Skin Tags – StatPearls – NCBI Bookshelf

Continuing Education Activity

Skin tags, also known as ‘acrochordons,’ are commonly seen cutaneous growths noticeable as soft excrescences of heaped up skin and are usually benign by nature. Estimates are that almost 50 to 60% of adults will develop at least one skin tag in their lifetime, with the probability of their occurrence increasing after the fourth decade of life. However, at the very outset, it should be noted that acrochordons occur more commonly in individuals suffering from obesity, diabetes, metabolic syndrome (MeTS), and in people with a family history of skin tags. Skin tags affect men and women equally. This article aims at providing a detailed understanding of the term ‘skin tag’, their classification and pathophysiology, and highlights the role of the interprofessional team in its management.

Objectives:

• Describe ‘skin tags’ and identify their etiopathological classes.

• Review the workup of a patient with skin tags.

• Identify conditions that closely simulate skin tags and the approach to such lesions.

• Outline the role of the interprofessional team in addressing and managing skin tags.

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Introduction

Skin tags, also known as ‘acrochordons,’ are commonly seen cutaneous growths noticeable as soft excrescences of heaped up skin and are usually benign by nature. Estimates are that almost 50 to 60% of adults will develop at least one of these harmless growths in their lifetime, with the probability of their occurrence increasing after the fourth decade of life. However, at the very outset, it should be noted that acrochordons occur more commonly in individuals suffering from obesity, diabetes, metabolic syndrome (MeTS), and in people with a family history of skin tags. Skin tags affect men and women equally.

Acrochordons may appear as early as the teenage years but are most common in the latter part of life. However, many studies have reported that the incidence of skin tags in children and adolescents is increasing. The latter seems to be in concert with the global rise in the incidence of childhood and teenage obesity. Skin tags, on the other hand, are rare after the seventh decade of life. These lesions tend to grow in areas where there are skin folds, such as the axilla, neck, eyelids, and groin. The lesions are skin-colored, brown, and even red ovoid growths that are often pedunculated and attached to a fleshy stalk. Skin tags are small, between 1 and 5 mm, but rarely can grow to be 1 to 2 centimeters in size. Acrochordons are not painful or tender but can be troublesome all the same. People frequently complain of skin tags getting caught on clothing or jewelry like necklaces. Sometimes the constant friction between the garments and the skin tag may result in bleeding or itching.

Certain genetic disorders may have a predisposition to skin tags. In patients with the Birt-Hogg-Dube (BHD) syndrome and tuberous sclerosis. [1][2] in addition to other cutaneous and systemic features, acrochordons may be seen in large numbers, often forming a ‘necklace’ like configuration around the neck- referred to as the ‘molluscum pendulum necklace sign.’

Etiology

Skin tags have found to be associated with[3][4]:

1. Abnormal lipid profile

2. Type 2 diabetes

3. Cardiovascular disease 

4. Obesity 

5. Genetic factors 

Frequent irritation of the skin has been implicated as a cause, chiefly in individuals who are obese. Experts believe that acrochordons are simply due to the normal aging process of the skin and the subsequent loss of elasticity. Hormonal imbalances may potentiate the development of skin tags (e.g., elevated levels of the female sex hormones, progesterone, and estrogen, elevated levels of human growth hormone in acromegaly). Both alpha tissue growth factor and epidermal growth factor (EGF) may also be risk or trigger factors for skin tags. While infective etiologies have not been reported to be a cause of acrochordons, there are anecdotal reports of some viruses that may be the cause. The human papillomavirus (HPV): in many studies conducted on various patients, researchers have observed a correlation between the infection and skin tags. Finally, there has also been an observed association with type 2 diabetes mellitus and skin tags in many studies.

Epidemiology

Frequency

Acrochordons have a reported incidence of 50 to 60% in the general population overall.[4]

Sex

Prevalence in males and females has been reported to be equal.

Age

Once a skin tag has developed, it may increase in size or number with advancing age. By the fifth to sixth decade, close to two-thirds of individuals may develop acrochordons, which usually remain until the end of life.

