Tips to Remove Skin Tags

I know skin tags are harmless, but how do I get rid of them?

A plague of skin tags

Q: My neck is slowly becoming populated with tiny brown tags of skin, mostly where I used to wear necklaces. They are not painful, but I would like to get rid of them. My GP was dismissive, saying that I should just leave them. Will they go, will more come, and how can I get rid of them?

A: They are skin tags. They aren’t serious, they aren’t cancerous and they won’t go away of their own accord. I don’t know if more will appear, but people who get them usually get quite a few. Another common place for skin tags is under the breasts and in the armpits. They become more common with age. There are several ways to remove them. A doctor will use either a scalpel, a pair of surgical scissors, or a freezing device that kills them. Another option is to tie them with thread. This cuts off their blood supply and they eventually die and drop off. Patients have told me that a simpler way of getting rid of them is to regularly rub them with a loofah or bath glove that is designed to clear away dead skin cells. If you do try this, let me know if it works.
Article from:    The Independent (London, England)  | Article date:  July 17, 2007 | Author:  Dr Fred Kavalier

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

Wart Treatment by Type of Drug and Procedure

The new advance in treatment of genital warts has been imiquimod (Aldara). This encourages the patient’s autoimmune system to attack the wart. This is particularly helpful in the moist areas of the skin or mucosal surfaces.

Salicylic acid
Salicylic acid can be applied either in the form of plasters or as liquid on to the warts. This will break down the thickened skin on the surface. It is more effective if the area is covered. These are useful for warts on the hands, knees and feet. They do turn the skin white. They can be used in combination with paring of the warts. Treatment with these at nighttime and covering with duct tape can be effective although slow.

Podophyllin

Podophyllin has a long history of use. It is useful mostly in genital warts. It should be applied very carefully on the warts, trying to prevent spread on to normal skin. It should be washed off after a few hours. There is irritation usually for a few days. Repeat treatments are usually required. A more purified form of podophyllin called podophyllotoxin is available for patient use. It can be used once or twice daily for a few days in succession. This produces some irritation. It has the advantage of not being as irritating as podophyllin and can be applied by the patients themselves.

Vitamin Acid

Vitamin acid (Tretinoin) is a vitamin A preparation. It is used in the treatment of acne and photo damage. Vitamin A products tend to regulate the surface of the skin, generally trying to keep the epidermis behaving normally. It may also cause some inflammation. In some individuals it can help reduce or even eliminate warts.

Cantharone

Cantharone (cantharidin) is derived from an insect. It can be very helpful in children but the application is painful. Inflammation and
blistering usually occurs later in the day, after application. Multiple treatments may be required. There are two concentrations. The
stronger version combines Cantharone with podophyllin and salicylic acid. Very occasionally the blistering reaction can be quite severe
and associated with swelling and pain. It is often very effective even in resistant warts.

Cryotherapy

Cryotherapy is the use of liquid nitrogen. This can be applied either with a Q-Tip or it can be sprayed on to the skin. It causes destruction by freezing water inside the cells. This damages the cell causing death. It is painful to apply and there is blistering associated with this. Multiple treatments may be required. Thawing and freezing again makes this therapy more effective. It can be a problem in dark skin in that it can either increase or decrease pigmentation, which can be permanent. This treatment can be used in combination with other therapies.

Electrodesiccation

Electrodesiccation is the use of an electric needle to burn warts. It usually requires a local anesthetic. It does have a potential risk of scarring. Very large warts can sometimes be scraped off before they are cauterized.

CO2 Laser

The CO2 laser has been used for many years. It essentially vaporizes water in the skin and causes destruction. It leaves a hole in the skin which will heal. There is often scarring with this technique. Other lasers such as the pulse dye laser are easier to use. The yellow light is absorbed by blood in the vessels that feed the warts. This is a similar laser used in the treatment of red birthmarks. The pulse dye laser at a high power setting can be effective particularly if multiple pulses are used in succession.

Aldara

Aldara is an immune response modulator. It boosts the patient’s immune response to viruses. It can also encourage the production of a
lasting immune memory. It has been available in Canada since 1999. It works best in the genital area as penetration into the skin is easier. When it is used elsewhere it often has to be covered to help with penetration into the skin. It has been shown to work well particularly in women. It is applied three times weekly. There will be some inflammation associated with this. The results may be enhanced by combining this with liquid nitrogen. This drug has added a very significant tool in treating genital warts.

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

Wart Treatment by Type of Wart

Treatment will depend in part on the location, the age of the patient, as well as the size and immune status of the individual. The treatment choice will depend in part on previous experience of the patient and the patient’s preference. Many of the treatments can be uncomfortable and therefore difficult to use in children.

