Acrochordon Treatment & Management

Updated: Jun 02, 2017
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Surgical Care

Skin tags are generally treated for noncosmetic reasons. Failure to clearly delineate how the skin tag is producing a problem for the patient when removing a symptomatic acrochordon may be a cause for concern. This documentation may be obligatory for insurance coverage because most plans do not cover cosmetic procedures. Additionally, inform the patient that the insurance company may not cover the procedure if the physician believes that he or she is performing the removal for cosmetic reasons.

Small, pedunculated acrochordons may be removed with curved or serrated blade scissors, while larger skin tags may simply require excision. For small acrochordons, application of aluminum chloride prior to removal will decrease the amount of minor bleeding. Some prefer ethyl chloride spray anesthesia prior to skin tag excision with microscissor and microforceps. [41]

Anesthesia prior to electrodesiccation is another option.

Other methods of removal include cryotherapy and ligation with a suture or a copper wire [42] ; however, freezing of the surrounding skin during liquid nitrogen cryotherapy may result in dyschromic lesions. Taking hold of the acrochordon with forceps and applying cryotherapy to the forceps may provide superior results.

A 2008 report describes a patient with circumferential prolapsed hemorrhoids with skin tags; the patient was treated with a modified Ferguson hemorrhoidectomy, with successful results. [43]

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Long-Term Monitoring

The possibility of a relationship between skin tags and colon polyps has been considered. [44] Although they may coexist, a relationship has not been shown and is probably coincidental. Lipid profile levels in individuals with skin tags and others in the healthy population have shown no salient differences. [45]

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