Pathophysiology

The histopathology of the skin tag will reveal an attenuated epidermis, a flattened basal cell layer, and often increased pigmentation. The extra mass is composed of loose fibrous tissue. The mass is connected to the skin by a narrow and thin pedicle. However, there are significant variations in this attachment. Melanocytic proliferation and nevus cells are not present in the majority of cases, and most such lesions probably fall into the seborrheic keratosis spectrum. However, there is an overlap with certain other conditions like melanocytic nevi and neurofibromas. It appears that some skin tags may be the last remnants of a pre-existing melanocytic nevus.

Histopathology

Histology of the pedunculated skin lesion will reveal the presence of mild hyperkeratotic epidermis, containing blood vessels of various sizes in the dermal stroma. Acrochordons are usually also identified by their flattened, acanthotic, presentation, or will have a ‘flowery’ pattern like epithelium. The dermal layer usually has loosely arranged collagen fibers along with lymphatic vessels and dilated capillaries. Appendages are generally not seen in the classic lesion. [5]

History and Physical

Presentation: The lesions are usually pedunculated on a thin stalk. The length of stalk varies, and the lesions are about 0.5 to 2.5 mm in diameter. Skin tags often appear round and soft and are easy to diagnose simply by a visual examination. Smaller lesions may be visible with the use of a magnifying glass. The skin tag may be the same color as the skin or be hyperpigmented; in general, the latter is more common. Skin tags are most on the side of the neck, axillary region, and groin.[6]

Acrochordons have the following general descriptions:

• Small skin tags:- furrowed papules of approximately 1 to 2 mm in width and height, most frequently appearing on the neck and the axillae

• Mid-sized skin tags:- solo or multiple filiform skin tags that are roughly 5 mm long and 2 mm wide, occurring at other sites on the body

• Large-sized skin tags: – pedunculated lesions that may demonstrate a baglike, nevoid, baglike appearance, or soft fibromas usually located on the lower part of the body (groin)

Giant skin tags attract considerable attention, as they are known to produce significant discomfort for patients when located in the axillae and genital regions.

Evaluation

The patient should undergo evaluation for diabetes mellitus by ordering levels of A1c, fasting blood glucose, and postprandial blood glucose. Additionally, the patient’s lipid profile should requires monitoring. The clinician should record the patient’s BMI should and serially follow it.

Treatment / Management

There are several treatments of skin tags, and all require removal of the lesion. Today, the use of radiocautery in the office is the most commonly performed procedure. Other methods of removal include the following:

• Snip excision

• Cautery 

• Cryosurgery 

Smaller skin tags are also removed using the nanosecond Q-switched Nd: Yag or the CO2 laser. Some patients may require an injection/topical application of a local anesthetic to minimize the pain. After excising the skin tag, the tiny wound usually heals on its own.

In most cases, the treatment almost always consists of excision and removal using radio cautery, snip excision, or cryosurgery. However, most specialists prefer radio cautery due to its ease of use and precision.

Risks associated with skin tag removal

Skin tag removal is primarily a low-risk clinic procedure. However, the lesion often freely bleeds when removed, requiring pressure and monitoring during the procedure. On occasion, coagulation with silver nitrate or electrocautery is necessary.

In rare cases, the patient may experience heavy bleeding or the development of an aberrant infection after the surgery. The clinician can mitigate the risk for complications by taking a proper history of any prescription or over-the-counter medications the patient might be taking since some drugs, and herbal supplements can alter the bleeding and clotting times.

It is also crucial that the patient follows proper instructions on how to care for the area of skin tag removal; this will reduce the risk of infection after the procedure. The patient must never try to remove the skin tags at home. Without proper technique and a sterile environment, the risk for excessive bleeding and infection increases.

Differential Diagnosis

• Dermatologic manifestations of neurofibromatosis type 1, in some instances, resemble skin tags.

• Genital warts sometimes also resemble skin tags.

• Melanocytic nevi resemble hyperpigmented skin tags.

• Nongenital warts resemble skin-colored skin tags.

