Skin tags, warts, and moles are common lesions you can find when you look in the mirror or perform a skin self-exam. These conditions are benign, though they may look concerning to some or make them self-conscious. Indeed, it can be hard to tell them apart from each other—or, more importantly, from skin cancer—without the sharp clinical eye of a skin expert.
Skin health is essential, like all other aspects of health. Understandably, you’d want to know when to consult a specialist for a skin condition. In this article, we tackle the similarities and differences between skin tags, warts, and moles. We also round up the various treatment options for these lesions and the signs that will tell you it’s time to take them to a skin doctor.
Skin tags, aka “acrochordons,” are soft outgrowths attached to the skin surface by a stalk. They range from one to five millimeters in size, though some reach up to two centimeters. They occur as solitary or multiple lesions in skin folds—the armpits, neck, eyelids, and others—which are areas of friction.
Skin tags contain mostly loose connective tissue and blood vessels. They usually have normal pigmentation, so they’re skin-toned, brown, or pinkish-red in color. They’re not painful or itchy. However, they develop these symptoms when inflamed or infected after a botched removal attempt or traumatic contact with clothes, jewelry, and others.
What Causes Skin Tags?
The cause of skin tag formation is unknown, though frequent rubbing in skin creases may play a role. It is also linked to the following conditions:
- Abnormal lipid levels
- Type 2 diabetes mellitus
- Heart disease
- Hormonal imbalance
- Genetic conditions like tuberous sclerosis and Birt-Hogg-Dube syndrome
- Normal aging of the skin with loss of elasticity
- Previous HPV infection
Big, multiple skin tags are more common among individuals with metabolic and predisposing genetic conditions.
How Do You Get Rid of Skin Tags?
Skin tags do not usually pose a serious health threat, so most are cosmetic cases. However, some may grow large enough to cause discomfort or affect vision, eyelid movement, and other important functions. They can also bleed or get inflamed when caught between clothes and jewelry. Unusual features like abnormal pigmentation and rapid growth are rare but raise concerns for skin cancer.
Any of the above is a good reason to have the lesion checked and treated by a healthcare provider. Removing a skin tag on your own is dangerous because it can lead to profuse bleeding and infection. It may also create long-term complications like scars and painful nerve growths in the skin called “neuromas.”
Skin tag removal options include the following:
- Simple excision—cuts out the lesion with surgical scissors or blades.
- Cautery—uses radiofrequency or electrosurgery to burn the skin tag.
- Cryosurgery—liquid nitrogen freezes the outgrowth, which later falls off spontaneously.
- Laser treatment—powerful light beams target the lesion or its blood supply.
These procedures are made painless by applying or injecting numbing medication. Currently, there are no scientifically-proven topical treatments for these lesions.
Skin tags do not recur after removal unless you have a medical condition that makes you prone to their formation. You can keep them from coming back by maintaining a healthy weight, using a non-soap cleanser, and moisturizing regularly.
Warts are abnormal skin reactions to the presence of human papillomavirus (HPV). The typical lesion is scaly, rough, and dry, with distinct margins. Pigmentation is usually normal, so it may be skin-toned, tan, brown, or pinkish-red in color. It normally doesn’t itch or cause pain unless hit traumatically or superinfected by bacteria. Warts bleed when cut, like normal skin.
Different HPV strains cause warts to have distinct distribution patterns and physical features. For example, common warts—associated with HPV 2, 4, 27, and 29—have a classic appearance and occur singly or in groups anywhere on the skin. Genital warts—linked to high-risk HPV types like 16 and 18—may grow large and develop jagged edges that make them look like cauliflower fragments.
A filiform wart is sometimes hard to distinguish from a skin tag, as it also appears in skin folds and looks elongated, as if with a stalk. HPV subtypes 1, 2, 4, 27, and 29 are the usual causes of filiform warts.
Wart sizes vary from a few millimeters to several centimeters, depending on the viral strain and patient factors.
What Causes Warts?
As mentioned previously, HPV infection causes warts. That means they’re contagious.
Warts can spread by direct skin-to-skin contact and sharing of HPV-contaminated personal items. It’s common for these lesions to grow in areas with broken skin, such as cracked heels and hand cuts. Touching, squeezing, or scratching a wart can also spread the virus elsewhere in the body, enlarging the original lesion or creating new ones—a process called “autoinoculation.”
