You’re standing in front of the bathroom mirror, maybe brushing your teeth or just checking a stray hair, when you notice it. A tiny, fleshy nub hanging off your neck or tucked away in your armpit. It wasn't there last month. Or maybe it was, and you just didn't care until it started snagging on your favorite necklace. These things are called acrochordons by doctors, but to the rest of us, they’re just skin tags.
They’re weirdly common. Honestly, almost everyone gets at least one by the time they hit 50. But the "why" is what usually keeps people scrolling through medical forums late at night. How are skin tags formed, anyway? Is it something you ate? Is your skin just... failing?
The short answer is that they are benign growths—completely harmless, non-cancerous clusters of collagen and blood vessels wrapped in a thin layer of skin. But the mechanics of how they actually pop up involve a mix of friction, insulin, and sometimes just crappy luck in the genetic lottery.
The Friction Factor: Why They Love Your Armpits
Most people notice skin tags in places where things rub together. Think about your neck, where a shirt collar constanty chafes. Or your armpits. Or the groin area. This isn't a coincidence.
Mechanical friction is arguably the biggest trigger. When skin rubs against skin, or skin rubs against tight clothing, it creates a localized area of persistent irritation. Your body, trying to be helpful but failing miserably, reacts to this micro-trauma. Some researchers believe this constant "rubbing" causes the fibers of collagen (the protein that gives your skin structure) to get bunched up and pushed outward.
It’s like a rug that keeps getting stepped on in the same spot until the fibers start to fray and lump together. Except it's your skin. And it's permanent until you snip it off.
Why the Neck?
The neck is the "Grand Central Station" for skin tags. Why? Because of the sheer variety of friction sources. You’ve got jewelry, scarves, high collars, and the natural folding of the skin when you turn your head. If you’re someone who wears heavy chains or sports bras with thick seams, you might notice a higher concentration of these little guys exactly where the material sits.
The Insulin Connection: It’s Not Just About Rubbing
Here is where it gets a bit more scientific and, frankly, a bit more serious. While friction is the physical "how," your internal chemistry often provides the "why."
There is a massive body of research, including studies published in journals like the Indian Dermatology Online Journal, linking skin tags to insulin resistance. When your body doesn't use insulin efficiently, your pancreas pumps out more of it to compensate. High levels of insulin in the bloodstream do more than just manage your sugar; they also act as a growth factor.
Insulin looks a lot like something called Insulin-like Growth Factor 1 (IGF-1). When you have too much of it circulating, it can accidentally "turn on" the growth receptors in your skin cells, known as keratinocytes and fibroblasts. This causes them to divide rapidly.
- Hyperinsulinemia (too much insulin) triggers growth receptors.
- Skin cells start multiplying in a small, concentrated area.
- A skin tag is born.
This is why doctors often look at skin tags as a "canary in the coal mine." If you suddenly sprout dozens of tags across your neck and torso, it might be your body’s way of saying your blood sugar levels are out of whack. It’s frequently associated with Type 2 diabetes and metabolic syndrome.
Hormones, Pregnancy, and Growth Sprints
Pregnancy is a wild time for the body. You’re growing a human, which means your hormones are basically throwing a party where everyone is invited—including skin tags.
Many pregnant women notice an explosion of skin tags during the second and third trimesters. This is usually a "perfect storm" of two factors. First, the massive shift in hormones (estrogen and progesterone) can stimulate skin cell growth. Second, the physical changes—weight gain and skin stretching—create new areas of friction. The skin under the breasts or in the inner thighs becomes a prime target.
Interestingly, these tags sometimes shrink or even vanish after delivery once the hormone levels stabilize, though many decide to stick around for the long haul.
The Role of Human Papillomavirus (HPV)
There has been some debate in the medical community about whether certain strains of HPV play a role in how skin tags are formed. A few studies have found HPV types 6 and 11 present in skin tag biopsies. However, it's not a settled fact. Unlike warts, which are definitely viral, skin tags aren't considered contagious. You can't "catch" a skin tag from someone else. If the virus is involved, it's likely just a passenger or a minor co-factor rather than the primary cause.