• Premalignant fibroepithelial tumor (Pinkus tumor) is rare but could be a consideration.

• Seborrheic keratosis is again a rare but possible differential diagnosis.

Surgical Oncology

Skin tags are usually benign, and after excision, the histopathology reports confirm the same in most cases.

Prognosis

The skin tag, if left unchecked, may increase in size due to the constant friction with clothing and skin fold. However, the histological features remain the same, and these lesions have a very low or no risk of malignancy.

Complications

A skin tag may twist on its pedicle and become inflamed; in many cases, obese individuals exhibit an increased risk of inflammation.[7]

Complications of Removal

• Scarring can occur with improper removal of the skin tag.

• Sometimes normal skin tissue can be removed, which can lead to changes in cosmesis. Thus, the need to seek assistance from an experienced clinician.

• Mild irritation and even irritant dermatitis may occur in the area where the skin tag removal took place.

• Rarely, a neuroma may result if a nerve growth in the skin tag gets cut, resulting in chronic pain for some weeks or even months.

Postoperative and Rehabilitation Care

Proper moisturizing agents help in the skin regrowth and also reduce the risk of irritant dermatitis.

Deterrence and Patient Education

Patients should understand that skin tags are benign lesions, but they may carry correlations with type 2 diabetes or obesity, hence the need to maintain healthy body weight and blood glucose levels. Patients with type 2 diabetes require monitoring by an endocrinologist to ensure control of blood glucose levels.[8]

For those with skin tags around the neck, they should be told to avoid wearing jewelry on the neck to prevent skin irritation and friction injuries.

Furthermore, the patient should be told to avoid wearing restrictive and synthetic clothing, which can also cause friction in the presence of a skin tag.

Pearls and Other Issues

Patients should be encouraged to lose weight, eat a healthy diet, and perform regular exercise; this not only helps lower the risk of obesity and diabetes, but it may also help with the prevention of skin tag formation. In some studies, the use of syndet bars for bathing and proper moisturizing have been shown to prevent skin tags and also reduced the local complications.[9]

Enhancing Healthcare Team Outcomes

Skin tags or acrochordons should not be considered as an isolated entity as they are more likely to be seen in diabetic patients and individuals with metabolic syndrome. Also, in young females in the second and third decades of life, skin tags may be seen in the presence of polycystic ovarian syndrome; thus, it is important to investigate these patients for these comorbidities. Simply excising the skin tag may improve the cosmesis, but one may miss a metabolic disorder ifs one omits further investigations. Various studies have indicated the correlation of skin tags and metabolic diseases like DM type 2; hence, a complete workup and follow up treatment should be the norm.[10]

Primary care clinicians should be fully aware that even though skin tags have no malignant potential, if they have any doubt about the lesion, they should order a referral to a dermatologist.

Removal of skin tags is a simple and non-eventful procedure when performed by trained individuals. However, the patient has to be encouraged to change his or her lifestyle. Otherwise, the lesions may recur in the future. A dermatology specialty-trained nurse can prove to be an invaluable asset in preparing the patient, assisting during the procedure, attending to the patient post-operatively, and providing patient counsel. The clinician or specialist and the nurse need to function as an interprofessional healthcare team to optimize patient outcomes in these cases. [Level V]

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Figure

Images of skin tags and their removal using the radio cautery in the area surrounding the neck region.
Also seen in the images Acanthosis Nigricans of the neck indicating the association of skin tags with diabetes and pre-diabetes. Contributed by Dr. (more…)

Figure

Skin tags on the neck. Image courtesy O.Chaigasame

Figure

Acanthosis nigricans with skin tags SV1. Contributed by Dr. Shyam Verma, MBBS, DVD, FRCP, FAAD, Vadodara, India

Figure

Skin Tags. Contributed by Dr. Shyam Verma, MBBS, DVD, FRCP, FAAD, Vadodara, India

References

1.

Zabawski E, Styles A, Goetz D, Cockerell C. Asymptomatic facial papules and acrochordons of the thighs. Birt-Hogg-Dube syndrome. Dermatol Online J. 1997 Dec;3(2):6. [PubMed: 9452372]

2.

