Skin Tag Orgins and Removal Treatments

What are skin tags?

Skin tags are small, benign growths that are composed of a core of fibers and ducts, nerve cells, fat cells, and a covering or epidermis. Additional names for skin tags include acrochordon, cutaneous papilloma, cutaneous tag, fibroepithelial polyp, fibroma molluscum, fibroma pendulum, papilloma colli, soft fibroma, and Templeton skin tag. They are often seen raised from the skin on a stalk called a peduncle.

Who gets skin tags?
Both men and women tend to get skin tags as they age. Skin tags are also more common in pregnant women, obese people, and people with type 2 diabetes mellitus. About 46% of people develop skin tags at some point in their lives.

Where do skin tags appear?
Skin tags often form in areas where the skin creases, such as the neckline, the groin, the underside of the arms, the area beneath the breasts, and the eyelids. The most common location is the armpit. It is common for skin tags to appear in groups. They often become stuck on jewelry, are shaved in error, and are agitated by clothing. Women who shave their armpits should be careful not to shave or cut skin tags that are located there.

Are skin tags harmful?
Although skin tags are technically tumors, they are benign and normally harmless. They can, however, become damaged and become inflamed and sore. If shaved off or rubbed hard, they may bleed.

What causes skin tags?
Although we do not know the exact cause of skin tags, the following are thought to be associated with their appearance:

* Chaffing and irritation from the skin rubbing together
* Hormones secreted during pregnancy or in cases of acromegaly (gigantism)
* Insulin resistance caused by diabetes
* Human papilloma virus
* Illegal steroid use that interferes with the body and muscles, causing the collagen fibers in the skin to bond so that skin tags are formed

How are skin tags removed?
Since skin tags are generally harmless, they are usually removed for aesthetic or cosmetic reasons. Physicians usually remove skin tags using one of the following methods:

* Cauterizatio - the skin tag is burned off using electrolysis
* Cryosurgery - the skin tag is frozen off using liquid nitrogen
* Ligation - the blood supply to the skin tag is interrupted
* Excision - the skin tag is removed with a scalpel

Squamous Cell Carcinoma Treatments

Most squamous cell carcinomas may be treated by one of the following methods. More healthy tissue around the lesion is removed
than for basal cell carcinomas because of the potential of squamous cell carcinomas to spread. Nearby lymph nodes are also examined
carefully. The choice of treatment is influenced by:

* size, location, grade, and type of tumour
* whether the tumour is primary or is recurring
* person’s age and health
* people with organ transplants are at a high risk of aggressive squamous cell carcinoma, which is considered in their treatment plan
* availability of the treatment

Surgery (Wide Excision)

# used for:
- most small lesions that are less than 2 cm
- superficial or SCC that has not spread
- verrucous carcinomas (slow growing and less aggressive)
- tumours that have previously been treated with radiation therapy
- lesions on the eyelid, forehead, scalp, lip, penis, vulva and anus

Mohs Micrographic Surgery

* used for all types of squamous cell cancer
* commonly used for:
- areas that are at high risk of recurrence (eyelids, nose, ears, forehead, scalp), as well as areas that have - already recurred
- areas where it is important to keep function and appearance
- lesions that are larger than 2 cm, and lesions with poorly defined borders
- aggressive tumours, and invasive lesions that have spread to nerves, cartilage or bone
- tumours that have been left untreated for a long time
- lesions that had not been completely removed with prior surgery it involves a meticulous study of tissues removed by a  pathologist at the time of surgery

Radiation Therapy

* used after surgery for:
- elderly individuals
- ensuring cancer free margins
- treatment of involved lymph nodes
- squamous cell carcinoma that has recurred after surgery
- to relieve or control the symptoms of very large tumours
- for people who are unwilling or unable to undergo surgery
- tumours on the eyelid, cheek, earlobe and nose not used for verrucous carcinomas (slow growing and less aggressive)

Chemotherapy

* systemic chemotherapy is used for squamous cell cancer that has spread to other parts of the body
* drugs used most often in chemotherapy:
- cisplatin
- doxorubicin
- bleomycin

Curettage And Electrodesiccation (C & E)

used for
- small areas that are less than 2 cm
- lesions that haven’t spread
- squamous cell carcinoma with distinct margins in Actinic Keratosis should not be used for:

- larger lesions that are greater than 2 cm
- recurrent tumours
- aggressive squamous cell carcinoma
- lesions with poorly defined borders
- hairy areas like the underarms, scalp, and the pubic area
- areas where it is important to keep function and appearance uncommonly used

Skin Tags and Seborrheic Keratoses

Nuisances You don’t have to put up with. As time goes on, we all acquire tiny bits of extra skin called skin tags. These can range in size from 1-10 mm, and are flesh colored or brown.

