Skin Tags and Cysts: When They’re Harmless and When They’re Not

Most fall under the harmless category

Skin tag

You’re putting on your favorite necklace and it gets caught on a tiny, rogue flap of skin that’s popped up right at your neckline. Sound familiar?

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Most of the time, common skin flaws like skin tags or skin cysts are nothing more than unsightly and annoying, but occasionally there can be more to them. It’s important to know when to have a doctor take a look.

Skin tags: Pesky but usually benign

Skin tags are flesh-colored skin growths that usually develop on areas of the body where skin rubs together, such as the neck, armpit or groin.

“They don’t discriminate — they affect people of all ages and body types and can occur anywhere, including the face,” says dermatologist Pamela Ng, MD.

Most of the time, skin tags are just an annoyance. “If it’s truly a skin tag, then it’s of no concern,” Dr. Ng says. “However, when skin tags are twisted, irritated, or bleeding, this might be a good reason to see a doctor.”

Don’t try this at home

It can be tempting to try to slice or pull off a skin tag that’s shown up in an inconvenient spot. Over-the-counter devices, patches and topical remedies also claim to get rid of them quickly.

But Dr. Ng warns against such do-it-yourself treatment, which can lead to bleeding and infection.

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She prefers to remove skin tags in-office by numbing the area and snipping off the tag. “I like the method of snipping best because it’s clean and the skin tags are gone by the time the patient leaves,” she says.

Other possible options include

  • Freezing, which will cause the tag to fall off after about 10-14 days, she says. However, freezing can cause greater inflammation to the surrounding skin.
  • Electrodessication, which is a surgical method of drying out tissue by touching it with a needle-like electrode that passes electric current into the tissue.

One thing to keep in mind, Dr. Ng says, is that skin tag removal is considered “cosmetic” by most insurance companies and usually is not covered.

Skin cysts: When in doubt, have them checked out

Skin cysts — called epidermoid cysts — are different from skin tags. They’re small nodules that form under the skin and fill with keratin, a structural protein found in the skin. Cysts can develop on various parts of the body, including the scalp.

Usually they’re nothing to worry about and don’t need to be removed unless they’re bothering you. But if one becomes inflamed, infected, or painful, Dr. Ng recommends getting it checked out by a doctor, as there are various tumors that can occur as lumps underneath the skin.

The don’t-try-it-at-home advice holds true for removing skin cysts, too.

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“Trying to take care of it on your own means you’re self-diagnosing,” she says. “You might be treating something inappropriate, like a skin cancer or a mole. Let a doctor diagnose it before you try anything at home.”

A doctor can make the cyst smaller and less inflamed or painful by injecting it with a steroid, which is sometimes mixed with an antibiotic. “I prefer this because it can decrease the swelling and pain without creating a scar or wound,” Dr. Ng says.

Sometimes, cysts have to be opened up and drained. This will leave a scar and the cyst can come back. Finally, cysts can be cut out surgically, but that will also be trading a bump for a scar.

If there’s ever any question about what’s going on with your skin, there’s no harm in having your doctor take a look, Dr. Ng says: “It’s best to have it evaluated by a physician if you are not sure what it is.”

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