Sachs C, Lipsker D. The molluscum pendulum necklace sign in tuberous sclerosis complex: a case series A pathognomonic finding? J Eur Acad Dermatol Venereol. 2017 Nov;31(11):e507-e508. [PubMed: 28543842]

3.

Farag AGA, Abdu Allah AMK, El-Rebey HS, Mohamed Ibraheem KI, Mohamed ASED, Labeeb AZ, Elgazzar AE, Haggag MM. Role of insulin-like growth factor-1 in skin tags: a clinical, genetic and immunohistochemical study in a sample of Egyptian patients. Clin Cosmet Investig Dermatol. 2019;12:255-266. [PMC free article: PMC6503204] [PubMed: 31118729]

4.

Kochet K, Lytus I, Svistunov I, Sulaieva O. [SKIN PATHOLOGY IN DIABETES MELLITUS: CLINICAL AND PATHOPHYSIOLOGICAL CORRELATIONS (REVIEW)]. Georgian Med News. 2017 Dec;(273):41-46. [PubMed: 29328028]

5.

Alkhalili E, Prapasiri S, Russell J. Giant acrochordon of the axilla. BMJ Case Rep. 2015 Jul 03;2015 [PMC free article: PMC4493254] [PubMed: 26142392]

6.

Bahce ZS, Akbulut S, Sogutcu N, Oztas T. Giant Acrochordon Arising from the Thigh. J Coll Physicians Surg Pak. 2015 Nov;25(11):839-40. [PubMed: 26577974]

7.

Ljubojevic S, Skerlev M. HPV-associated diseases. Clin Dermatol. 2014 Mar-Apr;32(2):227-34. [PubMed: 24559558]

8.

Bustan RS, Wasim D, Yderstræde KB, Bygum A. Specific skin signs as a cutaneous marker of diabetes mellitus and the prediabetic state – a systematic review. Dan Med J. 2017 Jan;64(1) [PubMed: 28007053]

9.

Belgam Syed SY, Lipoff JB, Chatterjee K. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 8, 2022. Acrochordon. [PubMed: 28846244]

10.

El Safoury OS, Ibrahim M. A clinical evaluation of skin tags in relation to obesity, type 2 diabetis mellitus, age, and sex. Indian J Dermatol. 2011 Jul;56(4):393-7. [PMC free article: PMC3179001] [PubMed: 21965846]

Disclosure: Amarendra Pandey declares no relevant financial relationships with ineligible companies.

Disclosure: Sidharth Sonthalia declares no relevant financial relationships with ineligible companies.

Cancerous skin tags: Pictures, removal, and more

Skin tags are not cancerous (benign) and cannot become cancerous. Although most skin tags do not need to be removed, a doctor can do so, if necessary.

In this article, learn about whether or not skin tags are cancerous.

This article also covers causes of skin tags, how to recognize them, when to contact a doctor, diagnosis, and removal (if necessary).

Skin tags are not cancerous and do not have the potential to become cancerous. Nearly half of all adults in the United States have one or more skin tags.

Skin tags contain loosely arranged collagen fibers and blood vessels encased in a thicker or thinner surface layer of the skin, or the epidermis.

Collagen is a large family of proteins present in most bodily tissues. It is very important for skin structure and a major component of the middle, thickest skin layer, or the dermis.

Skin tags are also known as:

• acrochordons
• papillomas (a general term for benign skin tumors)
• fibroepithelial polyps (skin growths made of fibrous tissue and the upper skin layers)

Although skin tags themselves are not cancerous, they can look similar to tumors associated with types of skin cancer — particularly basal cell carcinoma (BCC) or malignant melanoma. Also, tumors can sometimes resemble irritated or infarcted skin tags.

Doctors do not know why skin tags develop. However, there are several theories as to why they occur.

