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To the Editor.—
It has been my observation that scissors excision of skin tags can be painless if the transection is through the stalk and if there is no tension on the polyp. I hypothesized that this lack of sensation might be due to absence of cutaneous nerves in the tag.I examined 6-μm sections from 20 skin tags for cutaneous nerves using S100 protein immunostaining as a means of identifying their presence in the dermis. Appropriate positive and negative controls were included in each assay. Internal positive controls in the skin tags included the presence of Langerhans cells and melanocytes in the epidermis.I could not find dermal nerves in these skin tags. I conclude that tags generally lack innervation. Therefore, removal should be painless as long as subjacent dermis is not elevated by the forceps and transected by the scissors.
Pennys NS. Skin Tags Do Not Contain Cutaneous Nerves. Arch Dermatol. 1990;126(12):1654-1655. doi:10.1001/archderm.1990.01670360122031