What to Do About Skin Tags

It’s natural for your skin to sprout new bumps and blemishes over the years. The common growths described here can usually be left alone—and some should be. If you’d rather have them removed, it’s critical to do it the safest way and to go to the right professional.

Today, family doctors and aestheticians (people who administer facials, peels, and other skin treatments) advertise this type of care, sometimes offering to do it with powerful lasers. Even health care clinics at Walgreens offer to snip off skin tags.

But “you should never get anything removed from your skin without seeing a dermatologist first,” says Jessica Krant, M.D., a dermatologist and member of Consumer Reports’ medical advisory board. The American Academy of Dermatology agrees, and warns people about nondermatologists removing growths.

One major reason: Cancerous growths can resemble benign ones. And research has found that people who aren’t dermatologists often miss them. “These practitioners aren’t trained in dermatology,” says Lauren Ploch, M.D., a member of the American Academy of Dermatology. “In some cases, they may have only taken a weekend course. I worry that they’ll miss something or treat it inappropriately.” When family doctors do refer people to a dermatologist for an evaluation of a suspicious mark, it’s often found to be benign.

Dermatofibromas

These round, hard, reddish-brown bumps may have a dimpled center. They most often crop up on legs or arms, and they can develop after an insect bite or a shaving cut.
Safe removal: Your best bet is to leave them alone. “Removal often yields a worse mark,” says Bruce Robinson, M.D., a dermatologist at Lenox Hill Hospital in New York City and an AAD spokesman. If a fibroma is in a sensitive area or causes itching or bleeding, a dermatologist can remove it surgically. It can’t be shaved, snipped, or erased with a laser.
Will insurance pay? Maybe, but only if it’s very big or changes shape and looks suspicious.

Epidermoid Cysts

These skin-colored lumps are most common on the face, neck, back, and trunk. Some become infected and rupture.
Safe removal: Incision and drainage may be needed for an infected cyst. Once the infection has subsided, the cyst can be surgically removed.
Will insurance pay? If it’s large, inflamed, and painful.

Seborrheic Keratoses

These are waxy black, brown, or tan growths with small bumps that give them a wart-like surface.
Safe removal: Cryotherapy, which uses liquid nitrogen to freeze the lesion and turn it crusty, causing it to fall off. Another option is cauterization (heating) with a surgical tool.
Will insurance pay? If it’s inflamed, itchy, or bleeding.

Skin Tags

These stalks of skin tend to grow in high-friction areas, such as the underarm and neck. About half of American adults have a skin tag.
Safe removal: They can be shaved or snipped off by a dermatologist and cauterized to stop bleeding if necessary. Avoid over-the-counter treatments with claims that they will dissolve skin tags. Because they kill off skin cells, “you could harm the area around the tag, which could lead to increased scarring,” says Lauren Ploch, a dermatologist.
Will insurance pay? Possibly, if a tag is irritated, red, or bleeding, or it looks suspicious.

When to Consider Laser Treatment

Few skin growths require laser treatment. In fact, lasers may be more likely to cause pain and scarring than freezing, cutting, or shaving off a growth. That's why “many dermatologists don’t feel it is necessary to integrate lasers into their practices,” says Lauren Ploch, M.D. But they're used to treat cherry angiomas, bright red bumps made up of blood vessels, often on the chest. Heat from a pulse-dye laser causes the growth to bruise and fade in a week or so. It's often fine for nurses and technicians to do the procedure, Ploch says, if they have been trained by and are under the guidance of a dermatologist who has evaluated the growth. But insurance usually won't cover it.

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