These theories suggest that skin tags may occur due to:

• irritation or friction associated with skin-on-skin rubbing
• obesity, which means having more skin folds
• type 2 diabetes or insulin resistance
• human papillomavirus infections
• genetics
• the skin condition Birt-Hogg-Dube syndrome
• high levels of tissue and epidermal growth factors, especially during pregnancy or gigantism (acromegaly)
• hormone imbalances
• metabolic syndrome
• cardiovascular disease
• aging and the gradual loss of skin elasticity
• polycystic ovary syndrome

Skin tags are usually painless, but they may be itchy or become painful when they catch or rub against jewelry or clothing. They may also alter the skin’s appearance. In some people, they may also cause emotional distress.

Skin tags tend to grow in places where the skin folds, such as the:

• groin
• underarms
• neck
• eyelids

Skin tags often appear to hang off of the skin. They can vary in appearance but they are typically:

• skin colored or brown (or pink or red, especially after irritation)
• oval shaped
• soft
• attached to a fleshy stalk
• 2–5 millimeters to several centimeters across
• thread-like in appearance
• in clusters or strings, especially around the neck

Importantly, skin tags can sometimes look like growths associated with other skin conditions, such as:

• seborrheic keratosis
• molluscum contagiosum
• benign melanocytic nevi
• neurofibromas
• BCC
• warts

The chance of developing skin tags tends to increase with age. Skin tags can develop starting in someone’s teenage years or 20s. However, most people will stop developing new skin tags after the age of 70 years.

Most skin tags are harmless. However, those that develop on long, narrow stalks can twist, thereby reducing blood flow to the growth. If this occurs, the skin tag can become black or dark brown.

A person can talk with a doctor if their skin tag changes in feel, color, appearance, or size. They should also talk with a doctor about painful skin tags and those that cause physical discomfort or emotional distress.

A doctor can rule out other causes of skin growths that may be harmful, including skin cancer. They can also reassure people with skin tags that the growths are common and no cause for concern.

Doctors can often diagnose skin tags simply by examining them.

They may only perform a biopsy, or collect a tiny sample of the growth to examine using a microscope, if the cause is unclear. A doctor will normally send removed skin tags for pathological evaluation to determine the precise cause.

There are no specific laboratory, radiographic, or other diagnostic tests to diagnose skin tags. For this reason, the doctor may run other tests to rule out other potential causes.

They may also run tests to check for conditions known to potentially cause or worsen skin tags, such as diabetes or metabolic syndrome.

This may mean evaluating someone’s:

• A1c levels
• fasting and postprandial (after eating) blood glucose levels
• lipid profile
• body mass index (MBI)

Skin tags typically do not need to be removed. However, if they are irritating, uncomfortable, painful, large, or in an awkward location, a doctor or surgeon can remove them using one of several methods.

These include:

• surgical excision, which refers to cutting it out using scissors or other cutting tools
• electrocautery, which refers to delivering heat via an electric current
• CO2 laser therapy, which refers to using light-based energy
• cryosurgery, which refers to freezing it off using liquid nitrogen
• ligation, which refers to using a suture wrapped around the neck of the tag to stop blood flow
• shave excision, which refers to shaving or snipping it off after injecting the base with local anesthetics
• radiocautery, which refers to burning it off using radio waves

Most skin tags will heal on their own with proper care, such as moisturizing and basic hygiene. Typically, with professional removal, it only takes one session to remove a skin tag. However, a doctor may also schedule follow-up visits to ensure that the skin heals properly and that no further treatments are necessary.

Doctors may advise people with skin tags to maintain a moderate weight and practice healthful habits, such as getting enough exercise, staying hydrated, and getting enough rest.

Adopting these habits may help reduce the chance of developing new skin tags. Also, wearing loose clothing and not wearing jewelry in places that may come into contact with skin tags can help reduce irritation.

Skin tags are usually harmless. Most only require removal if they are causing pain, irritation, or emotional distress or are changing in size, shape, or color.

People should never attempt to remove or damage skin tags at home. Only doctors, and ideally dermatologists, should remove skin tags. This is to reduce the risk of excessive bleeding, scarring, and infection.

Removing a skin growth at home also increases the likelihood that a potentially cancerous or harmful growth will go undetected and spread or worsen.