Treatments can be either destructive as in the use of liquid nitrogen or most recently there is an immunological approach to boost the patient’s own immune system.

Common Warts

Liquid nitrogen cryotherapy is most commonly used in those who can tolerate the pain. Repeat treatments are frequently required. Excising or scraping off these warts is less desirable as it will scar. The use of pulse dye laser or very occasionally the Co2 laser can be used in resistant lesions. Cantharone can be used particularly in children as it is more easily tolerated. Other treatments involve the use of immune therapy. Substances such as DNCB involve painting the substance on the warts in order to develop an allergic reaction. This immune allergic reaction will be useful for destroying the wart.

Flat Warts

Flat warts frequently occur on the face and on the legs. Care needs to be taken not to use a treatment that will have a high risk of scarring. Very light liquid nitrogen cryotherapy can be used.

It is important that shaving is done very carefully or is stopped for a while as this is known to spread these warts. Treatments such as Aldara have been used. Topical treatments such as vitamin A acids (Tretinoin) can sometimes be of benefit. Efudex cream has also been used.

Plantar Warts

Plantar warts can be stubborn. Because of their location aggressive use of liquid nitrogen cryotherapy is difficult in that it can not only be painful but swelling and soreness can prevent walking for a number of days. Often paring the warts by thinning them down can be helpful. The use of salicylic acid preparations that are applied daily and cover the affected area will eat away at the surface of the wart allowing it to be pared down. This may make it more responsive to liquid nitrogen. The use of duct tape to soften the lesions in some individuals can be in itself curative. It appears that changing the water content and making the skin mushy enhances the patient’s ability to eradicate these warts. Treatments such as surgery and scraping of these warts is discouraged as scars can sometimes be painful on the weight-bearing parts of the foot. The pulse dye laser can be used once the wart has been thinned as it does not produce scarring. Occlusion combining these therapies with Aldara cream in some individuals is helpful.

Genital Warts

Genital warts are usually sexually transmitted. It is important that woman be checked to rule out any atypical changes on the cervix. Small warts can be treated with liquid nitrogen although this is uncomfortable. Podophyllin or podophyllotoxin can be applied every few days and this can be helpful.

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

Skin Tags and Thyroid Nodules Connected?

According to recent findings published on PubMed, a service of the U.S. National Library of Medicine and the National Institutes of Health, high prevalence of thyroid nodules have been found in patients with achrocordons (skin tags) and can indicate a possible role of insulin-resistance.

Excerpts from various published articles and comments follow below. From the Centro Privado de Endocrinología, Mendoza:

“Due to the observation of a great number of patients having achrocordons, when they underwent fine needle biopsies for thyroid nodules, we decided to perform a prospective study to investigate the relationship between this finding and the presence of insulin resistance (IR), since achrocordons are commonly seen in hyperinsulinemic subjects.

A total of 120 consecutive women, aged 18-35 yrs were studied. All subjects were also evaluated by thyroid ultrasound (US) for measuring thyroid volume and the presence of non-palpable nodules. Basal and post-prandial serum insulin was measured in all of them, as well as the Homeostasis Model Assessment (HOMA).

Subjects were divided in two groups: Group A, with achrocordons (n = 44) and Group B, without achrocordons (n = 76). Group A showed 24 patients (54.5%) with thyroid nodules, whereas Group B only 13 subjects (17.1%); p = 0.0087. When we considered, as having high normal thyroid volume, the glands weighting more than 16 grams by US, without nodules, it was found that 8/44 cases from Group A (18.6%) and 3/76 from Group B (3.9%) fitted in such category, p = 0.0076.

In patients with nodules and/or bigger thyroids, IR was observed in 36/44 (81.8%) of Group A and 14/76 (18.4%) of Group B, p = 0.0069, while the overall prevalence of IR was 0.47 in Group A and 0.05 in Group B, p = 0.00094. It is concluded that patients with achrocordons have a higher prevalence of US-detected thyroid nodules and larger thyroid glands. Then, it may be beneficial to search for thyroid abnormalities in those subjects with skin tags.”

A question followed from the Dermatology Department, Shiraz University of Medical Science, Shiraz, Iran.

“Is there any relation between serum insulin and insulin-like growth factor-I in non-diabetic patients with skin tag?”

Answer: Jowkar F, Fallahi A, Namazi MR.

Abstract Background Skin tags are common benign lesion occurring mainly on the neck and major flexures as a small soft pedunculated protrusion. This study evaluate insulin and insulin-like growth factor-I (IGF-I) in non-diabetic ones. Methods and materials A case-control study was conducted in non-diabetic persons. Comparing insulin and IGF-I between matched cases (n= 40) and controls (n= 40) by radioimmunoassay test.

