Skin Tags (Acrochordons)
Skin tags are benign fleshy growths that are far more common in people with obesity, insulin resistance and type 2 diabetes, and their number is linked to waist size and metabolic risk.
Plain English
Patient-Friendly Explanation
Skin tags, also called acrochordons, are small soft flaps of skin that hang from the neck, armpits, groin, eyelids and under the breasts. They are harmless and are not cancer, and between half and six in ten adults develop at least one during their lifetime. What makes them interesting in a weight clinic is that they cluster with metabolic problems. They are more common in people with obesity, type 2 diabetes and metabolic syndrome, and in children their appearance has risen alongside childhood obesity. The reason is thought to be high insulin levels. Insulin resistance makes the pancreas produce more insulin, and high insulin raises insulin-like growth factor 1, which encourages skin cells to multiply and the outer layer of skin to thicken. Friction in skin folds adds to the effect, which is why tags appear where skin rubs. In a study of 113 patients with skin tags compared with 31 healthy subjects, 53.9 per cent were overweight and 33.6 per cent were obese, and the group with tags had higher insulin resistance scores, glucose, insulin, HbA1c, uric acid and C-reactive protein than controls. A second study found that 71 per cent of patients with multiple tags met the criteria for metabolic syndrome, and that the number of tags correlated with waist circumference. Skin tags are different from acanthosis nigricans, the dark velvety patches that appear in the same skin folds, although both point to insulin resistance and the two often occur together. A person with many new tags should be offered a check of waist measurement, fasting glucose or HbA1c and a lipid profile, because removing the tags without addressing the underlying metabolic picture means they tend to come back.
Medical
Clinical Definition
Acrochordons are benign dermal fibroepithelial polyps with a prevalence of approximately 50% to 60% in adults, occurring equally in men and women and increasing in number with age and with body mass index. The proposed mechanism is hyperinsulinaemia with increased insulin-like growth factor 1 signalling driving keratinocyte and fibroblast proliferation and epidermal hyperplasia, compounded by mechanical friction in intertriginous areas. In a case-control study of 113 patients with skin tags and 31 controls, overweight was present in 53.9% and obesity in 33.6%, with dyslipidaemia in 59.3%, hypertension in 30.1% and insulin resistance in 21.2%; HOMA-IR, fasting glucose, insulin, HbA1c, high-sensitivity C-reactive protein, uric acid, free fatty acids, total cholesterol, LDL cholesterol and triglycerides were all higher in patients with skin tags. Another study found that 71% of patients with multiple tags met metabolic syndrome criteria and reported a positive correlation between the number of tags and waist circumference. In paediatric cohorts the prevalence of acrochordons was 17.1% in children with obesity against 1.2% in normal-weight children. Assessment of a patient with multiple acrochordons should include waist circumference, fasting glucose or HbA1c, a lipid profile and, where feasible, HOMA-IR. Differential diagnosis includes viral warts, molluscum contagiosum and neurofibromas; removal is by snip excision, cryotherapy or laser, and recurrence is common if the metabolic drivers persist. Skin tags are not premalignant.
Key Insight
Why It Matters
Skin tags give a visible, easily examined clue to insulin resistance, and patients frequently ask whether they are dangerous or whether removing them will help. The answer is that they are harmless in themselves but worth acting on as a prompt to check waist, glucose and lipids, because the same insulin excess that produces them sits behind the metabolic complications of weight gain. Removing them is a cosmetic procedure; the metabolic assessment is the part that changes health.
Sources
Reviewed against standard medical references.
Medically reviewed by
Family Physician & Registered Acupuncturist, Accord Medical Clinic. MBBS (NUS), Graduate Diploma in Family Medicine (NUS), Graduate Diploma in Acupuncture (Singapore College of TCM).
Last reviewed: October 2026
This page is general health education, not medical advice. Whether any treatment is appropriate for you is a decision made in consultation after assessment.