Skin pigmentation: what is it, causes of disorders and methods of treatment

1. What is it
2. Causes
3. How to prevent
4. How to reduce stains
5. How to fight
6. Medicinal products
7. Home treatment

Darker patches of skin are generally healthy. However, you may not like it aesthetically. In this case, a number of safe measures can be taken.

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The author of the article is Margarita Gecht, Leading Dermatologist at the Butterfly Children Charitable Foundation, lecturer at the online academy for skin problems Skill for Skin

What is skin pigmentation

skin is darker than others. Hyperpigmentation can appear in small areas, cover large areas or, in rare cases, even the entire body. This is a fairly common skin problem that affects people with all skin types.

The mechanism of hyperpigmentation is as follows. The color of the skin, hair and eyes is determined by the pigment melanin, which is produced by special cells – melanocytes. Melanin is usually evenly distributed over the skin, but some people may have areas of the skin in which the concentration of melanin is higher or lower than normal. As a result, brown or gray spots appear on the skin.

At the same time, people with phototypes 3–6 on the Fitzpatrick phototype scale [1] tend to be more prone to hyperpigmentation than people with phototypes 1 and 2.

Causes of pigmentation disorders

A number of factors can cause an increase in melanin production, but the main ones include sun exposure, hormonal changes, age, injury or inflammation of the skin.

Sun exposure

Excessive exposure to sunlight is the main cause of hyperpigmentation.

Sunlight triggers additional production of melanin, which acts as a natural sunscreen, protecting the skin from harmful UV rays. But excessive sun exposure disrupts this process, leading to hyperpigmentation.

In addition, exposure to the sun makes existing areas of hyperpigmentation – age or sun spots, melasma and post-inflammatory hyperpigmentation spots – even more pronounced.

Diseases and medicines

Certain diseases and medicines have been found to cause hyperpigmentation. It is also a symptom of certain diseases, such as autoimmune and gastrointestinal diseases, metabolic disorders and vitamin deficiencies.

Hyperpigmentation can also be caused by a number of medications, including chemotherapy drugs, antimalarials, anticonvulsants, and antibiotics.

Hormonal changes

Hormonal changes are the main causes of a special type of hyperpigmentation known as melasma or chloasma. This phenomenon is especially common among women and is believed to occur when the female sex hormones estrogen and progesterone stimulate the overproduction of melanin and the skin is exposed to the sun. This skin condition is typical for pregnant women.

Melasma occurs in 10-15% of pregnant women and in 10-25% of women taking oral contraceptives. In men, this condition is less common.

Age

Age or liver spots are a common form of hyperpigmentation.

Brown spots occur in people over 40 years of age on the hands, face, or other areas exposed to frequent sun exposure. Doctors call such spots “solar” lentigo.

They occur due to the fact that with age the number of skin cells that produce melanin decreases, but the rest of the cells increase and the distribution of melanin becomes less uniform.

Skin lesions and inflammations

Post-inflammatory hyperpigmentation occurs after injury or inflammation of the skin resulting from cuts, burns, chemical exposure, acne, atopic dermatitis or psoriasis. The skin darkens, and after the cause is removed, the areas of pigmentation become discolored.

© Shutterstock

How to Prevent Hyperpigmentation

Daily Broad Spectrum Sunscreen

Sun protection is the most important and essential step to help prevent hyperpigmentation. The sun’s rays affect the skin even on cloudy days, so it is recommended to provide the skin with daily sun protection, regardless of the weather.

For the city, the spectrum of action of the cream should be 15-25 SPF, for holidays at sea and in the mountains – 30-50+ SPF.

Limiting skin exposure to the sun will also help reduce hyperpigmentation. The hottest hours are best spent in the shade and, if possible, wear protective clothing, a sun hat and goggles. Before sun exposure, apply and reapply sun protection with the appropriate SPF level for your skin type and condition.

How to reduce existing age spots

Preventing age spots is easier than removing them. But fresh spots can be made less noticeable and prevent their recurrence.