Genetics: The "Thanks, Dad" Factor
Sometimes, you can do everything right—maintain a perfect weight, wear loose silk robes, keep your blood sugar in check—and you still get them.
Genetics play a huge role. If your parents were prone to them, you probably will be too. Some people simply have a genetic predisposition for their skin cells to "clump" more easily. There are also rare genetic conditions, like Birt-Hogg-Dubé syndrome, where skin tags (along with other skin tumors) are a primary symptom. While that's an extreme case, for the average person, "bad" skin genes are often the culprit.
Age and the Loss of Elasticity
As we get older, our skin loses its "snap." The collagen and elastin that keep everything tight start to break down. This looser skin is more prone to folding and sagging, which, as we established, creates the friction necessary for tags to form.
Most people start seeing their first tags in their 30s, and the frequency increases steadily until about age 70. It’s just one of those annoying parts of the aging process, like gray hairs or finding out you’re suddenly allergic to dairy.
Misconceptions: What Skin Tags Are NOT
Before you go grabbing the scissors (please don't do that), it's important to clear up what these things aren't.
- They aren't warts. Warts are caused by a viral infection and have a rough, "cauliflower" surface. Skin tags are smooth and soft.
- They aren't moles. Moles are pigmented (usually brown or black) and involve a different type of cell called melanocytes. If a "tag" starts changing color or bleeding, see a dermatologist immediately.
- They aren't contagious. You can't spread them to other parts of your body by touching them.
Can You Prevent Them?
Honestly? Not entirely. You can't change your DNA, and you can't stop aging. But you can mitigate the risks.
Managing your weight is the most effective "controllable" factor. By reducing the amount of skin-on-skin contact and keeping your insulin levels stable through a low-glycemic diet, you're giving your body fewer reasons to sprout new growths.
Also, consider your wardrobe. If you notice a specific area—like your waistline—is getting irritated, switch to looser clothing. Avoid abrasive jewelry if you're prone to neck tags.
What to Do Once They Appear
So, you’ve got one. It’s there. Now what?
Whatever you do, don't try "home surgery." I've heard stories of people using fingernail clippers, dental floss, or even duct tape. Just... no. The center of a skin tag is full of blood vessels. If you snip it off yourself, it will bleed a lot more than you expect, and you’re practically inviting an infection.
Professional Removal Options
Dermatologists can get rid of them in seconds. It's one of the most satisfying procedures in medicine because the results are instant.
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- Cryotherapy: Freezing the tag with liquid nitrogen. It eventually falls off.
- Cauterization: Burning the tag off with an electric needle. This also seals the blood vessels so there's no bleeding.
- Excision: The doctor snips it with sterile surgical scissors. Fast and effective.
- Ligation: Using a tiny band to cut off the blood supply.
Actionable Next Steps
If you’re bothered by skin tags or worried about why they’re forming, here’s a logical path forward:
- Audit Your Friction Points: Check if your clothing or jewelry is rubbing specific areas. Swap out tight synthetic fabrics for breathable cotton.
- Monitor Your Blood Sugar: If you’ve noticed a sudden "outbreak" of many skin tags, it’s worth asking your doctor for an A1C test or a fasting glucose check to rule out insulin resistance.
- Don't Pick: Irritating a skin tag can cause it to swell or become painful. Leave it alone until it can be professionally removed.
- See a Pro: If a growth is changing shape, turning multiple colors, or feels hard rather than soft and fleshy, get it checked by a dermatologist to ensure it’s actually a skin tag and not something more serious like a basal cell carcinoma.
- Cleanse Gently: Keep the area clean and dry. Moisture trapped in skin folds can exacerbate the irritation that leads to tag formation.