Skin tags PCOS: Causes, treatments, and prevention

If you've noticed soft, small skin tags and have PCOS, you're not alone. These benign growths are common in PCOS due to hormonal changes and insulin resistance. Let’s explore how PCOS links to skin tags and the best ways to treat and prevent them.

What are skin tags?

Skin tags are small, soft, growths that often appear on areas where skin rubs against skin or clothing, such as the neck, armpits, or eyelids. They may be the same color of your skin or darker and are typically benign and painless, but some people may want to remove them for cosmetic reasons or to reduce irritation.
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Why does PCOS cause skin tags?

Polycystic Ovary Syndrome can contribute to the development of skin tags through a combination of hormonal imbalances, particularly insulin resistance and elevated androgen levels.

Insulin resistance, a key feature of PCOS, occurs when the body's cells become less responsive to insulin, causing the pancreas to produce more of it. Higher insulin levels circulate in the bloodstream, and this excess insulin acts as a growth stimulant for skin cells. It triggers the overproduction of certain growth factors that promote skin cell multiplication, leading to the formation of skin tags, particularly in areas where the skin folds, like the neck, armpits, and under the breasts.

In addition to insulin resistance, elevated androgen levels (male hormones that are often elevated in women with PCOS) can further contribute to changes in skin texture and appearance. Androgens can promote thicker skin and excessive growth of hair, both of which create an environment conducive to the development of skin tags.

Together, these hormonal disturbances result in the conditions necessary for skin tags to form in some individuals with PCOS. Research suggests that managing insulin resistance and controlling androgen levels may reduce the likelihood of developing skin tags or help minimize their appearance.

Treatments for skin tag PCOS 

When it comes to treating skin tags associated with PCOS, medical treatment often aligns closely with a woman’s personal priorities, particularly concerning family planning. 

For those planning pregnancy in the short or long term, the treatment may focus on managing hormonal imbalances to promote regular ovulation and fertility. This can include ovulation-stimulating medications, such as clomiphene or letrozole, which are commonly prescribed to encourage ovulation and increase the chances of conception.

Alternatively, for women not focused on pregnancy, treatment may prioritize regulating hormonal levels and managing insulin resistance, the underlying cause of many PCOS symptoms, including skin tags. In these cases, options like hormonal birth control or anti-androgen medications (such as spironolactone) can be effective in managing symptoms without impacting fertility. These treatments help regulate hormone levels and, in turn, may reduce the development of new skin tags.

There are several treatment methods for removing skin tags, ranging from at-home remedies to medical procedures. Below are the most effective options.

1. Medical procedures:
   • Cryotherapy: This treatment involves freezing the skin tag with liquid nitrogen. It’s quick and often leaves minimal scarring.
   • Cauterization: This method uses heat to burn off the skin tag. It is generally performed in a medical setting.
   • Surgical Removal: A dermatologist can remove skin tags through minor surgery. This is typically painted with local anesthesia and allows precise removal, reducing the chance of regrowth.
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2. At-home treatments:
   • Apple cider vinegar: Some people apply apple cider vinegar to skin tags as a natural remedy, though results vary and medical support is limited.
   • Tea tree oil: Known for its antimicrobial properties, tea tree oil may dry out skin tags over time. It’s essential to dilute the oil and do a patch test first to prevent irritation. 

Note: Consult a dermatologist before trying any home remedies, as improper removal can lead to infection or scarring.