Pigmentation Specifics

If you’re concerned about hyperpigmentation, look to skincare products that have been formulated to address this problem and are clinically and dermatologically proven to work. In particular, the lines of pharmaceutical products marked “melascreen”, “depiderm”, “anti-pigment” deserve attention.

Dermatological treatments

Dermatological treatments such as chemical peels and laser treatments can help reduce hyperpigmentation.

Chemical peel is one of the effective ways to remove hyperpigmentation and stimulate the appearance of new and evenly pigmented skin. During the procedure, a chemical solution is applied to the face, neck and hands. In the process of such peeling, the skin is exfoliated and the growth of new skin cells is stimulated.

laser treatments provide a similar effect to a chemical peel, but the treatment can be more targeted as the dermatologist has more control over the intensity of the peel.

They are “irradiation” of the affected areas with high energy light. The softest laser treatments affect only the superficial layer of the skin, while the more intense ones work on the deepest skin layers.

© Shutterstock

Dealing with pigmentation issues

The root cause of hyperpigmentation must first be addressed. Treating this condition early will help prevent further darkening of the skin.

Some manifestations of hyperpigmentation, such as melasma during pregnancy, may disappear on their own.

Drugs for hyperpigmentation

A number of drugs are effective for hyperpigmentation. They can be used alone or in combination with each other, which enhances the effect. Some of these treatments require several months.

Hydroquinone

One of the most commonly used drugs for hyperpigmentation. Hydroquinone slows down the action of the enzyme needed to produce melanin. The drug is available in creams, lotions and gels, some of which can be bought without a prescription.

However, hydroquinone does not affect sunspots. Also, it can only be used for a limited time because, like chemical peels and laser treatments, it can irritate the skin and cause post-inflammatory hyperpigmentation, especially in people with phototypes 3-6.

Topical retinoids

These are creams, lotions and gels containing medicines derived from vitamin A. They can be used alone or in combination with other medicines to treat hyperpigmentation.

Azelaic acid

Azelaic acid gel and cream products slow down the production of tyrosinase, an enzyme needed to make melanin, and also inhibit the growth of abnormal melanocytes, the cells that produce melanin.

Kojic acid

This acid is produced by some fungi during fermentation. It slows down the formation of melanin and can be used in conjunction with hydroquinone and glycolic acid.

Ascorbic acid

Or the well-known vitamin C. In addition to its skin lightening function, it also has an anti-inflammatory effect and helps to reduce molecular damage caused by sunlight.

Regardless of the choice of therapy, always use sunscreen before going outside.

© Shutterstock

Treating Pigmentation at Home

The first step in reducing the risk of hyperpigmentation is to use sunscreen every day.

People with hyperpigmentation of the skin should also avoid the sun and wear protective clothing, hats and sunglasses. Remember that one day in the sun can negate months of hyperpigmentation treatment.

Secondly, it is important to maintain a balance of free radicals and antioxidants in the body. Free radicals damage healthy skin cells and cells in other body systems. Antioxidants neutralize free radicals and prevent damage to skin cells, helping the skin recover.

Antioxidants can be taken orally or used in cosmetic preparations to prevent pigmentation. To do this, you can:

Eat antioxidants with food

Vitamin C and glutathione supplements help neutralize free radicals and prevent oxidative stress. Strengthening the skin is also facilitated by a balanced diet with a sufficient amount of foods rich in “antioxidants” (greens, green vegetables, fruits, green tea).

Use cosmetics with antioxidants

Choose skin care products with antioxidant ingredients such as vitamin C, berry extracts, arbutin, glycolic, kojic, azelaic and ferulic acids, arbutin, retinol and niacinamide. Niacinamide, also known as vitamin B3, is a powerful ingredient that reduces the risk of hyperpigmentation and evens out skin tone. Its effectiveness has been clinically proven.

Topical formulations containing these ingredients inhibit melanin production while increasing cell turnover by removing the top layer of dead skin and thus reducing existing pigmentation. When selecting external preparations with these ingredients, it is necessary to pay attention to the concentration of active substances, which will allow you to get the maximum effect. These funds should be selected by the doctor individually.

