Skin tag, mole or wart: how can you tell them apart?
A skin tag is soft, skin-coloured or slightly darker, and hangs from a narrow stalk at a friction site such as the neck, underarms or eyelids. Moles and warts can look similar at a glance, which is why each lesion is examined before anything is removed.
A raised mole, or dermal naevus, is usually a firm dome rather than a floppy stalk, and may be brown or skin-coloured; it can sit anywhere on the face or body, not only in folds. Seborrhoeic keratoses, often called age warts, look stuck on, with a waxy or crumbly surface, and become more common from middle age. Viral warts have a rough, thickened surface, sometimes with tiny dark dots, and unlike tags they are caused by a virus and can spread.
Telling these apart matters because each is managed differently. Dr Sin Yong examines suspicious lesions with a dermatoscope, a magnifying light that shows patterns invisible to the naked eye. Tags are removed in the usual way; moles go through a dermatoscopy-first assessment before any removal is planned; and age warts are removed by methods suited to their thickness and site.
Can a raised mole be removed by laser, like a skin tag?
Some can. A small mole that looks benign on dermatoscopy can be vaporised in fine layers with a CO2 laser, or shaved and sealed with radiofrequency, in a similar way to a skin tag. The difference is the decision that comes first.
Laser ablation destroys the tissue rather than removing it whole, so nothing is left to send to a laboratory. That is acceptable only when the mole has been examined and shows a benign pattern. A mole that is changing in size, shape or colour, is unusually dark or irregular, bleeds, or simply looks different from your other moles is better removed by excision so that it can be examined under a microscope.
Moles also differ from tags in depth. A tag sits on the surface on its stalk; a raised mole extends into the dermis, so removal is about judging how deep to go, balancing the chance of regrowth against the risk of a pale or indented mark. For these reasons, laser mole removal is planned lesion by lesion rather than in the same quick sweep used for a cluster of tags.
How should I prepare for skin tag removal, and can I go back to work?
Little preparation is needed. It helps to mention any blood-thinning medication, a tendency to form raised or thickened scars, and any lesion that has recently changed, bled or become sore, since these affect how each tag is handled. Wearing a loose collar or top makes it easier to reach neck and underarm tags and keeps clothing off the treated sites afterwards.
Recovery depends on the number and site of tags treated, and is discussed at consultation. Each treated site is a small dot or crust, which can be left uncovered or protected with a light dressing if clothing rubs. Necklaces, tight collars and bra straps should be kept off healing sites, and the crusts should be left to separate on their own rather than picked.
Showering is fine; the sites are patted dry and kept moisturised. Sun protection on exposed areas, such as the neck and face, reduces the chance of a dark mark in Singapore's climate. If a site becomes increasingly red, swollen or painful, or begins to discharge, the clinic should be told so it can be checked.
