Case Report: Cosmetic Removal of Neck and Facial Skin Tags in a 42-Year-Old Male
by: Dr. Caroline Vaughn
Patient Presentation
A 42-year-old male presented to our dermatology clinic in Katy, Texas with a chief complaint of multiple unsightly skin lesions on the left cheek, right cheek, and left eye area. These lesions were cosmetically bothersome, and the patient sought treatment for removal.
Clinical Examination
A focused dermatologic examination of the face and neck was performed.
Findings included:
Multiple pedunculated papules consistent with acrochordons (skin tags)
Distribution included:
Right superior and central lateral neck
Left central and superior lateral neck
Left medial canthus
Right and left clavicular neck
Left inferior anterior neck
The patient was well-developed, well-nourished, alert, and in no acute distress. Dermatoscopy was used to confirm the benign nature of the lesions.
Diagnosis
Acrochordon (Skin Tags) – (L91.8)
Multiple benign pedunculated lesions across the neck and periocular area.
Treatment Plan
1. Skin Tag Removal (Cosmetic)
After thorough discussion and written informed consent, the risks and benefits were reviewed, including:
Bleeding
Infection
Pain
Pigmentary changes
Scarring (rare)
Procedure Performed:
10 skin tags were removed using gradle excision
Local anesthesia achieved with 3cc of 1% lidocaine with epinephrine
Sites cleaned and prepared in sterile fashion
Hemostasis achieved without complication
2. Future Treatment for DPNs
Dermatosis papulosa nigra (DPNs) were observed, and the patient was counseled that:
These will be treated at the follow-up visit in 1 month
Electrodesiccation is the planned method
Strict sunscreen use is recommended to avoid post-inflammatory hyperpigmentation after treatment
Counseling & Education
Understanding Skin Tags
Acrochordons are benign, extremely common skin lesions
Often occur in areas of friction such as the neck, eyelids, and underarms
May become irritated by clothing or jewelry
Removal is cosmetic, not medically necessary unless inflamed
Post-Care Recommendations
Clean treated areas gently
Apply petroleum jelly or antibiotic ointment if mild crusting occurs
Avoid picking at healing sites
Use broad-spectrum SPF 30+ sunscreen daily to prevent pigmentation changes
Return for evaluation if lesions recur or new growth develops
Discussion
Skin tags are among the most frequent benign growths evaluated in dermatology clinics. While harmless, they can be cosmetically undesirable or physically irritating. Simple procedures like gradle excision provide immediate results with minimal downtime.
For patients with both skin tags and DPNs, a staged treatment approach is ideal—addressing skin tags first, followed by cosmetic removal of DPNs using electrodesiccation.
At Village Dermatology in Katy and Houston, Texas, we specialize in safe, effective removal of benign facial and neck lesions with excellent cosmetic outcomes.
Conclusion
This 42-year-old male underwent successful cosmetic removal of 10 skin tags across the neck and periocular area. He will return in one month for DPN treatment. With proper aftercare and sun protection, he is expected to heal well with excellent cosmetic results.