Cases and controls were recruited from patients consecutively seen at an academic outpatient dermatology clinic. Results The insulin level in patients with skin tags was significantly higher than controls (P = 0.00) but IGF-I level was not significantly different (P = 0.43). Conclusion These results show an increased insulin level in non-diabetics ones and overall importance of insulin effect in pathogenesis of skin tags.

Conflicts of interest None declared.

Skin Tags and Impaired Carbohydrate Metabolism

Following up with a previous report on the correlation between high numbers of achrocordons (skin tags) and a possible role of insulin-resistance, a 2007 case-controlled study was published on PubMed, (a service of the U.S. National Library of Medicine and the National Institutes of Health), examining skin tags as a cutaneous marker for impaired carbohydrate metabolism.

Excerpts from the team’s findings are published below.

Department of Dermatology, Hazrat-e Rasool Akram University Hospital, Iran University of Medical Sciences, Tehran, Iran. Rasi A, Soltani-Arabshahi R, Shahbazi N.

BACKGROUND: Skin tags are common benign skin tumors usually occurring on the neck and major flexors of older people. A possible association with impaired carbohydrate metabolism has been suggested in previous studies, but the results are not conclusive.

OBJECTIVE: To investigate and compare the prevalence of diabetes and impaired glucose tolerance (IGT) in patients with skin tag and a control group.

PATIENTS AND METHODS: A case-control study was conducted in individuals over 15 years old, comparing cases (n = 104) with at least three skin tags and age-, sex-, and body mass index (BMI)-matched controls (n = 94) without skin tag. Cases and controls were recruited from patients consecutively seen at an academic outpatient dermatology clinic. All patients underwent a standard 2-h oral glucose tolerance test with 75 g glucose.

RESULTS: Patients with skin tag had higher frequency of diabetes than the control group (23.07% vs. 8.51%, chi(2)-test, P = 0.005). The difference in the frequency of IGT was not significant (13.46% vs. 10.63%, chi(2)-test, P = 0.543). There was a positive correlation between the total number of skin tags and the mean fasting plasma glucose (Pearson correlation, r = 0.260, P = 0.031); patients with more than 30 skin tags were particularly at an increased risk of diabetes (52.0%). No correlation was found between the number of skin tags and BMI. We did not find any correlation between the anatomical localization of skin tags and impaired carbohydrate metabolism, except for skin tags under the breast in women.

CONCLUSION: These results show an increased risk of diabetes mellitus in patients with multiple skin tags. With regard to the importance of early diagnosis of diabetes, we recommend a high level of suspicion for impaired carbohydrate metabolism in patients with skin tag.

Source: PMID: 17988334 [PubMed - indexed for MEDLINE

Skin Conditions: Is it a Skin Tag or a Mole?

There are several skin lesions that are very common and almost always benign (non-cancerous). These conditions include moles, freckles, skin tags, benign lentigines, and seborrheic keratoses.

Moles

Moles are growths on the skin that are usually brown or black. Moles can appear anywhere on the skin, alone or in groups. Most moles appear in early childhood and during the first 20 years of a person’s life. Some moles may not appear until later in life. It is normal to have between 10-40 moles by adulthood.

As the years pass, moles usually change slowly, becoming raised and/or changing color. Often, hairs develop on the mole. Some moles may not change at all, while others may slowly disappear over time.

What Causes a Mole?

Moles occur when cells in the skin grow in a cluster instead of being spread throughout the skin. These cells are called melanocytes, and they make the pigment that gives skin its natural color. Moles may darken after exposure to the sun, during the teen years, and during pregnancy.

Types of Moles

• Congenital nevi are moles that appear at birth. Congenital nevi occur in about one in 100 people. These moles may be more likely to develop into melanoma (cancer) than are moles that appear after birth. A mole or freckle should be checked if it has a diameter of more than 7 mm or any characteristics of the ABCDEs of melanoma.

• Dysplastic nevi are moles that are larger than average (larger than a pencil eraser) and irregular in shape. They tend to have uneven color with dark brown centers and lighter, uneven edges. These moles tend to be hereditary (passed on from parent to child through genes). People with dysplastic nevi may have more than 100 moles and have a greater chance of developing melanoma, a serious form of skin cancer. Any changes in a mole should be checked by a dermatologist to detect skin cancer.

How Do I Know if a Mole Is Cancer?

Most moles are not dangerous. The only moles that are of medical concern are those that look different than other existing moles or those that first appear after age 20. If you notice changes in a mole’s color, height, size or shape, you should have a dermatologist (skin doctor) evaluate it. You also should have moles checked if they bleed, ooze, itch, appear scaly, or become tender or painful.

Examine your skin with a mirror or ask someone to help you. Pay special attention to areas of your skin that are often exposed to the sun, such as the hands, arms, chest, neck, face, and ears.