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how to recognize and treat

Acne is the most common skin problem with about 9 people in their lives0% of the world’s population. Acne is different: those that appear in adolescence against the background of a hormonal surge, and those that can occur even in adulthood. Today we will talk about the most severe and aggressive form of acne – cystic acne. Why they appear, what consequences they leave behind, and how to treat them – you will find the answers to all these questions in our material!

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acne

acne treatment

how to remove a pimple

Cystic pimples or boils are considered a rare and serious form of acne that occurs when pores or hair follicles on the skin become clogged with sebum or other impurities. This type of acne has no age: it can break out both in a teenager and in older people with hormonal imbalances. Why cystic acne appears and how to distinguish it from another type of acne – let’s figure it out!

Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

Why cystic acne occurs

This type of acne is considered the most severe, because cysts in this case form deep under the skin. Inflammation in this case is provoked by contamination of the pores, which are clogged with bacteria, sebum and dead skin cells. At the same time, an unbalanced diet or poor skin hygiene are not the cause of cystic acne.

Cystic acne can appear in anyone, but still most of all they “love” those with oily skin. They are also common in adolescents, women in adulthood and older people with hormonal failure.

Acne all over the face: how a girl has been struggling with acne for 8 years

Cystic acne can go away on its own with age, but most often these painful and large rashes need specially selected treatment. If you have cystic acne, then a dermatologist should become your faithful and reliable friend for a long time. Only he will be able to choose the right treatment to solve this serious problem.

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How to distinguish cystic acne

Cystic acne is a boil on the skin of a rather large size. As a rule, they are also distinguished by a white purulent head. These signs will help you distinguish cystic eruptions from other types of acne:

• large, pus-filled pimple head;
• severe reddening of the skin;
• sensitive or painful rash.

Cystic pimples most commonly appear on the face, but can also affect other areas of the body, such as the chest, neck, back, and arms. In rare cases, cystic acne occurs even on the shoulders or behind the ears.

How to Treat Cystic Acne

Due to the complexity of this type of acne, most OTC products are not effective enough to treat. This means only one thing: when cystic acne appears, you should immediately contact a dermatologist who will select the right therapy and write a prescription for the necessary drugs.

However, one should not expect an instant effect from these drugs: most often, the result can be seen only after 8 weeks after the start of medication. In some cases, the doctor may choose a combined treatment with drugs of different types of action.

The following are commonly used to treat cystic acne:

• medications with the active ingredient isotretinoin – taking them is accompanied by a lot of dangerous side effects, so only a doctor should choose the recommended dose;
• antibiotics – they fight the causative agent of a bacterial infection and relieve inflammation, but can only be used in the short term;
• topical retinoids are derivatives of vitamin A that are available in the form of creams, gels and lotions. They are usually prescribed in tandem with antibiotics – the decision, again, is solely up to the doctor. However, it should be borne in mind that retinoids can cause dryness and redness of the skin – usually the side effect disappears after the skin gets used to it;
• doctor-prescribed diuretics – they can regulate the level of androgens that cause inflammation in the skin. These drugs are strictly prohibited for women planning a pregnancy, as well as for people with kidney disease;
• oral contraceptives – These hormonal drugs can help treat cystic acne in women whose skin eruptions are related to hormonal changes during the menstrual cycle. Only a doctor can prescribe them.

Treatment of cystic acne scars

Cystic acne leaves behind the largest number of scars in comparison with all other types of acne. To reduce the risk of the formation of terrible “bumps” on the skin, you should forever forget about the habit of squeezing or picking rashes. Physical exposure can also spread the infection even further, making it even more difficult to get rid of acne.

Why acne appears in winter and how to have clear and radiant skin even in cold weather

If you still have cystic acne scars on your skin, there are several ways to make them less noticeable. However, these measures should be applied only after the rashes themselves have been dealt with.

So, to get rid of scars on the skin helps:

• chemical peeling;
• dermabrasion;
• laser resurfacing.

How to prevent cystic acne

Taking care of your skin is the best way to reduce your risk of cystic acne.