Cysts, Moles and Skin Tags
There are a variety of skin issues that can cause embarrassment or discomfort due to the location or size including:
Read on for a bit of information about each of these skin conditions and some of the treatments that Dr. Adam Schaffner, a highly trained plastic surgeon here, at Patients Medical, may recommend for your medical condition.
Cysts
Cysts are harmless, sac-like growths in the deeper layers of the skin. They form from the lining of a hair follicle that gets blocked. It is not known why cysts appear or why some individuals have more than others.
 Pilar cyst |
 Pilar cysts |
 Multiple epidermal cysts |
 Large epidermal cyst |
 Large epidermal cyst |
 Milia |
Treatment
If you have a cyst, ask a dermatologist's advice.
Small cysts (eg. less than 5 mm) don't usually need treatment, but can be readily removed by a minor surgical procedure.
Larger ones are usually removed because they are unsightly or because they have been inflamed.
Cysts are treated by making a small surgical opening into the skin and removing the sac (excision biopsy). This is done under local anesthetic and may require stitches, removed a few days later.
Very occasionally the cyst recurs and needs further treatment.
Moles
Moles are common, usually harmless skin lesions. They are correctly called melanocytic nevi because they are caused by a proliferation of the pigment cells called melanocytes. Moles may be flat or protruding. They vary in color from pink flesh tones to dark brown or black. The number of moles a person has depends on genetic factors and on sun exposure.
 Multiple naevi |
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 Junctional naevus |
 Cellular naevus |
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Change in a mole
Malignant melanoma is a cancerous growth occurring in melanocytes (pigment cells). A melanoma may look like a harmless mole.
If a mole changes size, shape or color, or a new one develops in adult life, it should be evaluated by a doctor or preferably by a dermatologist. The dermatologist may examine the mole by dermoscopy. It is not always possible to tell whether the lesion is a melanoma, so sometimes it is necessary to cut the mole out for pathological examination.
Removal of moles
Although most moles are harmless and can be safely left alone, moles may be treated under the following conditions:
- Possible malignancy: a mole that has bled, has an unusual shape, is growing rapidly or changing colour.
- Nuisance moles: a mole that is irritated by clothing, comb or razor.
- Cosmetic reasons: the mole is unsightly.
Shave biopsy
Treating a protruding mole is simple using a procedure called a shave biopsy. After numbing the skin with local anesthetic the doctor removes the projecting part of the mole with a scalpel or by electrosurgery (e.g. Surgitron method). The wound heals to leave a flat white mark, but sometimes the color remains the same as the original mole.
Excision biopsy
Excision biopsy is necessary if the mole is a flat one or melanoma is suspected. The full thickness of the skin is removed and the wound is sutured (stitched). The specimen should always be sent to the laboratory for pathological examination (histology). The resulting scar may be just a thin line, but is sometimes more noticeable than the mole was.
The coarse hair that sometimes grows in a mole can be removed by shaving. Plucking may cause inflammation resulting in a painful lump under the mole. The hair can only be removed permanently by electrolysis or excision of the whole mole.
Skin examinations
- Perform a self skin examination monthly: report significant changes in moles or new lesions to your doctor or dermatologist.
- Arrange to have a skin examination regularly if you have numerous moles, atypical moles, previous skin cancer or your doctor recommends this.
- Photographic records can be useful if there are numerous moles &/or atypical naevi. Sophisticated digital mole mapping systems including dermoscopic images are of particular value in the diagnosis of melanoma as subtle changes can be detected on repeat scanning.
Skin tags
Skin tags are very common soft harmless lesions that appear to hang off the skin. They are also described as:
- Acrochordons
- Papillomas
- Fibroepithelial polyps
- Soft fibromas
- Pedunculated (this means they are on a stalk)
- Filiform (this means they are thread-like)
Skin tags develop in both men and women as they grow older. They are skin colored or darker and range in size from 1mm to 5cm. They are most often found in the skin folds (neck, armpits, and groin). They tend to be more numerous in obese persons and in those with type 2 diabetes mellitus.
Skin tags are made up of loosely arranged collagen fibers and blood vessels surrounded by a thickened or thinned-out epidermis.
Seborrhoeic keratoses, viral warts or molluscum contagiosum may resemble skin tags.
What causes skin tags?
It is not know what causes skin tags. However, the following factors may play a role:
- Chaffing and irritation from skin rubbing together
- High levels of growth factors, particularly during pregnancy or in acrogmegaly (gigantism)
- Insulin resistance (syndrome X)
- Human papilloma virus (wart virus)
How can they be removed?
Skin tags can be removed for cosmetic reasons by the following methods:
- Cryotherapy (freezing)
- Surgical excision (often with scissors)
- Electrosurgery (diathermy)
- Ligation (a suture is tied around the neck of the skin tag)
Treatment, Biopsy and Removal
Patients Medical's highly trained plastic surgeon, Dr. Adam Schaffner, is experienced in working with patients who have concerns about their cysts, moles and skin tags. He routinely removes cysts and skin tags, and does shaving and biopsy of moles, as well as other treatment procedures customized for the medical condition.
The first step is to have a consultation with Dr. Schaffner. If you are interested in making an appointment, please call 212-794-8800 or enter your contact information on the form below so that we can contact you with scheduling information.
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