If your moles do not change over time, there is little reason for concern. If you see any signs of change in an existing mole, if you have a new mole, or if you want a mole to be removed for cosmetic reasons, talk to your dermatologist.

The following ABCDEs are important characteristics to consider when examining your moles. If a mole displays any of the signs listed below, have it checked immediately by a dermatologist. It could be cancerous.

• Asymmetry. One half of the mole does not match the other half.
• Border. The border or edges of the mole are ragged, blurred, or irregular.
• Color. The color of the mole is not the same throughout or has shades of tan, brown, black, blue, white, or red.
• Diameter. The diameter of a mole is larger than the eraser of a pencil.
• Elevation.A portion of the mole appears elevated, or raised from the skin.

Melanoma is a form of skin cancer. The most common location for melanoma in men is the back and in women, it is the lower leg. Melanoma is the most common cancer in women ages 25 to 29.

How Are Moles Treated?

If a dermatologist believes a mole needs to be evaluated further or removed entirely, he or she will either remove the entire mole, or first take just a small tissue sample of the mole to examine thin sections of the tissue under a microscope (a biopsy). This is a simple procedure. (If the dermatologist thinks the mole might be cancerous, cutting through the mole will not cause the cancer to spread.)

If the mole is found to be cancerous, and only a small section of tissue was taken, the dermatologist will remove the entire mole by cutting out the entire mole and a rim of normal skin around it, and stitching the wound closed.

Reviewed by doctors at The Cleveland Clinic Department of Dermatology.

Skin Tag Removal at Home

If you are embarrassed or irritated from a funny little piece of extra skin somewhere on your person, you may have a skin tag.

Skin tags (medical name: acrochordon) as it turns out are a common condition, basically a benign tumor, or growth of skin, on various part of the body–most commonly the eyelids, nose, cheek, neck, armpits, upper chest and groin.   More women (especially pregnant women) than men get skin tags, and skin tags increase in both genders with age, diabetes, and obesity.  Skin tags usually don’t cause any serious health problems, but are unwanted for aesthetic reasons or because of the minor irritation they can cause.

Getting rid of a skin tag is relatively simple, as the suggestions below show.

Removing skin tags with a scalpel or scissors is a common and easy way to get rid of skin tags at home. Make sure the blade you use is sharp and sanitized (use an open flame, rubbing alcohol, or hydrogen peroxide), and cut as quickly and closely to the healthy skin as you can. Some bleeding may occur, but shouldn’t last for more than a minute. Tweezers may also be used to pull the skin tag off. Getting rid of skin tags this way will likely be painful, and you might want to numb the area first with an ice cube, or other cold substance.

Remove skin tags by freezing them off with liquid nitrogen (cyrotherapy).  Liquid nitrogen is a common treatment for skin growths. When applied to a skin tag, liquid nitrogen will destroy the cell tissue quickly and efficiently. Getting rid of skin tags with cyrotherapy may cause some minor pain and scarring, and the liquid nitrogen should not be applied to the same area of skin more than once a week.
Electrosurgery, or electrolysis, is an effective way to get rid of skin tags. This procedure is usually performed by a professional, who will use an electric needle to destroy the skin tag growth, as well as any additional growth beneath the skin. Electrolysis is usually fast and permanent, with minor scarring.

You can also remove skin tags by cutting off their blood supply. Use thread or string to tie off the skin tag close to the healthy skin to cut off the blood supply, which will eventually cause the skin tag to fall off (usually after a day or two). Depending on the location of the skin tag, you may either need help tying the string tight enough to be effective, or be unable to use this method (unless you don’t mind having a piece of string
hanging from your nose) to get rid of skin tags.

Cover skin tags in certain areas with a band aid to avoid further irritation before treatment, or to avoid treatment. Skin tags in areas like the armpits, the groin, the chest, and the back (basically any area that rubs against clothing or other skin on a frequent basis) are prone to irritation, which can cause skin tags to worsen, and in turn cause getting rid of skin tags to become more difficult or painful.

Treating Skin Conditions
If you don’t feel confident about diagnosing skin tags, see a dermatologist before attempting to treat yourself. There are numerous other, more serious, skin problems that may require more serious attention and different treatment than skin tags.These include moles, warts, freckles, and general skin damage from sun or chemicals.

Birt-Hogg Dube syndrome is a rare genetic disorder characterized by skin problems, especially noncancerious tumors occuring in hair follicles on the face, neck and chest. The presence of this syndrome can increase a person’s risk of other internal cancerous tumours and cysts. While it’s highly unlikely that you have this disorder, something like this is a good reason for you to consult a health professional if you are at all unsure about or unfamiliar with diagnosing or treating skin tags, or any other skin disorder.

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