Pendulous warts are not warts in the true sense of the word. True warts are transmitted by human papillomaviruses and are contagious. Skin tags, on the other hand, are noncontagious, benign growths on the skin. Medically, they are referred to as soft fibromas, or fibroma pendulans in Latin. Since skin tags are not warts, conventional wart treatments are ineffective.
Here you’ll find further information as well as a selection of specialists in skin tags.
Soft fibromas are rich in cells but low in fibers. Their tissue structure is characterized by loosely arranged fibers. The Latin term fibroma pendulans translates to “pendulous fibroma.” It refers to the growth of the fibroma on a stalk-like structure.
Pedunculated fibromas do not pose a health risk. If they do not cause any discomfort, they can simply be left alone without concern. However, due to their conspicuous appearance, they are often a cosmetic concern for those affected. Statutory health insurance plans generally do not cover the costs of treatments performed for aesthetic reasons. Therefore, those affected must pay the costs themselves.
There are no reliable statistics on the prevalence of skin tags. However, studies have shown that skin tags occur more frequently in severely overweight and older people.
Skin Tags and Their Symptoms
Stalk warts do not necessarily have to be stalk-shaped. Often, stalk warts also look like small clumps of tissue and are broad-based, sitting directly on the skin. Colloquially, this is referred to as a “cauliflower-shaped” growth.
The surface of skin tags is usually rough and scaly. Skin tags are generally slightly darker than the surrounding skin. A small, black dot is sometimes visible at the tip of a skin tag.
The size of a pedunculated wart can vary greatly. Most pedunculated warts are only a few millimeters in size. Occasionally, however, they can grow up to one centimeter in size.
Stalked warts prefer soft skin tissue. They are therefore more commonly found in areas of the body where the skin is soft, such as
- in skin folds,
- on the head—often covering a large area around the eyes—
- on the neck, and
- in the armpits.
In women, skin tags also frequently grow in the décolletage area or under the breast.
They can occur individually or in clusters close together. Such clusters can consist of up to 30 individual skin tags.
Depending on their size and location, skin tags can sometimes cause discomfort:
- pain from chafing against clothing,
- getting caught on jewelry,
- interference with shaving, ...
Stalk warts often grow on a stalk-like structure and can have a cauliflower-like appearance © Praewphan | AdobeStock
The Development of Skin Tags
Skin tags are caused by the excessive growth of certain skin cells, called fibroblasts. The cause of this overgrowth is not yet known.
Some people are more prone to skin tags than others. For example, it has been observed that in some patients, skin tags recur repeatedly even after removal. Others, however, remain free of skin tags.
A genetic predisposition to skin tags therefore seems likely. However, it has not yet been conclusively determined whether such a predisposition actually exists.
Several risk factors are now known to promote the increased growth of fibrocytes and, consequently, skin tags. These include
- poor personal hygiene,
- minor injuries to adipose and connective tissue, and
- heavy sweating.
Diagnosis of Skin Tags
Skin tags generally do not pose a health risk. However, you should have any rapidly progressing changes in color or sudden growth of a skin tag examined as soon as possible.
Such changes can have several causes and are not automatically a sign of malignant tissue changes.
Experienced doctors can recognize skin tags at a glance. However, if the doctor has any doubts or suspects a malignant growth, they will take a tissue sample. This can be examined in detail. Afterward, it will be certain whether it is a fibroma—that is, a benign growth.
Treatment of Pedunculated Warts
Due to the potential for confusion with other conditions, many people affected begin conventional wart treatments. However, these do not work for pedunculated warts. See a doctor, preferably a dermatologist.
Surgical removal of pedunculated fibromas is the only treatment that offers a good chance of success. Do not try to treat them with home remedies that are claimed to help. In most cases, these will cause more harm than good.
Also, do not try to cut off the pedunculated wart yourself. Soft fibromas usually contain a large blood vessel inside. Cutting off a skin tag can lead to complications such as bleeding and infection. Parts of the skin tag may also remain—and because its tissue structure has been damaged, it may grow back even more vigorously than before.
Traditional Surgery
Before the actual surgical removal of the pedunculated wart, the doctor disinfects the surrounding skin.
The procedure is performed under local anesthesia. The type of anesthesia used depends on the size and location of the pedunculated wart. For very small warts, the doctor will use a cold spray or an anesthetic cream. However, this provides only very limited numbing.
Often, pedunculated warts are larger or more firmly attached to the skin. In such cases, the doctor injects a local anesthetic directly at the base of the wart. This numbs the skin areas beneath the wart for a short time.
Depending on the shape and size of the growth, the doctor removes the skin tag with
- a scalpel,
- surgical scissors, or
- a surgical spoon.
Whether the doctor subsequently
- stitch it up,
- glue it, or
- cauterize it.
After the removal of skin tags, a scar may remain in some cases. However, when removed professionally by a doctor, the scar is usually very small. It can therefore only be seen upon close inspection.
Cryotherapy
An alternative is freezing the skin tag, a procedure known as cryotherapy. Cryotherapy is also a popular and effective treatment for common warts.
Liquid nitrogen is used for the freezing process. The pedunculated wart is treated using a cold spray or a cold probe. It freezes instantly and dies off.
Depending on the size of the growth, the pedunculated wart then falls off the skin immediately or after a few days. Especially with larger pedunculated warts, it may be necessary to repeat the procedure after some time.
Laser Removal
It is also possible to remove pedunculated warts using a laser. This treatment is also commonly used for regular warts.
A laser beam very precisely cuts off the skin tag just above the healthy skin areas. This may cause a brief, stabbing pain.
The laser procedure is very quick. The doctor must decide whether or not anesthesia is necessary.
Electrocoagulation
In recent years, electrocoagulation has become increasingly common for the removal of skin tags and even common warts.
The doctor uses high-frequency current to heat the skin tag for a fraction of a second. This causes the skin tag to die instantly. It then falls off either immediately or after a few days.
One advantage is that electrocoagulation immediately seals the wound and causes it to scab over. The scabbed remnant that remains on the skin usually falls off within the next few days. As a result, the skin tag disappears completely.
Sometimes, tissue remnants of the skin tag remain on the skin, especially with larger skin tags. For this reason, it may be necessary to repeat the procedure after some time.
Preventive Measures Against Skin Tags
No effective method of preventing skin tags is currently known. The same principle applies here: preventive measures and treatments for common warts are not effective against skin tags.
Being severely overweight can promote the growth of skin tags. Maintaining a healthy body weight therefore reduces the risk of developing a skin tag.
In addition, it is important to ensure proper personal hygiene at all times. Thoroughly clean the areas where skin tags tend to develop on a regular basis.
Women who are prone to skin tags should pay special attention to the areas directly under their breasts. People who are severely overweight should take particular care to clean skin folds thoroughly. You should also check these areas regularly for the presence of skin tags.
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