What Causes Skin Tags Under Arms and How to Reduce Them

Skin tags under the arms grow from a combination of skin-on-skin friction and internal metabolic factors, especially insulin resistance. The underarm is one of the most common sites for these small, soft growths because the skin there folds and rubs against itself constantly, while the warm, moist environment adds to the irritation. But friction alone does not fully explain why some people develop dozens of tags while others never get one. Hormones, body weight, blood sugar regulation, and possibly even certain viruses all play a role, and understanding which factors apply to you is the key to reducing them.

Why the Underarms Are a Hot Spot

Skin tags, known medically as acrochordons, are tiny benign growths made of a connective tissue core covered by a layer of skin. Under a microscope, they show a central stalk of collagen fibers and blood vessels draped in an outer layer that often looks slightly thicker than surrounding skin. One distinctive feature is that the elastic fibers inside skin tags tend to be thinner and fewer than in normal skin, which may explain their characteristic soft, floppy texture.¹

The underarm (axilla) ranks among the top locations for skin tags alongside the neck, eyelids, and groin. All of these sites share a common trait: they are intertriginous zones, meaning skin folds that regularly rub together. That chronic, low-grade mechanical irritation is widely considered the initiating trigger. Every time you swing your arm while walking, exercising, or reaching overhead, the underarm skin creases and slides against itself. Over months and years, this repeated friction can stimulate the epidermis and the connective tissue beneath it to overgrow into a small polyp. Tight clothing, bra straps, and underwire seams sitting in the armpit crease can make the problem worse by adding an extra source of rubbing.

A retrospective study of children and adolescents with skin tags found that the axilla was the predominant location for the growths even in younger patients, reinforcing the idea that this site is inherently vulnerable regardless of age.²

The Insulin Resistance Connection

Friction gets the process started, but the single most studied driver behind multiple or recurrent skin tags is insulin resistance. When your body becomes less responsive to insulin, the pancreas compensates by pumping out more of it. That excess insulin raises levels of insulin-like growth factor-1 (IGF-1), a powerful growth signal. IGF-1 stimulates both the outer skin cells (keratinocytes) and the connective tissue cells (fibroblasts) underneath to multiply faster than normal, producing the characteristic overgrowth that becomes a skin tag.³

This mechanism helps explain why skin tags cluster so heavily with obesity, type 2 diabetes, and metabolic syndrome. In the pediatric study mentioned above, about half the children diagnosed with skin tags were classified as obese, and the rates of type 2 diabetes and high cholesterol in that group were several times higher than in the general pediatric population.² Some dermatologists now view skin tags as a visible skin marker of insulin resistance, alongside darkened, velvety patches of skin known as acanthosis nigricans. Spotting these signs on a routine skin check can prompt earlier testing for blood sugar problems.⁴

That said, the relationship between metabolic syndrome and skin tags is not perfectly straightforward. A case-control study from eastern India found that while individual metabolic factors like obesity and blood sugar were more common in people with skin tags, a full multivariate analysis did not show a statistically significant link between the number of metabolic syndrome components and the number of skin tags a person had.⁵ In other words, having more metabolic risk factors did not reliably predict having more skin tags. This suggests that while insulin resistance is a strong contributor, other variables like genetics, hormones, and local friction patterns all modulate how many tags actually appear.

What About Cholesterol and Lipids?

You may have heard that abnormal cholesterol is linked to skin tags. The evidence here is genuinely mixed, and the honest answer is that it probably matters for some people but is not a universal driver.

