What's the difference between skin tags and moles?

Though skin cancer can look like a mole, true moles are harmless skin irregularities.
Though skin cancer can look like a mole, true moles are harmless skin irregularities.

Skin tags and moles are both types of skin growths. A skin tag is a small, soft balloon-shaped benign skin growth connected to the skin by a thin stalk. Skin tags are extremely common and harmless. They tend to occur in areas where the skin folds, such as the eyelids, armpits, neck, groin, buttock folds, and under the breasts. The cause of skin tags is unknown but obese, middle-aged adults develop skin tags more often than other people. Removal of skin tags may involve freezing, strangulation by tying them off, snipping, and burning.

A mole is a skin growth that develops from clusters of pigment cells (melanocytes). Moles are typically found on areas of the skin exposed to the sun. A common mole is usually smaller than 1/4-inch-wide, is round or oval, has a smooth surface, a distinct edge, is often dome-shaped, and has an even color of pink, tan, or brown. Common moles are not cancerous, but in rare cases they can turn into melanoma, the most serious type of skin cancer. Because common moles rarely turn into melanoma, they do not usually need to be removed.

If you notice any changes in color, size, texture, or height of a mole, or if the skin on the mole becomes dry or scaly, or the mole feels lumpy, starts to itch, bleed, or ooze, see a doctor.

What causes skin tags and moles?

Skin Tags

The medical term for skin tag is acrochordon. Other synonyms that have sometimes been used to refer to skin tags include soft warts, soft fibromas, fibroepithelial polyps (FEP), fibroma pendulans, and pedunculated fibroma. Skin tags can occur in anyone but tend to increase in frequency as we age. They are also more common in obese persons, possibly due to increased irritation and rubbing of skin folds. Hormonal factors or aging processes may also play a role in the development of skin tags.

Moles

The genes we inherit from our parents, along with our amount of sun exposure (especially during childhood) are major factors in determining mole numbers. Skin with more sun exposure tends to have more moles. However, moles may also occur in sun-protected areas.

Moles and freckles (medically termed ephelides) are darker than the surrounding skin. Moles may be raised or completely flat while freckles are always flat. Freckles and "sun spots" (medically termed lentigines) are due to an increase in the amount of dark pigment called melanin. Moles are more common in people prone to freckles. Freckles are flat spots that are tan, slightly reddish, or light-brown and typically appear during the sunny months. They frequently appear on people with light complexions. Many people with blond or red hair and green or blue eyes are more prone to these types of skin spots. Sun avoidance and sun protection, including the regular use of sunscreen may help to suppress the appearance of some types of moles and freckles.

Moles occur in all races (Caucasian, Asian, African, and Indian) and skin colors. Even animals have moles.

Moles may be present at birth or gradually appear later in the newborn period. Many children continue to develop moles through the teenage years and into young adulthood. Moles tend to grow very slightly in proportion to normal body growth. Congenital moles are those present at birth and so must have been present during fetal development. Other moles may arise later due to factors that are not genetic but environmental, such as sun exposure.

While many moles arise in the first years of life, the total number of moles typically peaks in the second or third decade of life to an average of 35. Most people do not develop new regular moles after the age of 30. Adults often develop non-mole growths like freckles, lentigines, "liver spots," and seborrheic keratoses in later adulthood.

New moles appearing after age 35 may require close observation, medical evaluation, and possible biopsy. A brand-new mole in an adult may be a sign of an evolving abnormal mole or early melanoma. It is important to have any new or changing mole evaluated by a dermatologist.

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What are the symptoms of skin tags vs. moles?

Skin Tags

Most skin tags are asymptomatic, meaning that they cause no symptoms. They are almost universally benign; reports of malignancies arising in skin tags are extremely rare. Skin tags can become irritated and inflamed, especially when located in skin folds or in areas where clothing rubs against them.

Skin tags are most commonly found in or near the armpits (axillae) and on the neck, but they occur commonly in all skin folds (such as the groin) and on the back and abdomen.

Moles

The medical term for mole is melanocytic nevus. Moles may be tan, brown, black, reddish brown, red, purple, or skin-colored and perfectly flat or raised. Most moles are smaller than a pencil eraser (about 1/2 inch).

Certain moles become darker and more apparent with sun exposure and pregnancy. Moles can occur anywhere on the skin, including the scalp, ears, eyelids, lips, palms, soles, genitals, and anal area.

A melanocytic nevus (plural nevi) is composed of masses of melanocytes, the pigment-producing cells of the skin. However, there are a variety of other skin lesions that are also mole-like. These include

  • seborrheic keratoses,
  • skin tags,
  • dermatofibromas,
  • lentigines, and
  • freckles.

In this article, the term moles will be synonymous with melanocytic nevus.

What is the treatment for skin tags vs. moles?

Skin Tags

Most doctors recommend removal of skin tags only when they are irritated or a source of discomfort, or if they constitute a cosmetic problem. Skin tags can be easily removed in the doctor's office by tying or cutting them after injecting a small amount of a local anesthetic. Freezing, a technique sometimes used to remove warts or other benign lesions of the skin, is also sometimes performed for the removal of skin tags.

If you are unsure about any changes in your skin or growths arising on the skin, always check with your doctor. He or she can identify skin tags and other skin conditions and can help you decide whether skin abnormalities should be removed.

Moles

Surgical removal treats true moles. Fairly minor in-office procedures (involving the surgical excision of the entire lesion) can easily remove them.

Regular moles do not necessarily need to be treated. A health care professional should surgically remove changing or medically suspicious moles in their entirety and sent to a lab for special tissue examination called pathology.

Although some countries and medical centers use lasers to remove some types of moles, laser treatments are not recommended for moles. Irregular moles need to be surgically removed and the tissue sent for testing. While sun spots or lentigines may respond to bleaching or fading creams, freezing with liquid nitrogen, laser, intense pulsed light, and chemical peels, true melanocytic nevi should not be treated by these methods.

Plastic surgeons may have specialized training in cosmetic skin-growth removal. Regardless of what type of doctor removes a mole, it is important to keep in mind that all mole removals will leave some type of scar.

Most people report no or minimal discomfort after mole-removal surgery and require no pain medication. Non-aspirin over-the-counter pain relievers are recommended if necessary for pain.

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Medically Reviewed on 1/13/2020
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