What Causes Skin Tags on Eyelids?

Skin tags are common growths found on the surface of the skin. Also known as acrochordons or soft fibromas, these benign tags appear as small soft bumps. Skin tags are most commonly found in areas of the body where the skin folds, such as:

• Underarms
• Neck
• Groin
• Eyelids

Skin tags are harmless and rarely cause pain. However, they can itch or become irritated when rubbed by clothing or jewelry. Constant friction can cause skin tags to bleed or fall off.

Acrochordons are a common problem affecting at least 50% of adults. They become more common with age but occur more frequently in people with a family history of skin tags. People with metabolic disorders like obesity and diabetes are also more likely to develop acrochordons.

Recognizing skin tags is important to prevent overlooking more serious skin growths that may require medical attention.

People can experience different types of bumps on their eyelids. To determine if your eyelid growth is a skin tag, look for the following characteristics:

• small, less than 5 mm in diameter.  
• flesh-colored, or may have slight pigmentation
• very soft and easily flattened
• painless or slight discomfort when irritated
• may have a discernible stalk which connects the tag to the surface of the skin

Doctors aren’t entirely sure what causes skin tags to form, but there are some theories about how they develop.

Lack of elastic tissue in the skin

As the skin ages, it loses its elasticity. Older skin has less collagen and fewer elastic fibers to maintain its texture. In localized areas where the skin folds regularly, like on the eyelids, this lack of elasticity could cause fibromas to develop.

Hormone imbalances

Skin tags often form during pregnancy on the face, neck, chest, and under the breasts. They typically go away on their own in the postpartum period. Skin tag formation could be due to high estrogen and progesterone levels affecting the integrity of the skin, possibly leading to fibromas on the eyelid.

Growth factors

Studies have found that people who develop skin tags have higher insulin growth factor (IGF-1) levels and more insulin growth factor receptors. These receptors are found in the skin and could be responsible for skin tag formation on the eyelids.

Epidermal growth factor (EGF) and its receptors regulate skin growth and are also found in greater amounts in people with skin tags. More research is needed to understand how an excess of these growth factors leads to the development of fibromas.

Human papillomavirus

Human papillomavirus (HPV) is more commonly associated with warts, but research has found it may also be responsible for skin tag growth. Several studies have detected HPV in biopsies of skin tags. Researchers have found the virus in up to 88% of skin tag specimens, suggesting that HPV infection could be a factor in skin tag development on eyelids.

Most people who experience skin tags on the eyelid want them removed for cosmetic reasons. Occasionally, eyelid skin tags can become irritated and could lead to an infection. If a fibroma is large enough to obscure vision, it should be removed.

Skin tags are usually benign, but if you have one changing in size and color or is becoming painful, you should make an appointment with your doctor.

Your doctor will be able to diagnose skin tags with a physical exam. Skin tags are very rarely malignant. However, if your doctor suspects your fibroma is precancerous or cancerous, they may have it biopsied.

Doctors have three options for removing skin tags of the eyelid:

Cryotherapy

Cryotherapy or cryosurgery is removing skin growths by freezing them. Your doctor will use liquid nitrogen to freeze the skin tag, after which it will fall off on its own. This procedure may need to be repeated to remove the tag completely.

Scissor Excision

Skin tags are typically attached to the eyelid by a thin stalk. A doctor can use a pair of sterilized scissors to cut through the stalk, removing the fibroma. This is best for small tags and is generally painless but may cause a small amount of bleeding.

Electrocautery

Electrocautery is burning the skin tag to remove it. The doctor transmits an electric current, which burns the fibroma, causing it to fall off. This method also cauterizes the tag, which prevents bleeding.