A small case series described patients with skin tags on the torso, neck, and underarms who also had a specific lipid pattern: elevated triglycerides and low HDL cholesterol. That combination, sometimes called the atherogenic lipid profile, is itself a hallmark of insulin resistance and carries increased cardiovascular risk.⁶ A separate study found that people with skin tags had higher total cholesterol and LDL levels than healthy controls.⁷

However, a comparison study from Tehran that directly measured cholesterol, triglycerides, LDL, and HDL in people with skin tags versus controls found no statistically significant differences in any of those measurements.⁸ The discrepancy likely reflects how tangled these metabolic variables are: obesity drives insulin resistance, which drives both abnormal lipids and skin tag growth, so lipid levels may be a fellow traveler rather than a direct cause. For practical purposes, if you have skin tags and have not had your blood sugar or cholesterol checked recently, it is reasonable to mention it to your doctor, but abnormal lipids alone are probably not what is making tags sprout under your arms.

Hormonal Influences

Hormones exert a separate and underappreciated effect on skin tag growth. Pregnancy is the clearest example. Many women notice new skin tags appearing during the second and third trimesters, particularly in the underarms, under the breasts, and on the neck. Skin tags are described as hormone-responsive lesions commonly found on the mucosal and cutaneous surfaces of women of reproductive age.⁹ The combination of rising estrogen, progesterone, and growth factors during pregnancy, along with weight gain that increases skin fold friction, creates ideal conditions for new tags to develop. Some of these tags shrink or fall off after delivery as hormone levels return to baseline, though many persist.

Growth hormone excess also promotes skin tags. In acromegaly, a condition where the pituitary gland overproduces growth hormone, pigmented skin tags are among the recognized skin findings.¹⁰ The mechanism parallels the insulin story: growth hormone stimulates IGF-1, which in turn drives the same fibroblast and keratinocyte proliferation that builds skin tags. For the average person, acromegaly is rare, but the finding reinforces that IGF-1 is a central growth signal for these lesions regardless of what is pushing IGF-1 levels up.

Do Viruses Play a Role?

A somewhat surprising line of research has looked at whether human papillomavirus (HPV) contributes to skin tag formation. One study using DNA analysis detected HPV types 6 and 11 in the vast majority of skin tag tissue samples examined.¹¹ HPV 6 and 11 are the low-risk strains best known for causing genital and laryngeal warts rather than cancer, so the finding was initially startling. The researchers suggested that HPV could play a role in the tissue overgrowth that produces skin tags, similar to how it drives the growth of other benign papillomas.

This remains a controversial area. Other researchers have had difficulty replicating such high detection rates, and the presence of viral DNA in a tissue does not automatically mean the virus caused the growth. HPV could simply be a bystander that colonizes the warm, moist skin folds where tags happen to develop. Most dermatologists still view friction and metabolic factors as the primary drivers, with HPV as a possible but unproven contributor. If you have skin tags under your arms, there is no reason to worry about a viral cause or to seek antiviral treatment for them.

Removing Skin Tags That Are Already There

Because skin tags are benign, removal is entirely optional and driven by comfort or cosmetics. Tags under the arms are particularly likely to get caught on clothing, snag on razors during shaving, or simply become irritating as they rub back and forth. When you want them gone, the standard clinical options are straightforward.

Snip excision: A doctor numbs the area with a small injection of local anesthetic and cuts the tag off at the base with fine scissors or a scalpel. This is quick, typically heals within a week, and leaves minimal scarring for small tags.
Electrosurgery: A small electrical current burns through the stalk of the tag. A clinical trial comparing electrosurgery to cryotherapy for skin tags found that both patients and physicians reported higher satisfaction with electrosurgery, likely because it offers more precise control over the area treated.¹²
Cryotherapy: Liquid nitrogen freezes the tag, which then falls off within days. Cryotherapy is fast but carries a somewhat higher risk of pigment changes in the treated skin, particularly lighter patches (hypopigmentation) or darker patches at the treatment site.¹²
Laser treatment: CO₂ or other ablative lasers vaporize the tag. A systematic review of treatment modalities found that electrosurgery and laser were consistently associated with better cosmetic scores than cryotherapy, which produced more pigmentary changes, an especially important consideration for people with darker skin tones.¹³

For very tiny tags, some dermatologists simply grasp the tag with forceps and snip without anesthesia, since the stalk is so thin the discomfort is momentary. The underarm area heals well because it has good blood supply, though you will want to keep the site clean and dry for a few days and avoid deodorant directly on the wound.

