Skin tags originate primarily from friction between skin folds or between skin and clothing, and they are influenced by factors such as age, genetics, hormonal changes, and certain health conditions like obesity and diabetes.
Causes and Risk Factors
Skin tags, medically known as acrochordons, develop when clusters of collagen and blood vessels become trapped within thicker pieces of skin, often in areas where skin rubs against skin or clothing. Common locations include the neck, armpits, groin, under the breasts, and eyelids. Friction is considered the primary trigger, which explains their prevalence in skin folds. Additional risk factors include aging, with incidence increasing after the fourth decade of life, and genetic predisposition, as they tend to run in families. Hormonal fluctuations during pregnancy and conditions like insulin resistance, type 2 diabetes, and metabolic syndrome are also linked to their development.
Biological and Medical Associations
Microscopically, skin tags consist of a fibrovascular core covered by normal epidermis, sometimes containing fat cells. While their exact biological mechanism is not fully understood, elevated levels of growth factors such as epidermal growth factor (EGF) and hormonal imbalances may contribute to their formation. Some studies have explored a potential association with human papillomavirus (HPV), particularly types 6 and 11, though findings remain inconclusive. Rarely, multiple skin tags may signal underlying conditions such as Birt–Hogg–Dubé syndrome or acromegaly.
Prevalence and Demographics
Skin tags are extremely common, affecting an estimated 50% to 60% of adults at some point in their lives. They occur equally in men and women and are more prevalent in individuals who are overweight or obese due to increased skin friction. Though typically harmless and painless, they may become irritated, bleed, or be removed for cosmetic reasons [