Warts are initially asymptomatic, taking months to grow. Patients may unknowingly spread the virus at this stage.
How Do You Treat a Wart?
Warts can disappear spontaneously within 2-4 years in people with robust immunity. Still, it’s best to have them checked and removed promptly. Not only are they contagious, but they can also become harder to treat over time. Additionally, high-risk HPV strains may cause cancer of the skin, mucosal surfaces, and internal organs.
Both at-home and in-office therapies are available for eliminating this skin problem. Evidence-based at-home treatments include the following:
- Salicylic acid—a hydroxy acid that exfoliates the abnormally thickened wart skin.
- Topical retinoids, particularly tretinoin and acitretin—vitamin A-like drugs that correct abnormal skin growth and modulate the skin’s immune function.
- Virucides, specifically glutaraldehyde and formaldehyde—agents that deactivate the wart virus and harden the lesion, making it easier to scrape off.
- Imiquimod—an immune-enhancing drug applied to genital warts.
- Podophyllin—an agent that suppresses abnormal skin growth and is used on genital warts.
In-office procedures for wart removal include the following:
- Cantharidin—the provider applies a drug that kills off and dries up the abnormal skin cells.
- Cryotherapy—liquid nitrogen freezes and dries up the wart.
- Electrosurgery and curettage—the specialist cauterizes the lesion, then takes it out with a surgical blade.
- Simple excision—surgical removal is done with surgical scissors or blades.
- Laser surgery—laser beams burn the wart or its blood vessel.
- Bleomycin injection—the provider injects an immune-enhancing drug into the skin growth.
- Radiofrequency—radio waves burn the lesion.
- Photodynamic therapy—the specialist applies a light-sensitizing drug on the wart, then exposes it to high-energy blue or red light.
Between at-home and in-office treatments, the in-office ones are proven to be safer and more effective. At-home remedies rely on patients’ varying degrees of compliance with the regimens. Meanwhile, in-office procedures are performed by licensed health professionals strictly observing standard protocols.
Warts can recur in patients with poor immunity or if their habits—such as sharing personal belongings, walking barefoot, touching warts, and others—increase HPV exposure. Anti-HPV vaccines protect against the causative virus.
Moles are benign skin growths notable for the excessive proliferation of melanocytes—the cells that produce the primary skin pigment melanin. Common acquired moles are oval or round, flat or raised lesions with sizes no greater than 6 millimeters. They’re typically symmetric, with distinct, smooth borders and uniform color.
Unlike skin tags and warts, moles frequently exhibit pigmentation changes. Skin-toned, pink, brown, and black are common. Finding hair or soft, tiny lumps on top of a mole is also normal. These lesions often appear on sun-exposed sites, though they may grow anywhere on the body.
What Causes Moles?
The causes of mole formation are unclear, but the biggest factor appears to be UV or sun exposure, especially in young people. Genetics also plays a part since some individuals are more prone to developing numerous moles, with or without significant UV exposure. Immune deficiencies can also make people vulnerable to mole formation.
How Do You Remove a Mole?
Common moles are harmless. However, you may have them removed for cosmetic reasons or if they impair vital functions like vision or motion. In some cases, what looks like a common mole may turn out to be an atypical mole, which can develop into melanoma—a type of skin cancer involving melanocytes. Consult your primary care physician or dermatologist when you spot a new, suspicious lesion or one that’s changing fast.
The ABCDE melanoma guide can help you distinguish an atypical mole and melanoma from a common mole:
The ABCDE Melanoma Guide
|Signs to Look For||Common Mole||Atypical Mole and Melanoma|
Typical colors: Skin-toned, pink, brown, and black
Abnormal colors: Blue, red, white, and gray
|Diameter||Less than 6 millimeters||6 millimeters or greater|
|Evolution and Elevation||Grows very slowly or doesn’t change at all||Changes in size and other features seen within months or years|
Your health provider may recommend a biopsy of the skin lesion if physical examination alone cannot rule out skin cancer.
Mole removal procedures include:
- Simple excision
- Laser surgery
- Cautery by radiofrequency or electrosurgery
- Dermabrasion or skin sandpapering using a fast-rotating rough wheel
Of these, simple excision is the treatment of choice, as it allows microscopic examination of the mole tissue after removal. If cancer cells are found, the specialist may recommend another surgical session or a systemic treatment like chemotherapy and radiotherapy. It’s impossible to do this kind of exam on other mole removal procedures.
