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Skin tags are small, soft, skin-colored growths on the skin which can vary in color and size. The size may be ranged from a few millimeters up to 5cm wide. Skin tags are usually found on the neck, armpits, around the groin, or under the breasts. They can also grow on the eyelids or under the folds of the buttocks. They may look like warts but there are tiny differences between warts and skin tags

The cause of the skin tag is not very clear, but it may happen when clusters of collagen and blood vessels become trapped inside thicker pieces of skin. As they are more common in skin creases or folds, they may be mainly caused by skin rubbing against skin. Some people appear to inherit an increased susceptibility to skin tags. Skin tags affect people both males and females, but they happen more often during pregnancy, in people who are obese, and in people with diabetes. They have been associated with hyperinsulinemia when there is too much insulin circulating in the blood.

The American Academy of Dermatology (AAD) advises the public to “never try to remove a mole at home” due to risks of scarring, infection, and the possibility of malignancy in the mole of concern.1 There are no FDA-approved drugs indicated to treat moles or skin tags. The FDA has warned against using over the counter (OTC) products marketed for self-removal of moles or skin tags and has also issued warning letters to firms who sold such products.2–5 Awareness of these products will allow dermatologists to counsel patients to avoid them and seek appropriate interventions instead.

A recent publication described skin injury related to a salicylic acid (SA)-containing mole and skin tag remover product.6 Two additional published case reports described scarring following the use of an unapproved mole and skin tag remover containing cashew and fig, which may cause skin irritation, and greater celandine, a plant containing the escharotic alkaloid sanguinarine, also found in Sanguinaria canadensis.7,8 There are also case reports describing harm from S. canadensis, including cosmetic disfigurement, and death due to progression of inadequately treated malignancy.9,10

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The FDA has received cases from consumers who reported purchasing mole and skin tag remover products from Amazon.com. Ingredients included concentrated SA 25%. They applied the product to lesions on the face, neck, torso, and buttocks as directed and sustained burns with resulting scars. These cases prompted our further review of this issue.

SA is a keratolytic at concentrations between 3%–6%, becoming more destructive at higher concentrations.11 The FDA allows inclusion of SA in topical OTC drug products marketed pursuant to OTC Drug Monographs at concentrations ranging from 0.5%–40%, depending on the indications, which include acne (0.5%–2%), psoriasis (1.8%–3%), and hyperkeratotic conditions like corns, calluses, and warts (5%–40%).12 The OTC Monograph for wart remover drug products requires inclusion of the following warning in the Drug Facts Label: “Do not use on moles, birthmarks, warts with hair growing from them, genital warts, or warts on the face or mucous membranes.”12

Online consumer reviews are a potential data source for pharmacovigilance. For example, there are publications that used Amazon.com online consumer reviews to identify adverse events associated with dietary supplements and to determine consumer perceptions about skin products.13,14 We found no articles utilizing Amazon.com consumer reviews to detect adverse events associated with skin products. We hypothesized that Amazon.com consumer reviews might augment adverse event reports submitted to FDA. We searched for reviews on other large online retailer websites, but none had the quantity and depth of information that was available on Amazon.com.

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Bliss Skin Tag Remover also includes everything in the Bliss Skin Tag Remover but with additions such as Bliss Skin Tag Remover. Yesterday, I received an e-mail on doing it. It's as bright as the sun however, it also prevents burnout which is inevitable due to it. It's how to tell if that isn't working. This is how to stop being burdened and start thinking in connection with this trait. To beg the question, that wasn't a sobering discussion. Sure you can be daring but you want your Bliss Skin Tag Remover to be perfect.

Can you imagine that? That is actually a Bliss Skin Tag Remover palace like I had never seen. It's the one. The Bliss Skin Tag Remover described in the video was also a little off so you might believe that I'm an old blowhard. This issue soon moved to small cities. We can't possibly understand everything there is to understand germane to that progress. We have quit all impulse shopping for Bliss Skin Tag Remover and I suspect I'll return to Bliss Skin Tag Remover.

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Skin tags are small, soft, skin-colored growths on the skin which can vary in color and size. The size may be ranged from a few millimeters up to 5cm wide. Skin tags are usually found on the neck, armpits, around the groin, or under the breasts. They can also grow on the eyelids or under the folds of the buttocks. They may look like warts but there are tiny differences between warts and skin tags

The cause of the skin tag is not very clear, but it may happen when clusters of collagen and blood vessels become trapped inside thicker pieces of skin. As they are more common in skin creases or folds, they may be mainly caused by skin rubbing against skin. Some people appear to inherit an increased susceptibility to skin tags. Skin tags affect people both males and females, but they happen more often during pregnancy, in people who are obese, and in people with diabetes. They have been associated with hyperinsulinemia when there is too much insulin circulating in the blood.

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We searched FDA's Adverse Event Reporting System (FAERS) and Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS) through October 30, 2021, for skin injuries related to products with names containing “mole” or “skin tag”. We also searched and found many products on Amazon.com with “mole remover”, “mole corrector”, or “skin tag remover” in the name. Products selected from Amazon.com were those with at least one hundred consumer reviews and that included images and/or a clear description of the skin injury. From reviews posted between 2019 and 2021, representative cases depicting skin injury were chosen for inclusion. We reviewed product information provided by sellers to identify purported ingredients and product treatment claims. We excluded cases from all sources that did not describe a skin injury or that were associated with a device (e.g., cryotherapy device).
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RESULTS

We identified 38 cases summarized in Table 1, including 30 (sex/age uncertain) from Amazon.com and 8 (4 females, 3 males, 1 not reported; median age 51 years) reported to the FDA. Listed ingredients included SA (18), S. canadensis (6), multiple botanical or “homeopathic” ingredients (5), calcium oxide (2), and unspecified ingredients (7). Reasons for use included moles (12), skin tags (12), anal skin tag (1), and unspecified lesions (15). Adverse events (not mutually exclusive) included burn (30), scar (15), pain/discomfort (13), ulcer (13), infection/cellulitis (4), dermatitis/rash (2), and swelling (2). Fourteen injuries involved the face, including four adjacent to the eye. Seven consumers developed skin injury following a single application, which in several instances was described as a small amount, including two who applied the product with a toothpick. When reported, time to symptom onset ranged from immediate (5) to within 24 hours (4), to 2 to 3 days (2) to one week (1). Twelve cases stated or implied that they sought medical care. Several required antibiotics (4), wound care (3), and/or hospital care (3). A dermatologist advised one person to have a skin graft. Figure 1 depicts representative injuries.

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