Home surgery is not a good solution for removing skin tags

DEAR DR. ROACH >> What is the best way to eliminate skin tags? Is there an over-the-counter item that will work effectively? There are many products that claim to remove them, but most don’t. — G.L.

DEAR READER >> Skin tags (acrochordons) are benign but unsightly outgrowths of normal skin usually found in places where the skin rubs against itself, such as in the groin or axilla (underarm).

They don’t need to be removed if they aren’t bothering you. If you want to remove them for cosmetic reasons, the best way to remove them is to see your doctor or dermatologist to get it done definitively. I usually use a scalpel blade (I use anesthetic), but they can be removed with liquid nitrogen or with a surgical electrodessicator.

I’m not convinced that any of the over-the-counter creams or oils are very effective. I don’t recommend attempting home surgery, because skin tags can bleed and occasionally need a stitch. Also, clean instruments and proper technique are essential for a good result and to prevent infection.

DEAR DR. ROACH >> In a recent column, you noted that swollen lymph nodes rarely are something to be concerned about. In March 2012, two lumps popped up in my neck below my left ear, both about the size of the tip of my index finger. I went to my doctor, but a neck CAT scan was inconclusive. An ear, nose and throat doctor attempted a needle biopsy, but could not get adequate cells. Finally, a surgical procedure removed one lump, and it was metastatic melanoma. The primary was on the crown of my head and was removed, after which I spent an unpleasant year on interferon. Since then, I have had a few basal and squamous cancers removed. So, lumps — in my humble opinion — are not something to be ignored. — J.E.D.

DEAR READER >> Unfortunately, “rarely” doesn’t mean “never.” There are characteristics of a lymph node or mass that should raise warning flags to the physician. Larger-size and multiple masses are of concern. The location of yours (below the ear, called the “posterior auricular chain”) is not typical for the usual kind of reactive node found under the jaw.

But I appreciate your writing, because occasionally lymph nodes do represent something serious. Painless nodes are more concerning: Those lasting more than four weeks or those larger than 1 or 2 centimeters should be evaluated.