How to Manage Skin Tags with PCOS

Preventing skin tags in PCOS often involves addressing underlying factors like insulin resistance and hormonal imbalance. Here are some practical tips:

1. Diet and Weight Management in PCOS and Skin Tag Reduction: Diet plays a crucial role in managing PCOS symptoms and reducing skin tags, particularly through addressing overweight and obesity. Excess weight can worsen insulin resistance, a key factor in PCOS that also contributes to hormonal imbalances and skin tag formation. 
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2. Research indicates that even modest weight loss—just 5-10% of body weight—can significantly improve insulin sensitivity, lower androgen levels, and support overall hormonal balance. Dietary adjustments, which have been shown to enhance insulin sensitivity, can thus offer a natural and effective approach to addressing both PCOS and skin tags.
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   - Low Glycemic Index (GI) Diet: A low-GI diet includes foods that release sugar gradually, helping to avoid insulin spikes and supporting overall insulin sensitivity. Research published in The American Journal of Clinical Nutrition found that women with PCOS who followed a low-GI diet experienced improved insulin sensitivity and better menstrual regularity.
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   - Mediterranean diet: The Mediterranean diet has shown benefits for individuals with PCOS. A study in Nutrition & Metabolism reported that this diet helped improve insulin sensitivity and reduce markers of inflammation in PCOS patients, suggesting a possible indirect effect on preventing skin tags This diet’s emphasis on vegetables, fish, and olive oil can help maintain steady blood glucose levels and potentially lower insulin resistance-related skin tags.
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   - High-Fiber, Low-Sugar Diet: A diet rich in fiber has been shown to slow sugar absorption, which keeps blood glucose levels more stable—an essential benefit for managing insulin resistance. "A high-fiber diet can support hormonal balance by regulating insulin and androgen levels, which is essential for women with PCOS," explains Dr. Felice Gersh, an integrative OB-GYN specializing in PCOS care. "Fiber helps to slow sugar absorption, promoting stable glucose levels and reducing insulin spikes."
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   - Anti-Inflammatory Foods: Including more anti-inflammatory foods like leafy greens, fatty fish, and berries can help counteract the elevated inflammation levels often seen in PCOS. Dr. Mark Hyman, a functional medicine physician, notes, "The anti-inflammatory effects of omega-3 fatty acids are well-documented. In PCOS patients, these healthy fats can help improve insulin sensitivity and reduce skin-related symptoms by balancing inflammation levels."
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1. Regular exercise:
   Exercise plays a crucial role in improving insulin sensitivity, which is key for managing PCOS. When insulin resistance improves, insulin levels drop, reducing the growth factors that contribute to skin tag formation. Studies show that regular physical activity - especially aerobic and strength training -can help balance blood sugar and improve hormonal levels, indirectly reducing the likelihood of developing skin tags.
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2. Skincare routine:
   A consistent skincare routine can help maintain overall skin health and may prevent irritation that can make skin tags more noticeable or uncomfortable. Using gentle cleansers and moisturizers, especially those with anti-inflammatory ingredients, can keep the skin’s barrier intact and promote healing. While skincare doesn’t directly prevent skin tags, taking care of your skin can help reduce friction and irritation, which can contribute to their growth.
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3. Stress management:
   Chronic stress increases cortisol levels, which can worsen insulin resistance and disrupt hormonal balance—both of which are linked to skin tag development in PCOS. Research has shown that stress management techniques, such as yoga, meditation, and deep breathing, can lower cortisol levels and improve insulin sensitivity. By reducing stress, you can help manage the hormonal imbalances that drive skin tag formation.
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Personal Insight: In my experience working with clients managing PCOS, simple lifestyle changes like consistent exercise and dietary tweaks often lead to noticeable improvements in both skin health and hormonal stability. 

In conclusion, while skin tags linked to PCOS are harmless, they’re often an unwelcome cosmetic concern. Understanding their connection to insulin resistance and hormonal shifts sheds light on why they form and how best to manage them. Taking a holistic approach—through balanced nutrition, regular exercise, mindful skincare, and stress management—not only targets skin tags but also addresses the broader impacts of PCOS.

As research advances, so does our understanding of how PCOS affects the body, opening doors to more precise treatments and better lifestyle strategies. By adopting these science-backed approaches, individuals can support both their skin health and overall well-being. For personalized advice, consulting with a healthcare provider can be invaluable in crafting an effective plan tailored to unique needs.