Case Report: Cosmetic Removal of Skin Tags and Treatment for Photoaging in a 38-Year-Old Female
by: Caroline Vaughn
At Village Dermatology in Katy and Houston, Texas, we often see patients seeking both cosmetic dermatology services and medical evaluation for concerning growths. This case highlights the treatment of skin tags, dermatosis papulosa nigra, and photoaging, along with the importance of biopsy for uncertain lesions.
Patient Presentation
A 38-year-old female presented as a new patient with two main concerns:
Cosmetic removal of growths on the neck.
Cosmetic consultation for management of oil glands and photoaging.
The growths had been present for several years, were bothersome, and occasionally irritated by clothing and jewelry.
Examination Findings
A focused dermatologic exam of the face and neck revealed:
Dermatosis Papulosa Nigra (DPNs): Multiple small, brown, verrucous papules distributed on the cheeks and neck.
Skin Tags (Acrochordons): Numerous pedunculated papules located throughout the anterior, lateral, and trapezial regions of the neck.
Pruritus: Localized itching on the left posterior neck, associated with skin tags.
Neoplasm of Uncertain Behavior: A papule on the left posterior neck requiring biopsy for diagnosis.
Photoaging: Pigmented changes and early fine lines noted on the forehead, cheeks, and chin.
Treatment & Management
Skin Tag Removal (Cosmetic)
After informed consent, 20 skin tags were removed from the neck using gradle excision under local anesthesia.
Patient was counseled regarding risks including pigment changes, scarring, bleeding, and infection.
Pruritus was managed with triamcinolone cream as needed.
Dermatosis Papulosa Nigra (DPNs)
Planned for future cosmetic treatment with cryotherapy or light electrodesiccation at $250 for up to 20 lesions.
Neoplasm of Uncertain Behavior
A shave biopsy was performed on the posterior neck to rule out atypical nevus or other pathology.
Patient will be notified of pathology results within 2 weeks.
Photoaging (Dermatoheliosis)
Initiated tretinoin 0.025% cream, starting with 2–3 nights per week and gradually increasing as tolerated.
Counseling provided on sun protection, retinoid use, and adjunctive options such as chemical peels and laser treatments.
Patient Counseling
Skin Tags & DPNs: Benign, common, and removable for cosmetic purposes.
Biopsy: Necessary for any lesion of uncertain behavior.
Photoaging: Prevented and improved with broad-spectrum sunscreen, retinoids, and cosmetic procedures.
Self-Monitoring: Patient was advised to return if new or changing lesions develop.
Conclusion
This case highlights how dermatology can address both medical and cosmetic concerns in the same visit. At Village Dermatology in Katy and Houston, Texas, we provide expert care in treating benign growths like skin tags and DPNs, while also helping patients achieve healthier, younger-looking skin through cosmetic treatments.
If you’re seeking cosmetic removal of skin tags, treatment for photoaging, or evaluation of new skin lesions, schedule a consultation with our dermatology team today.