Skin tags can be found on any part of the body, but are most common on the eyelids and neck, and in the armpits and groin, and under the breasts.  While skin tags are benign they can be annoying if they become irritating or rub on sporting equipment, and skin tags can interfere with shaving and can detract from one’s appearance and self-image.

Fortunately, we don’t have to put up with skin tags. These little annoyances can be easily removed in an office visit with little or no discomfort. Skin tags can almost always be removed without needing stitches, and the treated areas usually have healed completely in a week or two.

The cost of removing skin tags is quite reasonable - ranging from about $80 for a few tiny ones to about $200 for a larger number scattered over several areas.

Seborrheic keratoses are firm flat or raised, sometimes scaly or crusty flesh-colored, brown or black “barnacles” which accumulate (usually on the face and trunk) as time goes on. Some people start to develop seborrheic keratoses in their thirties, and most people have at least a few by the time they are sixty. To look at pictures of different types of moles, click on www.SkinCancerGuide.ca .

Seborrheic keratoses are usually just a nuisance, but - like skin tags — they can rub on clothing and equipment, and their appearance can sometimes be so distressing that they interfere with choice of clothing, sports like swimming, and intimacy.  Because seborrheic keratoses grow above the skin (but not down into the skin) they can be easily scraped off, and the treated areas heal up nicely within a few weeks. Sometimes the healed area remains pink for a few months after the seborrheic keratosis is removed.

The cost of removing seborrheic keratoses is similar to that for removal of skin tags: about $80 for one or two, with the cost gradually increasing depending on the number and size of seborrheic keratoses to be removed.

The cost of removing skin tags and seborrheic keratoses is a tax-deductible medical expense, just like things like dental bills.  So, if you are annoyed by skin tags or seborrheic keratoses you can be confident that it is simple and inexpensive to rid yourself of these nuisances.

By Kevin C. Smith MD FACP FRCPC

Identifying Skin Lesions - Warts, Moles and SebKs

By Van Le |  While freckles can add to a person’s beauty and uniqueness, other skin lesions such as large moles, skin tags, warts, and seborrheic keratoses can be unsightly and embarrassing. Most lesions are malignant (non-cancerous), however, it is important to be aware of and track any skin abnormalities on your body as a preventative measure.

Freckles

Freckles are irritating for some and embraced by others. They are pigment cells that retain within the skin to form light brown spots, and individuals with lighter complexions are more susceptible to freckles since their skin contains less melanin. Freckles, also known as ephelides, can appear on the face, arms and other sun-exposed areas. Excessive and continued exposure to harmful UV rays can cause more freckles and cause them to appear darker. While they are harmless, it is important to distinguish between freckles and symptoms of melanoma, a type of skin cancer that can grow from an existing freckle. Consult your doctor if you notice any change in freckle size, shape and color.

Skin tags

Skin tags are pieces of skin that hang from the surface of a surrounding area. Like freckles, they are benign, but can cause irritation if located on an area that is exposed to constant contact, such as the eyelids or areas where they can be snagged by jewelry or clothing. Skin tags can vary from a small pin-point size to a large grape size. While some can fall off on their own, there are several ways to medically remove skin tags, including freezing and burning. There are home remedies as well as creams available on the market to remove unwanted and embarrassing skin tags.

Seborrheic keratoses

Seborrheic keratoses, another benign skin lesion, can form anywhere on the body, but is commonly found on the chest and back. They can be distinguished from other types of lesions due to their waxy, stuck-on-the-skin appearance and often described as brown candle wax stuck on the skin. While the cause is still unknown, scientists have found that they can be hereditary and not affected by sun exposure.

Warts

Most warts are skin infections caused by viruses of the human papillomavirus (HPV) family. Basically, warts are benign tumors of the epidermis (outer layer of skin), and can occur in people of all ages, but are most commonly found on children and teenagers. There are different types, including flat and plantar warts. Flat warts are small in size but can be high in quantity, can spread to other areas of the body by shaving or scratching, and can be transferred person-to-person by physical contact. Plantar warts grow on the heel, ball or sole of the foot, and pressure from standing or walking pushes them into the deeper layers of skin.

Skin lesions like warts, seborrheic keratoses and skin tags are often harmless, but they can be embarrassing. While they can be surgically removed, there are creams and ointments available on the market to remove and reduce their appearance. If you have further questions about a particular skin lesion, consult your doctor or pharmacist for proper diagnosis and treatment.

Van Le is a staff writer for the CSU Daily Titan and writing intern for Vivoderm Laboratories in Los Angeles, California. She is currently pursuing a Journalism degree at California State University, Fullerton.

For the latest findings on skin lesions and treatments, you can also link to http://www.dermatosispapulosanigra.net