Genital warts vs. skin tags: How to tell the difference

Genital warts and skin tags are different skin conditions that resemble each other. However, they are not typically harmful and do not develop into cancer.

Genital warts, or anogenital warts, are a symptom of HPV infection that take the form of small lumps in the anal and genital regions, including:

• the penis, including under the foreskin in those who have not had a circumcision
• around or inside the vagina
• around or inside the anus, most often in people who receive anal intercourse
• the area between the anus and genitals, or perineum

Experts estimate that 10% to 20% of people in the United States have HPV, but only 1% experience symptoms.

However, skin tags most commonly affect the following areas:

• neck
• eyelids
• underarms
• beneath the breasts

Genital warts and skin tags have different appearances. This can help individuals to identify which condition they may have.

However, a healthcare professional should check any new growths on the skin.

Genital warts may have the following characteristics, although they may appear differently on different people:

• They may appear on their own or in clusters that look a little like cauliflower.
• They can have different colors but often take on the color of the skin around them or turn slightly darker.
• They might feel either firm or soft.

Genital warts do not often cause symptoms once they appear, but a person may experience itching, pain, or bleeding. They may also lead to uncomfortable or painful sex and discomfort or frequent starting and stopping while passing urine.

Skin tags can resemble genital warts as they are often the same color as the skin or darker. They can also show signs of redness, discoloration, or irritation.

However, skin tags are generally soft and attach to a fleshy stalk known as a peduncle. They are often small but can grow to 2 to 5 centimeters (cm).

More research is necessary to confirm the cause of skin tags. However, genital warts are a result of HPV infection.

The main cause of genital warts is the HPV virus. HPV is the most common sexually transmitted infection (STI) in the United States. There are various types of HPV, and some do not cause any symptoms. However, certain types of HPV can lead to genital warts or cancer.

HPV is generally preventable with the vaccine.

HPV does not always cause genital warts, and the immune system often prevents their development by protecting the body from the virus. However, in people with compromised immune systems, such as those with late stage HIV or who have undergone cancer treatment, genital warts may be more likely to develop.

Warts may not develop for weeks or even months after acquiring HPV.

The cause of skin tags is not clear, although some healthcare professionals theorize that friction contributes to them. This is because most skin tags grow in skin folds where the skin is more likely to encounter rubbing. They may also result from the natural aging process as skin tissue loses elasticity.

People with obesity or diabetes also have a higher risk of skin tags. Some theories suggest that obesity increases the number of skin folds, while others link the cells’ reduced response to insulin to their development.

A genetic disorder called Birt-Hogg-Dube syndrome can lead to excess skin tags along with other symptoms.

People do not always require treatment for genital warts, and removing skin tags is typically a cosmetic or elective procedure. People with skin tags do not usually require treatment but may choose it.

If a healthcare professional recommends genital wart treatment, it may include:

• ointments, liquids, or creams
• cryotherapy, which involves freezing off the warts over several sessions
• surgical removal, in which a healthcare professional numbs the area with an anesthetic and removes the warts using a scalpel, laser, or heat

However, treatment depends on the appearance of the warts and where they develop. Genital warts often return after treatment, and HPV may still transmit from person to person after the warts have resolved.

People who have had genital warts can get them again, either from recurring HPV or from a new infection.

People can choose to undergo treatment to remove skin tags for cosmetic reasons or because they regularly catch on clothes. Cryotherapy and surgical removal can also remove skin tags.

Other treatment options include electrosurgery or a healthcare professional tying a band around the top of the skin, which may help it eventually fall off.

A person should not try to remove skin tags on their own. This can lead to infection, scarring, and bleeding.

Genital warts may be preventable using barrier methods during sex, such as a condom. Even though this reduces the risk of transmission, the virus passes from one person to another through skin-to-skin contact. If the condom does not cover the area with warts, HPV may still transmit.

Another option for preventing genital warts is the HPV vaccination. Two types of HPV, 6 and 11, cause 90% of all genital warts, and the HPV vaccine provides protection against both of these, among other types. However, it is only effective before a person acquires the virus.

The Centers for Disease Control and Prevention (CDC) recommends this vaccine for children ages 11 to 12 years. People can still receive the vaccine over 25 years of age if they did not complete the course of the vaccine when they were younger.

A small study of people with skin tags found that a high proportion had HPV, but this research only included 49 individuals. No conclusive evidence links skin tags and HPV, but they may appear similar to genital warts, which occur due to HPV.

Around 30% of genital warts resolve without treatment in 4 months.

Genital warts and skin tags look similar but develop for different reasons. Skin tags often develop on the folds of the neck and armpits, while genital warts only appear on the penis, vagina, anus, or perineum.

Skin tags commonly hang from peduncles and can grow up to 5 cm long.

Genital warts occur due to STIs called human papillomavirus (HPV). More research is necessary to confirm the cause of skin tags.

Both are treatable, but it is not possible to prevent skin tags. Condoms and the HPV vaccine can help reduce a person’s risk of genital warts.

A healthcare professional should check any new growths or bumps on the skin.