Skin tags, while usually harmless, should not be removed at home

Q: I turned 46 years old last winter, and all of a sudden I started getting skin tags. I worried it might be a sign of skin cancer, but my sister insists they're harmless. Is that true? There are a few on my neck that keep getting irritated by my clothes and jewelry. Is there any way to get rid of them?

A: We'll begin by reassuring you your sister is correct. Skin tags, which are also known as acrochordons, are not a sign of cancer. Other than looking a bit odd, and potentially getting in the way of clothing or jewelry, they are typically harmless.

For those who aren't familiar, skin tags look like fleshy tubes or bumps that sit on the surface of the skin. They're often around 2 millimeters long, which is about the size of a grain of rice, but they can grow a bit larger.

Skin tags are malleable, with a springy texture. They move around quite easily, and touching them doesn't cause pain or discomfort. They are often the same color as the surrounding skin, but in certain cases can appear slightly darker. Older skin tags may begin to take on a brown or russet hue. Some can be lumpy and uneven, with a rough, warty texture. In those cases, it's a good idea to have a doctor take a look. You want to be sure it's a skin tag and not a precancerous growth.

Up to two-thirds of all adults will develop skin tags. The condition affects women and men equally, and it becomes more common with age. The cause of these fleshy protrusions remains unknown, but genetics is believed to play a role. When you have family members with the condition, you have an increased likelihood of developing it as well.

Skin tags are seen more often in individuals who are overweight or obese. They often arise in areas where there is rubbing or chafing, such as the creases of the armpits, beneath the breasts, on the eyelids, along the neck and around the groin.

Recent research suggests a possible link between skin tags and metabolic syndrome, high blood pressure and insulin resistance. The connections to those health problems mean it's worth talking with a doctor about a sudden or marked increase in the number of skin tags.

Because they are neither harmful nor dangerous, it is not necessary to have skin tags removed. However, some people choose to do so. This may be for cosmetic reasons, or because, as in your case, their location makes them a nuisance. It's never a good idea to try to remove them yourself. Skin tags are vascular, which means they have a blood source. They sometimes also have nerves. Cutting them off with scissors is not only painful, but it can also lead to uncontrolled bleeding. There is also a risk the area can become infected.

A doctor or dermatologist can safely and easily remove skin tags with minimal pain and scarring. This is done by snipping them off with a sharp, sterile blade, freezing with liquid nitrogen or burning them off with cautery.

Arm numbness at night

Q: My arms and hands have begun to go numb when I'm lying down in bed at night. It wakes me up, so I'm not sleeping well. What causes this? I'm healthy, eat a pescatarian diet and exercise regularly. I don't have diabetes, but I may have high blood sugar. Should I see a doctor?

A: When our ancient ancestors began to walk upright, they earned us some important evolutionary advantages. These include increased agility, improved endurance and freeing up our arms and hands to carry loads and manage tasks. The vertical stance led to increased flexibility of our spines and a remarkable range of motion in our joints. It increased our odds of survival, but it also came at a price.

Becoming bipeds left us more vulnerable to the effects of gravity and, thus, to a host of back and other skeletal problems. It's a risk that persists even in sleep. When the skeletal muscles relax, the pull of gravity takes over. This results in sustained, and often uneven, pressure on the joints and connective tissue of the shoulders, legs and hips. Depending on variables such as someone's age, weight, skeletal structure, general health and fitness and existing injuries, this can have an adverse effect on the nerves involved in motion and sensation.

One area that turns out to be particularly susceptible is the cervical spine. This is the series of seven vertebrae that support the head and neck. They also play host to a bundle of interconnected nerves known as the brachial plexus. These nerves branch into the upper torso and control motion and provide sensation to the arms, wrists, hands and fingers. If any of these nerves get compressed, damaged or lack for oxygen and nutrients, it can cause tingling, a pins-and-needles feeling or numbness. It can also result in muscle weakness.

Compression can arise from something as simple and reversible as poor physical positioning. A number of conditions can play a role, as well. This includes stenosis, which is a narrowing of the spinal column; arthritis; carpal tunnel syndrome; repetitive stress; degenerative diseases; infection; and physical injuries. Tingling and numbness can also arise due to damage to the nerves themselves, whether from illness or injury. This is known as neuropathy. Your mention of possibly having high blood sugar is also very important, as it is a risk factor for neuropathy.

Lifestyle changes can be effective. Begin by assessing your sleep habits and environment. Proper support from a mattress and pillow will ease potential pressure points in the head, neck and upper torso. Avoid lying with your arm under the pillow or stretched overhead, as this can compress nerves. A wrist brace can add stability during sleep.

With your combination of high blood sugar and persistent numbness, it's wise to discuss these symptoms with your doctor. Blood sugar management is crucial to good health, and your doctor can help you get yours under control. Your doctor may also suggest certain blood tests or scans that can help pinpoint the potential sources of this nighttime numbness.

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu.