Hi there,
This is Francesca, the writer behind The PCOS Newsletter. Welcome to another issue of this weekly publication. Do you have a curiosity about PCOS? Ask here.
This week's question:
Are skin tags a sign of PCOS?
The answer :
Skin tags and PCOS have an interesting connection. It amazes me how our body uses every tool in its power to communicate to us what is happening within. It is our job to listen and pay attention.
Before we dive in, let's quickly define what skin tags are
They're small, soft growths on our skin that can vary in colour and size. They're usually found in places like the neck, armpits, around the groin, or under the breasts (basically, anywhere you don't want them to be). They can also grow on the eyelids or under the folds of the buttocks. They might not be harmful, but they can certainly be annoying, especially when they get caught on your bra wire (ouch!). If any look odd to you, please air on the side of caution and get them checked.
Now, onto the question at hand: Are skin tags linked to PCOS?
Yes, there seems to be an indirect association with PCOS through insulin resistance. Given 60-70% of PCOS cases are driven by insulin resistance it's common to see skin tags in women with PCOS, although it is still unknown whether insulin resistance is a cause or effect of PCOS. Some publications even consider skin tags as a "clinical signature" of PCOS.
It’s important to note that most of the studies focus on the association between insulin resistance, obesity and skin tags. Although it is a well-known fact that skin tags are associated with obesity and insulin resistance, there are limited data regarding normal-weighted people with PCOS. Skin tags can also be genetic or associated with other things, so it's not a definitive diagnosis.
A large study of 52,545 fifth-grade students identified skin tags in 4.5% of these students. Out of those with skin tags, 79% of them displayed signs of insulin resistance. This is a strong correlation and can help us identify signs of metabolic abnormalities at an early age and potentially teenage girls with a risk for PCOS. For those who are reading this and have children, it's worth paying attention to the appearance of these little growths of skin.
So, what's causing these pesky skin tags?
The culprit seems to be hormone variations such as IGF-1 (insulin-like growth factor-1), insulin, TGFα (transforming growth factor- α) and epidermal growth factor (EGF). An excess of these hormones stimulates the growth of skin tags.
Now, what can we do about them?
If you haven't already, I would recommend getting your insulin levels checked. Keep in mind that insulin resistance is not a diagnostic, but a mechanism by which certain diseases like type 2 diabetes can start and manifest themselves. The best way to find out is through an OGTT (oral glucose tolerance test), Hb1c (A1c) or a glucose monitor. The gold standard is OGTT, but it can be difficult to get this done through a GP in the UK. Standard blood glucose tests (HbA1c) are poor at identifying insulin resistance early on (I will go into more detail on this in another issue).
Skin tags can also be removed by freezing or burning them off at a dedicated clinic (please don't try this at home). This can provide temporary relief, but if the root cause of your skin tags is insulin resistance, addressing that will likely be the best long-term treatment.
In conclusion, don't be mad at your body for growing skin tags. It's just trying to communicate with you. If you have skin tags and PCOS, it's another sign to listen to your body and take care of it as it requires.
If what you read has sparked more questions, please don't hesitate to comment, reply to my email, or submit another question here. This whole project is based on the importance of curiosity and getting to know our bodies.
See you next Sunday!
Francesca
1 Sources
Keen, M. A., Shah, I. H., & Sheikh, G. (2017). Cutaneous manifestations of polycystic ovary syndrome: A cross-sectional clinical study. Indian Dermatology Online Journal, 8(2), 104–110. https://doi.org/10.4103/2229-5178.202275
Ragunatha, S., Anitha, B., Inamadar, A. C., Palit, A., & Devarmani, S. S. (2011). Cutaneous disorders in 500 diabetic patients attending diabetic clinic. Indian Journal of Dermatology, 56(2), 160–164. https://doi.org/10.4103/0019-5154.80409
Shaheen, M. A., Abdel Fattah, N. S. A., Sayed, Y. A. A., & Saad, A. A. (2012). Assessment of serum leptin, insulin resistance and metabolic syndrome in patients with skin tags: Leptin, insulin resistance and skin tags. Journal of the European Academy of Dermatology and Venereology: JEADV, 26(12), 1552–1557. https://doi.org/10.1111/j.1468-3083.2011.04401.x
Sherin, N., Khader, A., Binitha, M. P., & George, B. (2022). Acrochordon as a marker of metabolic syndrome – A cross-sectional study from South India. Journal of Skin and Sexually Transmitted Diseases, 0(1), 1–7. https://doi.org/10.25259/jsstd_63_2021
Skin tags. (n.d.). Nhs.uk. Retrieved January 15, 2023, from https://www.nhs.uk/conditions/skin-tags/
Tamega, A. de A., Aranha, A. M. P., Guiotoku, M. M., Miot, L. D. B., & Miot, H. A. (2010). Associação entre acrocórdons e resistência à insulina. Anais Brasileiros de Dermatologia, 85(1), 25–31. https://doi.org/10.1590/s0365-05962010000100003
Disclaimer: We are all so unique in our own ways so this information is for education purposes only. Please further consult your healthcare provider about your health needs.