Skin tags are common and usually harmless, but having many skin tags—especially on the neck, armpits, eyelids, groin, or under the breasts—can be a clue to insulin resistance. They do not prove diabetes. The useful next step is not self-diagnosis, but asking a clinician whether blood sugar and metabolic testing make sense. 1 3 4
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See if you qualify →Can skin tags be a sign of insulin resistance?
Yes, they can be a clue—but not a diagnosis. Skin tags are small, soft, benign growths of skin, also called acrochordons. Studies have found that people with multiple skin tags may be more likely to have insulin resistance, but many people with skin tags do not have a blood sugar problem. 1 4
What skin tags are
Skin tags often develop where skin rubs against skin or clothing, including the neck, underarms, groin, eyelids, and under the breasts. Friction, body size, genetics, age, and pregnancy can all play a role. 3
Why a few skin tags often mean nothing
A single skin tag—or a few—does not tell you whether you have insulin resistance. They are common in the general population, and their presence alone is not a reason to assume you have prediabetes or type 2 diabetes. 2
Why multiple or new skin tags can be a metabolic clue
The association becomes more useful when someone has many skin tags, especially alongside central adiposity, a family history of type 2 diabetes, high blood pressure, abnormal cholesterol, polycystic ovary syndrome (PCOS), or darker velvety patches in skin folds. These features can justify a conversation about metabolic testing. 2 4 7
How are skin tags connected to insulin resistance?
Insulin resistance means muscle, fat, and liver cells do not respond normally to insulin. The body may compensate by making more insulin, called hyperinsulinemia, while glucose levels can remain normal for a time. 7
Researchers have proposed that higher insulin levels may stimulate insulin-like growth factor receptors on skin cells, including keratinocytes and fibroblasts. That signaling may contribute to skin growth in some people, but it cannot prove why an individual skin tag formed. 5 6
Weight, friction, genetics, age, and pregnancy can contribute independently. In other words, skin tags may be a visible prompt to consider metabolic health—not a diagnosis made in the mirror. 3 6
What other skin changes can point to insulin resistance?
The most recognized skin finding is acanthosis nigricans: darker, thicker, velvety-looking skin. It often appears on the back or sides of the neck, armpits, groin, under the breasts, or knuckles. 5
Acanthosis nigricans and skin tags can occur together, and both have been associated with insulin resistance. Still, skin color and texture changes have other possible causes, so a clinician should assess new or concerning changes. 5 6
Do skin tags mean I have diabetes or prediabetes?
No. Skin tags do not mean diabetes or prediabetes, and some people with insulin resistance have no visible skin changes at all. Diabetes and prediabetes are diagnosed with blood tests, not with skin findings. 7
Symptoms such as increased thirst, frequent urination, unexplained weight loss, blurred vision, or recurrent infections deserve timely medical attention, but type 2 diabetes and prediabetes can also have no obvious symptoms. 7
What tests can help check insulin resistance or diabetes risk?
A clinician chooses testing based on your symptoms, health history, medicines, and risk factors. A1C and fasting glucose are common starting points; an oral glucose tolerance test can be useful in selected situations. 7
| Test or assessment | What it can help assess | Important limitation |
|---|---|---|
| Fasting plasma glucose | Blood glucose after fasting | A normal result does not rule out every form of metabolic risk. 7 |
| A1C | Average blood glucose over roughly the prior 2 to 3 months | Some health conditions can affect interpretation. 7 |
| Oral glucose tolerance test | How the body handles glucose over time | It takes longer and is not needed for everyone. 7 |
| Fasting insulin and metabolic markers | Possible insulin resistance context | There is no single fasting-insulin cutoff that diagnoses insulin resistance for everyone. 7 |
| Blood pressure, lipids, waist measure, PCOS review | Related cardiometabolic risk factors | These findings need interpretation in the full clinical picture. 7 |
If you have irregular periods, acne, excess facial or body hair, or difficulty with weight changes, asking whether PCOS evaluation is appropriate may also be reasonable. PCOS is associated with a higher risk of impaired glucose regulation. 7 For more on recognizing possible risk factors, read our guide to how to know if you have insulin resistance.
Do skin tags fall off if you stop eating sugar or lose weight?
Usually, no. Existing skin tags usually stay unless they are physically removed. Better nutrition, activity, sleep, and weight management can support metabolic health, but there is no good evidence that these changes reliably make current skin tags fall off. 2 3
If removal matters to you, a qualified clinician or dermatologist can confirm that the growth is a skin tag and discuss safe options. Do not remove skin tags at home without clinical guidance: bleeding, infection, scarring, and mistaking another skin condition for a skin tag are real risks. 10
What actually helps insulin resistance?