The Problem with Over-the-Counter Skin Tag Products

Walk through any pharmacy or scroll through online retailers and you will find dozens of creams, patches, and liquid solutions claiming to dissolve or remove skin tags at home. Be cautious. An analysis of adverse events linked to unapproved mole and skin tag removal products found reports of serious skin injuries, including chemical burns and scarring. Common ingredients in these products included salicylic acid, bloodroot extract (Sanguinaria canadensis), various botanical or homeopathic ingredients, and calcium oxide.¹⁴

Bloodroot is particularly concerning because it contains alkaloids that destroy tissue indiscriminately. Products marketed as “black salve” or “drawing salve” for mole and skin tag removal often contain it, and the resulting chemical burn can leave a wound far worse than the original skin tag. The underarm is sensitive skin that sweats and chafes, so applying caustic substances there carries extra risk of irritation and infection.

Home-tying methods, where you loop a piece of thread or dental floss around the base of a tag to cut off blood flow, are widely discussed online. For very small tags on a thin stalk, this can work, and the tag typically darkens and falls off within a few days. The risks are infection from a non-sterile ligature, incomplete removal that leads to regrowth, and pain if the tag has more blood supply than expected. If you decide to try it, clean the area and the thread thoroughly beforehand, and see a doctor if you notice redness spreading around the site.

How to Reduce Future Skin Tags Under the Arms

Since skin tags result from friction meeting metabolic and hormonal factors, reducing them means addressing as many of those inputs as you can. No strategy guarantees zero new tags, but each one shifts the odds.

Reduce friction: Wear loose-fitting tops and sleeves when possible. Moisture-wicking fabrics help keep the underarm area dry, reducing the tacky skin-on-skin contact that promotes irritation. Applying a thin layer of anti-chafing balm or even plain cornstarch-based powder to the armpit crease can further minimize rubbing.
Manage weight: Because excess body fat both increases skin fold friction and drives insulin resistance, weight loss targets both of the main causes at once. Even moderate weight loss can improve insulin sensitivity and reduce IGF-1 levels.
Address insulin resistance: If you have been told your blood sugar is borderline or you have prediabetes, dietary changes and regular physical activity are the first-line approaches to improve insulin sensitivity. Lowering circulating insulin and IGF-1 removes a key growth signal for skin tags.³
Keep the area dry: After showering or exercising, pat the underarms dry thoroughly before dressing. Sweat softens skin, making it more vulnerable to friction damage.

Pregnancy-related skin tags are harder to prevent because the hormonal surge is unavoidable, but keeping friction low during pregnancy and managing gestational weight gain within recommended ranges may help limit how many appear. As noted earlier, some pregnancy tags resolve on their own postpartum.

When a Skin Tag Might Not Be a Skin Tag

Most of the time, a soft, flesh-colored, painless little nub dangling from the armpit skin is exactly what it looks like. But a few other growths can mimic skin tags and deserve a different approach.

Neurofibromas, the benign nerve-sheath tumors associated with neurofibromatosis, can look almost identical to skin tags when they are small and sit on the skin surface. If you have many soft bumps appearing across your body and a family history of neurofibromatosis, mention it to your doctor. Seborrheic keratoses, which are waxy, stuck-on-looking growths, sometimes appear in the underarm area and can be confused with larger skin tags. And rarely, what looks like a skin tag could be a small pedunculated melanocytic nevus (a mole on a stalk) or, in very unusual cases, a skin cancer mimicking a benign growth.

The practical rule is: if a growth under your arm is changing color, growing rapidly, bleeding without being snagged, or feels firm and fixed rather than soft and wiggly, have it evaluated. A dermatologist can examine it with a dermatoscope or biopsy it to confirm the diagnosis. For the vast majority of typical skin tags, no biopsy is necessary.

