Insulin Resistance Skin Tags: Causes and Treatment

Insulin resistance skin tags are more than a cosmetic nuisance: clusters of these small, soft growths may signal an underlying metabolic disturbance worth investigating. Skin tags, medically known as acrochordons, are benign and common, but research suggests that people with multiple skin tags are significantly more likely to have impaired insulin sensitivity or type 2 diabetes. Understanding the link between elevated insulin levels and abnormal skin cell growth can help you recognise early warning signs, seek timely assessment from your GP, and take steps to protect your long-term metabolic health.

Can insulin resistance really cause skin tags?

Insulin resistance is strongly associated with skin tags, with studies showing that multiple skin tags correlate with raised fasting insulin levels, though skin tags can also occur in people with normal metabolic health.

Insulin resistance is strongly associated with skin tags, and several studies have found that people with multiple skin tags are significantly more likely to have impaired insulin sensitivity or type 2 diabetes than those without them. Skin tags, known medically as acrochordons, are small, soft, benign growths that typically appear in skin folds such as the neck, armpits, groin and under the breasts. While they are harmless in themselves, their presence in clusters has been recognised as a potential external marker of underlying metabolic disturbance.

The association is documented in dermatological and endocrinological literature. A 2010 study published in the Journal of the European Academy of Dermatology and Venereology found that the number of skin tags correlated with fasting insulin levels and markers of insulin resistance. It is important to note, however, that skin tags can also occur in people with entirely normal metabolic health, particularly as a result of skin friction, ageing or genetic predisposition. Having a skin tag does not confirm insulin resistance, and the absence of skin tags does not rule it out.

Clinicians increasingly regard multiple skin tags as a prompt to investigate metabolic health, particularly when they occur alongside other signs such as weight gain around the abdomen or darkened skin patches. If you have noticed an increase in skin tags, it is reasonable to mention this to your GP, who can arrange appropriate blood tests to assess your metabolic profile.

If you experience marked thirst, frequent urination, unintentional weight loss or unusual drowsiness, seek same-day medical advice, as these may indicate significantly elevated blood glucose requiring prompt assessment.

Why does the body grow skin tags when blood sugar is disrupted?

Elevated circulating insulin may overstimulate growth receptors on skin cells, triggering localised proliferation, though current evidence supports an association rather than a proven causal mechanism.

One proposed explanation for skin tag formation in the context of insulin resistance is that elevated circulating insulin acts as a growth-promoting signal on skin cells. When cells become resistant to insulin's glucose-regulating effects, the pancreas compensates by producing more insulin, a state known as hyperinsulinaemia. Insulin and insulin-like growth factor 1 (IGF-1) are both hypothesised to bind to receptors on keratinocytes and fibroblasts, the cells that make up the outer layers of skin and its connective tissue. Overstimulation of these receptors may trigger localised proliferation of skin cells, resulting in the small pedunculated growths we recognise as skin tags. It should be noted that multiple pathways have been proposed and that causality has not been definitively established; current evidence supports an association rather than a proven causal mechanism.

This same proposed mechanism helps explain another skin condition closely linked to insulin resistance: acanthosis nigricans, the velvety darkening of skin folds. Both conditions may reflect the downstream effects of excess insulin signalling on skin tissue, though they involve different cell types and present differently.

Chronically elevated blood glucose is also associated with low-grade systemic inflammation and changes in collagen structure, which may further encourage abnormal skin growth in areas subject to friction. Adipose tissue, particularly visceral fat, releases inflammatory cytokines that can compound these effects. This is why skin tags tend to cluster in skin folds, where friction, warmth and local metabolic signals combine.

The relationship is probabilistic rather than deterministic. Not everyone with insulin resistance develops skin tags, and the precise threshold of hyperinsulinaemia at which skin proliferation occurs likely varies between individuals based on genetic susceptibility and other factors.

What other signs of insulin resistance should I look out for?

