First, What Exactly Is a Skin Tag?

A skin tag is a small benign growth of skin.

The medical term is acrochordon.

Skin tags are typically soft and may project slightly from the skin, sometimes on a small stalk.

They frequently develop in areas where skin folds or surfaces come into contact.

The neck and underarms are particularly common locations.

They can also occur around other body folds.

Most skin tags do not cause symptoms.

They may become noticeable because of appearance, because jewellery or clothing catches on them, or because repeated friction irritates them.

And importantly:

having a skin tag is not itself a disease.

If Skin Tags Are Common, Why Link Them With Insulin Resistance?

Because researchers have repeatedly noticed that skin tags occur more frequently in people with certain metabolic abnormalities.

Cleveland Clinic lists skin tags among signs that may be seen in people with prediabetes and insulin resistance.

Mayo Clinic similarly includes skin tags among physical signs a clinician may look for while assessing possible insulin resistance.

Dermatology research has gone further by comparing people with multiple acrochordons against people without them.

These studies have reported associations with:

• higher insulin resistance
• higher fasting glucose
• higher body mass index
• higher triglycerides
• lower HDL cholesterol
• higher blood pressure
• diabetes
• metabolic syndrome

That makes skin tags interesting not because they diagnose a metabolic problem, but because the skin may occasionally provide an external clue to something occurring internally.

What Might Insulin Have to Do With the Skin?

During insulin resistance, cells in tissues such as muscle, liver and fat respond less effectively to insulin.

The pancreas may compensate by producing more insulin.

This can produce hyperinsulinemia—higher-than-usual levels of circulating insulin—even while blood glucose remains within a normal range for some time.

The proposed connection with skin tags involves the growth-promoting effects of insulin and related insulin-like growth-factor pathways.

Dermatology literature has described acrochordons among skin manifestations associated with hyperinsulinemia and insulin resistance.

Research examining acrochordon tissue has also reported greater expression of insulin-like growth-factor receptors and associations involving insulin, IGF-1 and HOMA-IR.

This offers a biologically plausible explanation for why persistently elevated insulin signalling might influence skin-cell growth in susceptible individuals.

But biology is rarely that simple.

Skin tags may also be associated with body weight, friction, genetics and other factors.

Does the Number of Skin Tags Matter?

This is where the evidence becomes particularly interesting.

A single small skin tag is extremely nonspecific.

Some studies have therefore focused specifically on people with multiple skin tags.

In one cross-sectional study, researchers defined cases as people with more than five skin tags on the neck and/or underarms.

The presence of multiple skin tags was associated with higher HOMA-IR—a commonly used research estimate of insulin resistance—even after adjustment for several other risk factors.

Other case-control research comparing people with multiple acrochordons with controls has found higher fasting glucose, body mass index, insulin resistance, cholesterol, triglycerides and blood pressure among those with skin tags.

Researchers have therefore proposed that multiple acrochordons may sometimes serve as a cutaneous—or skin—marker of underlying metabolic abnormalities.

Does This Mean “Five Skin Tags = Insulin Resistance”?

No.

The study finding should not be converted into a home diagnostic rule.

Research groups often choose numerical definitions—such as more than five skin tags—to compare one group with another.

That does not mean that four tags are safe and six tags diagnose insulin resistance.

Nor does it mean that everyone with multiple tags has abnormal insulin levels.

These studies are observational.

They demonstrate an association between groups, not a diagnostic threshold applicable to every individual woman.

This distinction is crucial when health information moves from a research paper to a bathroom mirror.

Does Where the Skin Tags Appear Matter?

Studies investigating metabolic associations have often examined tags around the neck and axillary—or underarm—regions.

These are also common places for skin tags generally.

The location therefore does not by itself make a tag metabolically significant.

What may be more useful is the overall pattern:

• Are there many skin tags rather than one?
• Have more appeared over time?
• Are they occurring around the neck or underarms?
• Is there also dark, thick or velvety skin nearby?
• Has waist circumference increased?
• Are glucose, HbA1c, triglycerides or blood pressure elevated?
• Are there reproductive or hormonal issues such as PCOS?

Each additional clue adds context.

Skin Tags and Acanthosis Nigricans Are Not the Same Thing

These two skin findings often appear together in discussions of insulin resistance, but they are different.

Skin tags are small protruding benign growths.

Acanthosis nigricans causes areas of darker, thicker, often velvety skin, usually in body folds such as the neck, underarms or groin.

Mayo Clinic notes the association between insulin resistance and acanthosis nigricans, and affected skin may also develop skin tags.

Because both can occur around similar body areas, women may sometimes confuse one for the other.

They can also occur together.

But they should not be treated as interchangeable findings.

Acanthosis nigricans will be the subject of Part 3 of this series.

When Might Skin Tags Be More Worth Paying Attention To?

Skin tags may deserve more metabolic context when they appear alongside established risk factors or abnormalities.

For example:

• increasing abdominal or central fat
• prediabetes-range glucose or HbA1c
• high triglycerides
• low HDL cholesterol
• high blood pressure
• family history of type 2 diabetes
• physical inactivity
• history of gestational diabetes
• PCOS
• acanthosis nigricans

Cleveland Clinic notes that insulin resistance can exist before obvious symptoms appear because the pancreas may initially compensate by producing additional insulin.

That is why visible skin findings can sometimes be useful—not as proof, but as a reason to consider the wider metabolic picture.

Why Can This Be Particularly Relevant for Women?

For women, insulin resistance may intersect with reproductive as well as metabolic health.

PCOS is strongly associated with insulin resistance in many affected women.

A woman may therefore encounter several apparently unrelated changes:

• skin tags
• darkening around the neck or underarms
• increasing central fat
• irregular periods
• acne
• increased facial or body hair
• abnormal glucose or triglycerides

None of these individually establishes insulin resistance or PCOS.

But viewing them together may reveal a pattern that deserves clinical assessment.

This is one reason Diafemme's six-part series looks at signs separately while continually returning to the same principle:

the whole pattern matters more than any single clue.

I Have Several Skin Tags. What Should I Actually Do?

First, do not panic.

Most skin tags are benign.

And do not attempt to diagnose insulin resistance by counting them.

Instead, consider whether there are other metabolic reasons to check your health.

A healthcare professional may review:

• your personal and family history
• waist circumference and body composition
• blood pressure
• fasting glucose
• HbA1c
• lipid profile
• history of gestational diabetes
• possible PCOS or other hormonal conditions

If your skin tags themselves are bothersome, repeatedly irritated, bleeding or diagnostically uncertain, a dermatologist or other qualified clinician can also assess them directly.

The useful response to a possible metabolic clue is therefore not:

“How do I remove the evidence?”

but:

“Is there anything else in my health that I should investigate?”

Will Removing Skin Tags Treat Insulin Resistance?

No.

Removing a skin tag removes the skin growth.

It does not treat an underlying metabolic abnormality.

Likewise, the disappearance or removal of skin tags cannot be used to prove that insulin sensitivity has improved.

If metabolic risk is present, the relevant response focuses on the underlying factors—such as physical activity, nutrition, weight management where appropriate, sleep, metabolic monitoring and medical treatment when indicated.

Skin treatment and metabolic treatment answer different questions.

When Should a Skin Change Be Checked?

A healthcare professional should assess a growth if you are uncertain that it is actually a skin tag or if a skin lesion changes unexpectedly.

Also consider medical review when:

• many new skin tags appear
• the growth looks different from your other skin tags
• it bleeds repeatedly
• it becomes persistently painful or irritated
• there are accompanying dark, thickened skin patches
• you have additional risk factors for prediabetes or type 2 diabetes
• you have symptoms or signs suggesting PCOS or another hormonal condition

A clinician can determine whether the lesion itself needs attention and whether a broader metabolic assessment is appropriate.

Myths Worth Avoiding

Myth: “A skin tag means I have diabetes.”

Fact: No. Skin tags are common benign growths. They have been associated with insulin resistance and diabetes, but they are not diagnostic.

Myth: “One skin tag means my insulin is high.”

Fact: No. An isolated skin tag is very nonspecific. Research associations are more notable in studies involving people with multiple skin tags.

Myth: “More than five skin tags proves insulin resistance.”

Fact: Some studies have used more than five tags as a research definition, but this is not a universally accepted diagnostic threshold.

Myth: “Skin tags and acanthosis nigricans are the same condition.”

Fact: They are different skin findings, although both may occur in association with insulin resistance and can appear together.

Myth: “If I remove my skin tags, I have solved the metabolic problem.”

Fact: Removal treats the growth itself. It does not diagnose or treat insulin resistance.

Diafemme Perspective: Sometimes the Skin Is Part of the Metabolic Conversation

We usually think of the skin as something outside the body.

Metabolic health seems like something happening inside.

But the two are not completely separate.

Hormones, glucose, insulin, circulation and inflammation can all influence the skin.

That makes visible changes occasionally useful clues.

Not diagnoses.

Not predictions.

Clues.

A woman who has had one harmless skin tag for years may have no metabolic problem at all.

Another woman may notice several tags appearing alongside increasing central fat, darkening around the neck, irregular periods and rising glucose.

The skin tag has not suddenly become a diabetes test.

But the pattern has become worth noticing.

Frequently Asked Questions

Are skin tags a sign of insulin resistance?

They can be associated with insulin resistance, particularly when multiple skin tags are present, but skin tags themselves do not diagnose insulin resistance.

What are skin tags medically called?

They are called acrochordons. They are generally benign skin growths.

Where do skin tags commonly appear?

They commonly occur around areas such as the neck and underarms and other body folds.

Does having one skin tag mean my insulin is high?

No. An isolated skin tag is very nonspecific. Research linking acrochordons with insulin resistance has often focused on people with multiple skin tags.

How many skin tags suggest insulin resistance?

There is no universally accepted diagnostic number. Some studies have investigated people with more than five or with multiple acrochordons, but these research definitions should not be used as home diagnostic cutoffs.

Why might high insulin contribute to skin tags?

One proposed mechanism involves elevated insulin and insulin-like growth-factor signalling stimulating growth-related pathways in skin cells. Research has found associations between acrochordons, insulin levels, HOMA-IR and insulin-like growth-factor receptors.

Are skin tags the same as acanthosis nigricans?

No. Skin tags are small protruding growths. Acanthosis nigricans causes darkened, thickened or velvety areas of skin, typically in body folds. Both can be associated with insulin resistance.

Should I get my blood sugar checked if I have many skin tags?

Skin tags alone do not determine whether testing is necessary, but multiple tags occurring with other risk factors can be a useful reason to discuss glucose, HbA1c and broader metabolic assessment with a healthcare professional.

Will removing my skin tags improve insulin resistance?

No. Removing the growth treats the skin tag itself. It does not treat an underlying metabolic condition.

Diafemme's Takeaway

A skin tag is usually just that:

a small, benign skin growth.

But several skin tags may occasionally belong to a larger metabolic picture.

Research has found associations between multiple acrochordons and insulin resistance, higher glucose, abnormal lipids, obesity, blood pressure and metabolic syndrome.

Major clinical sources also recognize skin tags among physical findings that may occur in people with insulin resistance or prediabetes.

Still, there is no skin-tag count that can tell you:

“You have insulin resistance.”

Look beyond the tag.

Consider your waist, glucose, HbA1c, blood pressure, lipids, family history and hormonal health.

If several clues begin appearing together, investigate the pattern rather than diagnosing yourself from the skin.

Sometimes what appears on the surface is simply a skin change. Sometimes it is one small reason to look deeper.