Lasers have the advantage of producing excellent cosmetic results, though they’re not advisable if cancer can’t be ruled out. Cautery, cryotherapy, and dermabrasion may cause scarring or worsen the lesion.
There are currently no FDA-approved drugs for mole treatment.
What Are the Similarities Between Skin Tags, Warts, and Moles?
The most important clinical similarity between skin tags, warts, and moles is their benign nature. That means they’re skin-deep, grow slowly and don’t spread damage to other parts of the body if left on their own. Recurrence after surgery doesn’t necessarily mean they’re dangerous. However, it may point to an underlying condition that needs separate treatment, as in cases of skin tags in people with lipid disorders.
Being benign doesn’t mean you can effectively or safely remove these lesions on your own. The best way to deal with them is to have them examined and treated by a skin care specialist.
What Are the Differences Between Skin Tags, Warts, and Moles?
The table below should help you easily remember the differences between these lesions.
Important Clinical Differences Between Skin Tags, Warts, and Moles
|Features||Skin Tag||Wart||Common Mole|
|Cause||Unknown, but may be related to frequent skin friction and metabolic or genetic conditions||HPV infection||Unknown, but UV exposure, genetics, and poor immunity contribute to its formation|
|Has a stalk||Yes||Sometimes||No|
|Surface||Usually smooth||Rough in most lesions||Usually smooth, but may have hair or tiny, soft lumps|
|Typical colors||Skin-toned, brown, and pinkish-red||Skin-toned, tan, brown, and pinkish-red||Skin-toned, pink, brown, and black|
|Usual location||Skin folds||Depends on the HPV strain, but more common in areas with skin breaks||Anywhere on the skin, but more common in sun-exposed locations|
|Age of onset||Middle to late adulthood||Any age, but people with poor immunity are most vulnerable||Childhood to early adulthood|
If you have a suspicious lesion you can’t identify on your own, it’s best to see your health provider about it. Besides the characteristics we mentioned here, other concerning signs that should prompt a dermatology consult include the following:
- Bleeding with minimal or no trauma
- Numbness or unbearable pain
- The presence of systemic symptoms like fever, nausea, poor appetite, unintentional but rapid weight loss, and others
- Persistence despite close adherence to the doctor-prescribed treatments
Perform a self-skin check regularly, especially if you have risk factors like immunosuppression, previous treatment for any cancer type, and a family history of skin cancer.
Skin tags, warts, and moles often resemble each other by appearance. Correct identification can help you decide whether or not you need to have them treated right away. However, it’s easy for inexperienced observers to confuse one with another. So if you’re unsure about a skin lesion, your best move is to ask your health provider about it as soon as possible.
Finally, skin imperfections are best left to highly-trained, board-certified dermatologists. They have the expertise in identifying various skin conditions and determining the treatment option most suitable for every patient. At Dr. Ben Behnam’s clinic, you can rest assured that you’ll get high-quality care and the best therapeutic experience every time you visit. The sooner you get rid of a pesky lesion, the better for your peace of mind.
Book your appointment today!
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- Cuda, JD, et al. Chapter 115: Melanocytic Nevi. Fitzpatrick’s Dermatology, 9th edition. 2019.
- Faiz, SM, et al. Giant Acrochordon of Left Side Neck, a Rare Case Finding. Era’s Journal of Medical Research. December 2020.
- Goldstein, AO. Overview of benign lesions of the skin. UpToDate Online. February 10, 2023.
- Hassel, JC and Enk, AH. Melanoma. Fitzpatrick’s Dermatology, 9th edition. 2019.
- Konkel, K, et al. Serious Skin Injuries Following Exposure to Unapproved Mole and Skin Tag Removers. Journal of Clinical and Aesthetic Dermatology. January 2023.
- Pandey, A and Sonthalia, S. Skin Tags. StatPearls Publishing, LLC. August 1, 2022.
- Sardana, K, et al. Optimal management of common acquired melanocytic nevi (moles): current perspectives. Clinical, Cosmetic and Investigational Dermatology. March 19, 2014.
- Sterling, JC. Chapter 167: Human Papillomavirus Infections. Fitzpatrick’s Dermatology, 9th edition. 2019.
- Sterling JC, et al. Guidelines for the management of cutaneous warts. British Journal of Dermatology. January 2001.
- Wichey, DJ, et al. Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management. The Journal of the American Osteopathic Association. February 2018.
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