Key signs include acanthosis nigricans, central weight gain, fatigue after meals, increased thirst, and raised fasting glucose or HbA1c on blood testing.

Insulin resistance often produces a cluster of physical and biochemical signs that, taken together, can alert both patients and clinicians to an underlying metabolic problem. The most recognisable physical signs include:

• Acanthosis nigricans: dark, velvety patches of skin in the neck creases, armpits or groin, associated with the same IGF-1 driven skin cell proliferation described above

• Central weight gain: accumulation of fat around the abdomen rather than the hips and thighs, sometimes described as an apple-shaped body

• Fatigue after meals: some people with insulin resistance report low energy or difficulty concentrating after eating, though this is non-specific and can have many causes

• Increased thirst and frequent urination: signs that blood glucose may be rising towards pre-diabetic or diabetic levels; if these symptoms are marked or accompanied by unintentional weight loss or drowsiness, seek same-day medical advice

• Polycystic ovary syndrome (PCOS): in women, insulin resistance is a recognised driver of PCOS, which can present with irregular periods, excess hair growth and acne (NICE guideline NG193)^[6][7]

Blood tests may reveal raised fasting glucose, elevated HbA1c, high triglycerides and low HDL cholesterol, a pattern consistent with metabolic syndrome as defined by standard criteria such as those of the International Diabetes Federation. Fasting insulin is not part of the standard diagnostic criteria for metabolic syndrome, though it may be measured in some clinical contexts.

NICE recommends that adults with a BMI of 25 kg/m2 or above, or 23 kg/m2 or above in people of South Asian, Chinese, Black African or African-Caribbean origin, should be considered for type 2 diabetes risk assessment (NICE guideline NG28).

If you recognise several of these signs together, including multiple skin tags, it is worth booking a routine appointment with your GP rather than waiting for symptoms to worsen. Early identification of insulin resistance allows lifestyle and, where appropriate, pharmacological intervention before progression to type 2 diabetes.

How are skin tags and insulin resistance diagnosed and treated on the NHS?

Insulin resistance is diagnosed via fasting plasma glucose and HbA1c blood tests; skin tags are benign and not routinely removed on the NHS unless clinically indicated.

Insulin resistance is diagnosed through blood tests rather than by the presence of skin tags alone, and your GP is the appropriate first point of contact for assessment. Standard investigations include a fasting plasma glucose test and an HbA1c measurement. A fasting plasma glucose of 6.1 mmol/l or above, or an HbA1c of 42 mmol/mol (6.0%) or above, may indicate non-diabetic hyperglycaemia (pre-diabetes), while values of 7.0 mmol/l fasting glucose or 48 mmol/mol (6.5%) HbA1c on two occasions are diagnostic of type 2 diabetes. A fasting lipid profile is also commonly requested.

For people at high risk of developing type 2 diabetes, NICE guidance (NG28, Type 2 diabetes in adults: management, and the associated prevention pathway) outlines a structured pathway including referral to the NHS Diabetes Prevention Programme. Metformin may be considered for people with non-diabetic hyperglycaemia who are at high risk and have not responded adequately to lifestyle measures, in line with NICE guidance; your GP can advise on eligibility.^[2][5]

Skin tags themselves do not require treatment on clinical grounds, as they are benign. The NHS does not routinely fund their removal for cosmetic reasons. If a skin tag becomes irritated, bleeds repeatedly, changes in appearance, or if any skin lesion is pigmented, rapidly enlarging or ulcerated, your GP can assess it and, if necessary, refer you to a dermatologist. Do not attempt to remove skin tags yourself, as this carries a risk of infection and may delay assessment of a lesion that requires clinical review. Removal methods used in clinical settings include cryotherapy, snip excision and electrocautery, but these are generally only available privately unless there is a clinical indication.^[1]

For insulin resistance, the NHS pathway prioritises lifestyle modification as the first-line intervention. This includes structured dietary advice, increased physical activity and, where appropriate, weight management support. For people with established type 2 diabetes, a broader range of medicines is available, including GLP-1 receptor agonists and dual GIP and GLP-1 receptor agonists, which your GP or diabetes team can discuss with you based on your individual circumstances.