Skin Tags in Children and Teenagers

Skin tags are often thought of as a middle-aged adult problem, and they do become more common with age. But they are not exclusive to adults. A retrospective study of pediatric skin tag patients found a mean age of diagnosis of about 10 years, with the majority being female and the underarm being the most common location. Roughly half of the children in the cohort were obese, and about a fifth were overweight. The prevalence of obesity, type 2 diabetes, elevated cholesterol, and high blood pressure in these children was substantially higher than in the general pediatric population based on national survey data.²

For parents, the takeaway is that a child developing skin tags, particularly under the arms, is worth discussing with a pediatrician. It does not mean the child has diabetes, but it may be an early visible signal that metabolic screening would be worthwhile. Catching insulin resistance early in childhood opens a window for lifestyle changes before more serious metabolic problems develop. The tags themselves are harmless and do not need removal unless they bother the child, but they can serve as a useful clinical clue.

Genetic and Family Patterns

If your parents or siblings are prone to skin tags, there is a good chance you will be too. A genetic susceptibility has long been suspected based on the observation that skin tags run in families even after controlling for shared lifestyle factors like diet and body weight. Some research into the IGF-1 pathway has explored genetic polymorphisms that might make certain people’s skin more responsive to the growth signals produced by insulin resistance.³ In practical terms, if you have a family tendency toward skin tags, the friction-reduction and metabolic strategies discussed above become even more important, because your skin may be primed to form these growths with less provocation than average.

Aging also shifts the equation. As skin loses collagen and elasticity over the decades, it becomes more susceptible to mechanical deformation. The thinning of elastic fibers that characterizes skin tags may reflect an exaggeration of the normal aging process in the connective tissue.¹ Combined with the fact that insulin resistance tends to increase with age, it is no surprise that skin tags become more prevalent in the forties, fifties, and beyond. This is one of those frustrating cases where biology stacks the deck over time, but the modifiable factors, particularly weight management, friction reduction, and blood sugar control, still make a meaningful difference at any age.

1
International Journal of Pathology and Clinical Research. Reduced and Thinned Elastic Fibers in Skin Tag
2
PubMed. The relationship between acrochordons, obesity, and metabolic syndrome in the pediatric population: A retrospective cohort study
3
PubMed Central. Role of insulin-like growth factor-1 in skin tags: a clinical, genetic and immunohistochemical study in a sample of Egyptian patients
4
PubMed Central. Skin Manifestations of Insulin Resistance: From a Biochemical Stance to a Clinical Diagnosis and Management
5
PubMed Central. Association of Skin Tag with Metabolic Syndrome and its Components: A Case–control Study from Eastern India
6
PubMed Central. Skin tags and the atherogenic lipid profile
7
PubMed Central. Serum Leptin, Atherogenic Lipids and Glucose Levels in Patients with Skin Tags
8
PubMed Central. A comparison study of lipid profile levels between skin tags affected people and normal population in Tehran, Iran
9
BMJ Case Reports. Giant vulvar acrochordon (skin tag) presenting in second trimester of pregnancy
10
PubMed. Skin manifestations in acromegaly
11
PubMed. The detection of human papillomavirus DNA in skin tags
12
PubMed Central. Evaluation and Comparison of the Efficacy and Safety of Cryotherapy and Electrosurgery in the Treatment of Sebaceous Hyperplasia, Seborrheic Keratosis, Cherry Angioma, and Skin Tag: A Blinded Randomized Clinical Trial
13
The Innovation Lab Journal. Best Cosmetic Outcomes for Skin Tag Removal: A Systematic Review of Treatment Modalities and Patient-Reported Aesthetic Results
14
PubMed Central. Serious Skin Injuries Following Exposure to Unapproved Mole and Skin Tag Removers