tag has fully dried and turned black, it should naturally fall off, which can take anywhere from two days to two weeks. After the tag detaches, the remaining area should be kept clean to promote healing.
Safety Warnings and Signs of Infection
Not all skin growths are true skin tags, and attempting this method on a lesion that is not an acrochordon, such as a mole or cancerous growth, can lead to serious complications and delay proper diagnosis. This ligation method is contraindicated for large skin tags, typically over five millimeters in diameter, as these tags may have a more robust blood supply leading to significant bleeding or incomplete removal. Tags located on sensitive areas, including the eyelids, genitals, or deep within skin folds, should also not be treated at home due to the high risk of irritation, pain, or damage to delicate tissues.
Any skin tag that is already bleeding, painful, or has a suspicious, dark, or rapidly changing appearance should be evaluated by a healthcare professional before any removal attempt. After the ligation, a high level of hygiene is necessary to prevent a localized infection at the site of the ligature.
Signs of a developing infection require immediate medical attention:
- Increasing redness that spreads beyond the immediate area
- Worsening swelling and warmth around the removal site
- The presence of pus or cloudy discharge
- Persistent or increasing pain
- Red streaks extending from the wound
- The onset of a fever or chills
Ignoring these symptoms can lead to a more severe condition requiring professional medical intervention, such as prescription antibiotics.
Professional Removal Options
For individuals who are uncomfortable with at-home removal, several professional options are available through a dermatologist or physician. These methods utilize sterile equipment and carry a lower risk of infection or scarring. Professional removal also ensures the growth is correctly identified before treatment begins.
Cryotherapy involves the application of liquid nitrogen to freeze the skin tag. This procedure causes the tag to blister, scab, and fall off naturally, typically within one to three weeks. Cauterization, or electrosurgery, uses a heated probe or electric current to burn the skin tag off at its base, which simultaneously seals the blood vessels to prevent bleeding.
Surgical excision, where the skin tag is snipped off at the peduncle using sterile surgical scissors or a scalpel, is another common method. This technique is often used for larger tags and provides immediate results, sometimes requiring a local anesthetic to ensure a comfortable experience. Professional methods are generally safer and more effective.