Skin tags form when your skin produces extra cells and collagen, usually in response to repeated friction. They’re small, soft, flesh-colored growths that hang off the skin by a thin stalk, and they’re extremely common in adults over 30. While friction is the most straightforward trigger, the full picture involves metabolism, hormones, genetics, and possibly even a common virus.
Friction Is the Primary Trigger
Skin tags overwhelmingly show up in places where skin rubs against skin or clothing. The underarms, groin, under the breasts, eyelids, and neck are the most common sites. When skin in these areas experiences continuous rubbing or pressure, it responds by growing excess cells and collagen fibers, producing the small pouch of tissue that becomes a skin tag.
Clothing plays a role too. Tags frequently form along the collar line and waistband, anywhere fabric repeatedly presses or chafes against the same spot. This is why gaining weight or wearing tight clothing can increase your chances of developing them: more skin folds mean more friction, and more friction means more opportunity for tags to form.
The Insulin and Metabolism Connection
Friction explains where skin tags appear, but it doesn’t fully explain why some people develop dozens while others get none. One of the strongest underlying links is insulin resistance, a condition where your body’s cells don’t respond efficiently to insulin and your pancreas compensates by producing more of it.
Higher circulating insulin activates growth factor receptors on fibroblasts, the cells that produce collagen and other structural tissue in your skin. When those receptors are overstimulated, fibroblasts multiply faster than normal, and the result can be skin tags. This is why multiple skin tags are sometimes considered a visible marker of metabolic issues happening beneath the surface.
Research published in the Journal of Clinical and Aesthetic Dermatology found that people who are overweight are significantly more likely to present with multiple skin tags compared to those at a normal weight. The same study found statistically significant associations between skin tags and abnormal cholesterol and triglyceride levels. Patients with acanthosis nigricans, a condition where patches of skin darken and thicken (itself a hallmark of insulin resistance), had nearly a 20-fold higher chance of having multiple skin tags. The statistical model that best predicted who would develop skin tags included BMI, cholesterol levels, and the number of body areas affected.
Hypothyroidism also showed a notable connection. Patients with an underactive thyroid had about a 5.4-fold higher chance of developing multiple tags compared to those without the condition. The mechanism isn’t fully understood, but thyroid hormones influence metabolism broadly, and disruptions can affect how skin cells grow and repair.
Hormonal Changes During Pregnancy
Many women notice new skin tags appearing during pregnancy, particularly in the second and third trimesters. Hormone levels shift dramatically during this period, and those shifts appear to stimulate the same kind of excess tissue growth that friction causes. According to MD Anderson Cancer Center, hormonal birth control pills can produce similar skin changes. Most pregnancy-related skin tags are harmless and sometimes shrink or fall off after delivery, though many persist.
Genetics Play a Role
If your parents or siblings develop skin tags easily, you’re more likely to as well. The exact genes involved haven’t been pinpointed, but health authorities note that skin tag formation is likely driven by a combination of lifestyle and genetic factors. Some people simply have skin that’s more prone to producing these growths in response to the same friction or metabolic signals that wouldn’t trigger tags in someone else.
A Possible Link to HPV
One lesser-known area of research involves human papillomavirus, the same family of viruses responsible for warts. A study in the Egyptian Journal of Medical Microbiology tested skin tag tissue for HPV DNA and found that about 71% of skin tag samples tested positive for low-risk HPV types 6, 11, or both. By comparison, only about 13% of normal skin samples taken from nearby areas tested positive. That difference was highly statistically significant. No high-risk HPV types (the kinds associated with cancer) were detected in any sample.
This doesn’t mean skin tags are contagious or that HPV definitively causes them. But it suggests the virus may be a contributing factor in some cases, potentially making skin cells in a given area more susceptible to the kind of overgrowth that friction and metabolic signals then push along.
What Skin Tags Are Not
Skin tags are not cancerous and do not become cancerous. They’re benign overgrowths of normal skin tissue. They don’t spread to other parts of your body, and having them doesn’t indicate any serious skin disease. The main reasons people want them removed are cosmetic annoyance or physical irritation from jewelry, clothing, or shaving catching on them.
Removal Options
Skin tags don’t require treatment, but if they bother you, a dermatologist can remove them quickly. The three standard methods are cryotherapy (freezing them off with liquid nitrogen), electrocautery (burning them off with an electric probe), and simple snipping with medical scissors or a scalpel, which tends to work better for larger tags. These are typically done in a single office visit with minimal discomfort.
Home remedies are widely discussed online but poorly supported. Over-the-counter freezing kits exist but usually require multiple applications and are less precise than professional treatment. Ligation bands that cut off circulation to the tag’s base can work but carry a risk of infection. Tea tree oil and apple cider vinegar are frequently recommended on social media, yet there’s little research data behind either one. Both can cause skin irritation, and tea tree oil in particular triggers allergic reactions in some people. If a skin tag is large, bleeds, or changes color, having it evaluated professionally is the safer path.