Skin tags are extremely common and usually harmless, but when they appear in large numbers, they can signal underlying metabolic issues like insulin resistance, high blood sugar, or abnormal cholesterol levels. About 1 in 2 adults will develop at least one skin tag in their lifetime, so having a few is perfectly normal. What matters more is the pattern: how many you have, where they show up, and whether they keep appearing.
How Skin Tags Form
Skin tags develop when the body produces extra cells in the top layers of skin. They tend to grow in areas where skin folds rub against each other, which is why they cluster in predictable spots: the armpits, neck, eyelids, groin, under the breasts, and along the thighs. This friction-based explanation accounts for many skin tags, especially isolated ones that pop up in middle age and don’t multiply quickly.
But friction alone doesn’t explain why some people develop dozens of skin tags while others never get one. That’s where the metabolic connections become important.
Insulin Resistance and Blood Sugar Problems
The strongest and most consistent link researchers have found is between multiple skin tags and insulin resistance, a condition where your cells stop responding efficiently to insulin and your body compensates by producing more of it. That excess insulin circulating in your blood stimulates skin cell growth, which is thought to drive skin tag formation.
Insulin resistance is the precursor to type 2 diabetes, and studies have confirmed a positive association between skin tags and elevated fasting blood sugar. One study comparing 110 people with skin tags to 110 controls found that those with skin tags had meaningfully higher average fasting blood glucose levels (123 mg/dL versus 115 mg/dL in controls). Research published in Anais Brasileiros de Dermatologia found that having more than eight skin tags was actually more sensitive than other skin markers when it came to identifying problems with carbohydrate metabolism.
This doesn’t mean a single skin tag on your neck means you’re diabetic. But if you’re noticing new skin tags appearing regularly, especially alongside weight gain or fatigue, it may reflect changes in how your body processes sugar that are worth checking with a blood test.
The Link to Cholesterol and Triglycerides
Multiple skin tags are also associated with abnormal lipid levels. A 2018 study in The Journal of Clinical and Aesthetic Dermatology found statistically significant relationships between multiple skin tags and both elevated cholesterol and elevated triglycerides. In the study’s multivariate analysis, high cholesterol remained a significant independent predictor of skin tags even after accounting for other variables.
Interestingly, the same study did not find a significant link between skin tags and high blood pressure. So the metabolic connection appears to be more about what’s happening in your bloodstream (sugar and fat levels) than about cardiovascular pressure specifically.
Skin Tags and Obesity
Obesity ties many of these threads together. People who carry excess weight tend to have more skin folds (creating friction), higher insulin levels, and worse lipid profiles. Multiple skin tags are frequently found in obese individuals, and it can be difficult to separate whether the tags are driven by the mechanical rubbing, the metabolic disruption, or both. In practice, it’s likely a combination. The friction creates opportunity for tags to form, and the hormonal environment of insulin resistance accelerates the process.
Hormonal Changes During Pregnancy
Pregnant women often notice new skin tags, particularly during the second and third trimesters. The hormonal shifts in estrogen and progesterone during pregnancy appear to promote skin cell growth, and skin tags are more frequent in pregnant women than in the general population. These tags sometimes shrink or fall off after delivery as hormone levels return to baseline, though many persist. This is considered a normal part of pregnancy-related skin changes and not a sign of metabolic disease on its own.
Skin Tags With Dark, Velvety Patches
If you notice skin tags appearing alongside dark, thickened patches of skin in your armpits, neck folds, or groin, that combination is particularly worth paying attention to. Those dark patches are called acanthosis nigricans, and both conditions share a common driver: excess insulin. When the two appear together, the signal for insulin resistance becomes stronger. Acanthosis nigricans is considered a more specific marker for insulin resistance, while multiple skin tags are a more sensitive one, meaning skin tags cast a wider net but are less precise on their own.
What Skin Tags Don’t Signal
Despite some older reports from the 1980s suggesting a connection between skin tags and colon polyps, more rigorous research has not held up that link. A prospective study published in the American Journal of Gastroenterology found that 22.8% of patients with skin tags had colon polyps, compared to 22.5% of patients without skin tags. That’s essentially identical. Even among people at higher risk for polyps due to metabolic syndrome, skin tags did not predict advanced polyps.
Skin tags are also not a sign of skin cancer. They’re benign growths of normal skin tissue. If a growth changes color, bleeds, or looks irregular, that’s worth having examined, but that would suggest something other than a skin tag.
Removal Options
Skin tags don’t require removal for medical reasons. They’re painless and harmless. But if they snag on jewelry or clothing, or if you simply find them cosmetically bothersome, a doctor can remove them quickly by cutting them off, freezing them with liquid nitrogen, or tying them off at the base to cut off blood flow. Recovery is minimal for all three approaches. Keep in mind that removing existing skin tags doesn’t prevent new ones from forming, especially if the underlying metabolic factors haven’t been addressed.
If you’re developing multiple skin tags, particularly if you’re over 40 or have a family history of diabetes, a simple blood panel checking your fasting glucose, insulin levels, and lipid profile can clarify whether the tags are reflecting something deeper. For many people, they’re just a cosmetic nuisance. For others, they’re an early, visible hint that metabolic changes are underway before more serious symptoms appear.