Skin Tags

Skin tags are small flesh-coloured or brown growths that hang off the skin and look a bit like warts. They are very common and harmless.

Skin tags are usually a few millimetres in size, although some can be as big as 5cm.

They are commonly found on the neck, in the armpits, around the groin or under the breasts. Sometimes they grow on the eyelids or under the folds of the buttocks.

The medical name for skin tags is acrochordons.

 
Why skin tags occur

Anyone can develop skin tags, but they are particularly common in older people. Some people are prone to developing them for no apparent reason.

It is thought that skin tags grow where skin rubs against skin or clothing. This would explain why they also tend to affect overweight people who have excess folds of skin and skin chafing.

When skin tags can be a problem

Skin tags are harmless and do not usually cause pain or discomfort.

However, you may want to consider getting them removed if they are ugly and affect your self-esteem, or if they snag on your jewellery and bleed. You will usually need to pay for this procedure privately.

This is because the removal of skin tags is regarded as cosmetic surgery, which is rarely available through the NHS. Generally, the NHS will only carry out cosmetic surgery procedures if the problem is affecting your physical or mental health.

Sometimes, skin tags fall off on their own if the skin tissue has twisted and died from a lack of blood supply.

How to remove skin tags

If skin tags are upsetting you, consider making an appointment with a privately practising GP to have these removed.
The GP can easily burn or freeze off the skin tags, just as they would remove warts.

If the skin tags are very small and have a narrow base, the GP might suggest that you try removing them yourself, by:

• tying off the base of the skin tag with dental floss or cotton, to cut off the blood supply and cause it to drop off, or
• cutting it off with fine sterile scissors

Do not attempt to remove large skin tags yourself, as they will bleed heavily.

Moles

Moles, also known as melanocytic naevi, are small skin lesions that are usually brown. They are a collection of cells called melanocytes, which produce the pigment (colour) in your skin.

Moles are usually a brownish colour, although some may be darker or skin-coloured. They can be flat or raised, smooth or rough and some have hair growing from them. Moles are usually circular or oval with a smooth edge.

Moles can change in number and appearance. Some moles fade away or fall off over time, often without you realising. They also sometimes respond to hormonal changes, for example during:

• pregnancy: when they may get slightly darker
• the teenage years: when they increase in number
• older age: when they may disappear from 40 to 50 years of age onwards
  
  

When do moles develop?

Some moles, known as congenital melanocytic naevi, are present at birth. However, most moles develop during the first 30 years of life. These are called acquired melanocytic naevi. People with fair skin often have more moles than people with darker skin.

Most moles have a genetic cause and are inherited. This is often the case with people who have a lot of moles. Where you were brought up may also make a difference,. For example, if you have been in the sun a lot for many years you may have an increased number of small moles.

People who spend a considerable amount of time in the sun often develop brown marks on their skin, especially the face and arms. These tend to be sun spots or solar lentigines and appear later on in life. Severe sunburns on the shoulders, for example, may also cause some sun spots which are not moles.

Malignant melanoma

Most moles are harmless, but in a few rare cases they can develop into malignant melanoma, which is an aggressive form of skin cancer.

Malignant melanoma is the most serious type of skin cancer. The cause of melanoma is complex and is usually explained by a mix of genetic factors and the environment, mainly exposure to the sun. However, many melanomas are not caused by excessive sunbathing and may occur on parts of the body that have not been exposed to much sun.

Malignant melanoma can appear anywhere on the body. It may be a dark, fast-growing spot where there was not one before, or a pre-existing mole that changes size, shape or colour and bleeds, itches or reddens. However, the bleeding, crusting and itching are late signs and ideally melanoma should be diagnosed earlier. Itching is also not a very specific sign, as benign (non-cancerous) moles may itch occasionally.

Warts

Warts are small, rough lumps on the skin that are benign (non-cancerous). They often appear on the hands and feet.

Warts can look different depending on where they appear on the body and how thick the skin is. A wart on the sole of the foot is called a verruca. The clinical name for a verruca is a plantar wart.

Warts are caused by infection with a virus known as the human papilloma virus (HPV). HPV causes keratin, a hard protein in the top layer of the skin (the epidermis) to grow too much. This produces the rough, hard texture of a wart.

Types of warts

There are several different types of warts. The more common types include:

• common warts
• plantar warts (verrucas)
• plane warts
• filiform warts
• periungual warts
• mosaic warts

The appearance of each type of wart will depend on several factors:

• where it is located on your body
• the strain (type) of HPV that is responsible for the wart
• factors such as whether you have a weakened immune system
• whether you have rubbed or knocked the wart

Who gets warts

Most people will have warts at some time during their life. However, they are more common in school children and teenagers than in adults. Research has indicated that 4-5% of children and adolescents in the UK have warts.

Warts are uncommon in babies and occur in equal numbers between males and females.

People who have an increased risk of developing warts include those with weak immune systems, for example, following treatment for cancer or due to an illness such as HIV and AIDS, and those who have had an organ transplant. Around 50% of people who have had a kidney transplant develop warts within five years.

A type of wart that is known as a ‘butcher's wart’ can sometimes develop on the hands of people who are regularly in contact with raw meat, fish or poultry for long periods of time. However, this type of wart is rare.

Prognosis

Most warts disappear on their own without treatment, although treatment can help to get rid of them more quickly. Treatment may be recommended in cases where:

• the wart is causing you pain or is unsightly
• there are associated risk factors, such as having a weakened immune system

Several treatment options are available to help treat warts and verrucas successfully.

Spider Veins

These are fine red or sometimes blue veins on the face. They are most frequently found around the nose or the cheeks. They can be removed in clinic by applying a local anaesthetic cream for about half an hour to the affected area. Then the veins are touched with a machine called a hyfrecator which coagulates the vein. The body then reabsorbs it. Sometimes two or three treatments required to remove them all.

Keratoses

Seborrhoeic keratoses, also called solar or actinic keratoses, are skin blemishes that can mimic moles. They are benign (non-cancerous) and are common in older people. They differ from moles and look like raised warts. Seborrhoeic keratoses can be skin-coloured, black, dirty-yellowish or a grey-brown colour. They can crumble away from the skin and you usually have several, especially on the chest and tummy.