Can improving insulin sensitivity help reduce skin tags?

Improving insulin sensitivity through diet, exercise and weight reduction may slow new skin tag formation, but existing tags rarely disappear once established.

Improving insulin sensitivity can reduce the hormonal signals that may drive skin tag formation, and there is reasonable biological plausibility that lowering circulating insulin levels may slow the development of new skin tags. However, robust clinical trial evidence specifically on skin tag regression is limited, and any such benefit should be regarded as observational rather than established. Existing skin tags do not typically disappear on their own once formed, regardless of metabolic improvement, because they represent established fibrovascular tissue rather than an active inflammatory process.

The most evidence-based approaches to improving insulin sensitivity include:

• Dietary change: reducing refined carbohydrates and ultra-processed foods, increasing dietary fibre and adopting a Mediterranean-style or low-glycaemic eating pattern

• Regular physical activity: both aerobic exercise and resistance training improve skeletal muscle glucose uptake independently of weight loss^[13][14]

• Weight reduction: evidence underpinning the NHS Diabetes Prevention Programme and NICE prevention guidance indicates that even a modest reduction in body weight can meaningfully improve insulin sensitivity and reduce HbA1c; your GP or diabetes team can advise on realistic targets for your circumstances

• Sleep and stress management: chronic sleep deprivation and elevated cortisol are both associated with worsened insulin resistance^[15][16]

For people who meet clinical criteria, weight management medicines authorised by the MHRA may be considered as part of a comprehensive programme. Semaglutide (Wegovy) and tirzepatide (Mounjaro) are MHRA-authorised for chronic weight management in the UK, and clinical trial data summarised in their respective UK SmPCs and NICE technology appraisals indicate improvements in markers of insulin resistance alongside weight reduction.^[8] Oral semaglutide 25 mg (Wegovy tablets), approved by the MHRA in June 2026 for weight management, is a further option that a prescriber may consider.^[9] Bolt Pharmacy is a GPhC-registered online pharmacy offering weight-management consultations with prescriber review and pharmacist support; medicines such as Wegovy or Mounjaro are only prescribed where a registered prescriber determines they are clinically appropriate following an individual consultation.

If you are considering any pharmacological approach, speak to your GP or a registered prescriber who can assess your full medical history before any treatment is initiated.

Scientific References

1. Skin tags.
2. Type 2 diabetes: prevention in people at high risk (PH38).
3. Type 2 diabetes: prevention in people at high risk – Recommendations (PH38).
4. Preventing the progression of pre-diabetes to type 2 diabetes – Evidence review (PH38).
5. Metformin hydrochloride – BNF/NICE.
6. Polycystic ovary syndrome – Treatment summaries, BNF/NICE.
7. Polycystic ovary syndrome (PMOS) guideline document (GID-NG10436).
8. GLP-1 medicines for weight loss and diabetes: what you need to know.
9. First GLP-1 tablet for weight loss approved in the UK.
10. Mechanism of compensatory hyperinsulinemia in normoglycemic insulin-resistant states.
11. Molecular signaling networks that connect tissue dysfunction to systemic insulin resistance.
12. The lipotoxicity-ferroptosis axis in the transition from insulin resistance to type 2 diabetes: mechanistic integration and therapeutic opportunities.
13. Update on the effects of physical activity on insulin sensitivity in humans.
14. Increased skeletal muscle capillarization after aerobic exercise training and weight loss improves insulin sensitivity in adults with IGT.
15. Sleep Debt and Insulin Resistance: What's Worse, Sleep Deprivation or Sleep Restriction?.
16. Clamping Cortisol and Testosterone Mitigates the Development of Insulin Resistance during Sleep Restriction in Men.
17. Timing Modulates the Effect of Sleep Loss on Glucose Homeostasis.
18. Diabetes.

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