Skin Tag vs. Mole: How to Tell the Difference

How Skin Tags Look and Feel

A skin tag is a small, soft growth that hangs from the skin on a narrow stalk. Pressed gently with a fingertip, it moves and folds over, because it is attached at a single point. The surface is smooth or slightly wrinkled, and the color matches the surrounding skin or runs a shade darker. Some skin tags are barely visible specks, and others grow into raised flaps that catch the light.

Skin tags form in places where skin folds or creases. The neck, the underarms, the eyelids and the chest are the classic sites, and the back and the bra line are other places they appear. A person can have a single skin tag or a cluster of them in one area.

Skin tags are non-cancerous. One on the eyelid can get in the way of makeup, and that kind of daily nuisance is one reason a skin tag comes up at an appointment.

Because a skin tag hangs loose, it can be pulled, scraped or caught during ordinary activities. That loose attachment is also a feature an examiner looks for when telling a skin tag apart from a mole.

How Moles Differ

A mole is a cluster of melanocytes, the cells that produce melanin, the pigment that gives skin its color. In a mole, those cells gather in one spot. That concentration of pigment is the reason a mole looks tan, brown or black.

Moles come in different forms. Some are flat and level with the skin, and others rise into a smooth dome. A typical mole has a round or oval outline with a clear, even edge, and its color stays consistent from one side to the other. Some moles grow hair, and that hair is harmless. A raised mole can lighten over the years until it is close to skin-colored, and at that stage it can resemble a skin tag at first glance.

Moles can appear from childhood onward, and sun exposure can play a part in how many develop. They can form anywhere on the body, including the scalp, the soles of the feet and areas that see little sunlight. Melanoma can also develop on skin that sees little sun, including the palms, the soles and the skin under the nails.

The key structural difference is attachment. A skin tag dangles from a stalk. A mole is part of the skin itself, either flat within it or raised from a broad base. That difference matters when removal comes up, because a mole carries pigment cells that a physician may need to examine, and a growth that looks unusual gets that examination before anything else happens.

ABCDE Changes to Know

Physicians use five letters, ABCDE, as a checklist for spotting changes in a mole that may signal melanoma, a type of skin cancer. The letters are a way to notice and describe change. A diagnosis belongs to a physician, who examines the spot directly. Basal cell carcinoma and squamous cell carcinoma are other types of skin cancer, and they can appear as pink, pearly bumps or scaly patches.

• A for asymmetry: one half of the spot does not match the other half in shape.
• B for border: the edge is ragged, notched or blurred, and the pigment can seem to fade into the surrounding skin.
• C for color: the spot holds more than one shade, such as tan, brown and black, or patches of red, white, gray or blue.
• D for diameter: the spot is larger than about 6 millimeters across, although melanoma can be smaller.
• E for evolution: the spot changes in size, shape, color or height over weeks or months, or it develops new symptoms.

Another sign sits alongside the five letters. A spot that looks unlike the rest of a person's spots, sometimes called the "ugly duckling," deserves attention even when it meets none of the letters. A mole that stands out from its neighbors in size, color or shape is a reason to have a physician take a look.

Tip: A dated photo of a spot, taken in the same light and from the same distance each time, gives a physician a fixed record for judging whether its size, shape or color has changed between appointments.

Bleeding, Itching and Growth

Symptoms add to the picture that shape and color provide. A skin tag can bleed when it catches on a zipper, a necklace or a razor. Bleeding from any growth, even after a snag, is still a reason for an examination.

On a mole, bleeding without an injury, crusting or oozing on its surface, or a sore that fails to heal all need a physician's evaluation. Itching, tenderness or pain in a spot that used to cause no sensation belongs on the same list. These symptoms are signs that a growth deserves a closer look, and a physician makes any diagnosis.

Growth is the third signal. A spot that keeps getting larger, changes from flat to raised, or develops a new bump inside its outline has changed in a way an examiner wants to see. A note of when each change was first noticed helps the physician understand how quickly it happened.

Any growth that changes in size, shape or color, bleeds, itches, or looks unlike a person's other spots needs evaluation by a physician. That rule applies whether the spot seems to be a skin tag or a mole, because an outside view of a growth cannot settle what it is.

The Evaluation Before Any Removal

Removal starts with an evaluation. The nurse practitioner examines each lesion and reviews the person's medical history to confirm that a growth is a benign skin tag before treatment is planned. The conversation can cover how long each growth has been present, whether it has changed, and whether it has bled, itched or become sore.

History questions can extend beyond the growth itself and can include a personal or family history of skin cancer, past sunburns and any earlier treatment on the same spot.

Any growth that looks suspicious is referred to a physician for evaluation before treatment. A spot with irregular color, an uneven border, recent change or unexplained bleeding falls into that category. The physician can examine a spot with a dermatoscope, a lighted magnifier that shows pigment patterns beneath the surface, and a biopsy, in which a small sample is examined under a microscope, confirms a diagnosis. Removal of that spot waits until the physician has assessed it.

Once the provider confirms a growth is a benign skin tag, the area is cleansed and numbed, and each one is removed with the technique suited to its size and location.

Frequently Asked Questions