Ask the Doctor: ‘Are skin tags hereditary? What can be done to remove and prevent them?’

“My 6-year-old has a number of skin tags, especially around her joints (inner elbow, underarms, back of knees etc and even some on her neck). She is not overweight, but my husband also has a lot of skin tags — is this hereditary? Is there anything we can do about them? My daughter is very conscious of them, and is now refusing to go to her swimming classes as some of the other children have noticed them and have asked her about them.”

Answer from Ms Yasmin Ismail, Consultant Plastic, Reconstructive & Aesthetic Surgeon Incl Paediatrics, Beacon Hospital

Skin tags—medically known as ‘acrochordons’—are commonly seen growths of soft excrescences or heaped-up skin, and are benign by nature. Almost 50-60% of adults and children will develop at least one tag in their lifetime, with the probability increasing after the fourth decade of life.

However, they can occur more commonly in individuals suffering from obesity, diabetes, during pregnancy, and in people with family history affecting both males and females alike. The incidence in children is increasing globally due to obesity, but they are rare after the seventh decade in life.

They tend to grow in areas where there are skin folds, such as armpits, neck, eyelids, groin and are often skin coloured or brown or even red, attached to a fleshy stalk. Most often, they tend to be between 1 and 5mm but can grow to several centimetres or more in size. Some patients will complain that they catch on clothing or jewellery, or cause friction, while others do not like the appearance of them.

It is important to bear in mind that the vast majority of these are benign, but if there is any indication of constant bleeding or pain, or rapid increase in size, then they should be seen by a doctor. They can also twist on their stalk and become inflamed. Skin tags do not have to be removed as they are rarely harmful, and although skin tag removal is a low-risk procedure, it is not without risks.

They can be removed surgically but a young child will not tolerate local anaesthesia (numbing injection around the area). They can be safely left until the child is older, unless the skin tag is very large or complex, requiring a general anaesthetic. Other options include cautery (heat) and cryotherapy (cold freezing), both of which can be carried out by family doctors. Occasionally they can simply fall off. There are many over-the-counter or internet skin tag removal products, but these treatments can be unsafe and carry a higher risk of complications, including unpredictable scarring and incomplete removal.

Currently, there are no proven methods to prevent skin tags, but it is important for children and adults alike to eat a healthy diet and perform regular exercise, which will help lower the risk of obesity as well as diabetes, hence preventing or lowering the risk of skin tag formation.

Have a question for the professionals you’d like answered? Get in touch with sarah.gill@image.ie with the subject headline ‘Ask The Doctor’.