The best-supported approach is a plan built around food patterns you can maintain, regular physical activity, sleep, and care for weight-related risk when relevant. Lifestyle change reduced diabetes risk by 58% over about 2.8 years in the Diabetes Prevention Program among adults with elevated glucose and overweight; individual results vary. 8
- Nutrition: A lower-glycemic, minimally processed eating pattern can help some people manage glucose and appetite. A prediabetes diet can be a practical place to start. 7
- Activity: Both aerobic activity and resistance training can improve insulin sensitivity and support muscle health. 7
- Sleep and stress: Poor sleep can make glucose management harder, so sleep is a useful part of a broader plan. 7
- Medication: A clinician may consider medication based on test results, body weight, medical history, and goals. It is not a skin-tag treatment. 7
Prescription weight-management medicines can cause side effects and are not right for everyone. Semaglutide and tirzepatide labels warn about gastrointestinal effects such as nausea, vomiting, diarrhea, constipation, and abdominal pain; they also carry contraindications, including a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. 9 10
| Your situation | A sensible next step | Why |
|---|---|---|
| A few stable, typical skin tags and no other concerns | Mention them at a routine visit if you want reassurance | Skin tags are common and are not diagnostic. 2 |
| Multiple skin tags plus metabolic risk factors | Ask about glucose, A1C, blood pressure, and lipid testing | The combination can justify metabolic evaluation. 4 7 |
| Velvety dark patches in skin folds | Arrange a clinical evaluation | Acanthosis nigricans can be associated with insulin resistance but has other causes. 5 |
| A painful, bleeding, dark, or rapidly changing growth | Seek prompt in-person assessment | Not every changing growth is a skin tag. 10 |
| Weight-related metabolic risk and interest in prescription care | Discuss eligibility with a licensed clinician | Medication decisions require an individual benefit-risk review. 7 9 10 |
3-min quiz
Want help discussing metabolic risk?
If weight-related metabolic risk is part of your picture, Chia providers can review your health history online and determine whether prescription treatment may be clinically appropriate. A prescription requires a medical evaluation and is not guaranteed. Compounded medications are not FDA-approved.
When can weight-loss treatment fit into insulin resistance care at Chia?
At Chia, weight-loss treatment is not a treatment for skin tags. It may be one part of care for eligible adults whose weight-related health risks and goals support prescription treatment after a licensed provider reviews their history. Learn more about insulin resistance treatment before deciding what to ask at a visit.
We offer compounded semaglutide by injection. Semaglutide is a GLP-1 receptor agonist drug class; Wegovy and Ozempic are brand-name semaglutide products. In the STEP 1 trial, once-weekly 2.4 mg semaglutide was studied alongside lifestyle intervention in adults with overweight or obesity; that trial does not establish outcomes for compounded formulations. 9 Compounded semaglutide through a state-licensed 503A pharmacy is not FDA-approved.
We also offer compounded tirzepatide as tablets or injection. Tirzepatide is a dual GIP/GLP-1 receptor agonist; Zepbound and Mounjaro are brand-name tirzepatide products. In SURMOUNT-1, tirzepatide was studied once weekly in adults with obesity or overweight; those results do not establish outcomes for compounded tirzepatide formulations. 10 Provider-guided microdosing plans are available when clinically appropriate, but dosing is individualized and never self-directed.
| Chia option | Available form | What to know |
|---|---|---|
| Semaglutide | Injection; plans currently start at $249/mo | A licensed provider evaluates eligibility and guides dosing over time. 9 |
| Tirzepatide | Tablets from $249/mo; injection from $299/mo | Microdosing plans may be available when clinically appropriate; provider guidance is required. 10 |
| Weight + Energy protocol | Compounded NAD+ injection plus a choice of GLP-1; from $309/mo | A clinician determines whether any component fits your health needs. Compounded NAD+ is not FDA-approved. 7 |
| Weight + Muscle protocol | Compounded sermorelin injection plus a choice of GLP-1; from $329/mo | A clinician reviews risks, goals, and whether treatment is appropriate. Compounded sermorelin is not FDA-approved. 7 |
Our process is fully online: you complete a health questionnaire, a licensed US provider reviews it, and medication is prescribed only when clinically appropriate. If prescribed, medications are compounded by state-licensed US 503A pharmacies and shipped to your door. Patients can message their care team through the portal between visits. You can also review the Weight + Energy protocol and Weight + Muscle protocol pages for current details.
When should you get skin tags checked urgently?
Most typical skin tags are not urgent. But a changing or painful growth should not be assumed to be a skin tag. Arrange prompt evaluation if a growth bleeds, becomes painful, changes quickly, turns very dark or irregular, appears unusual, or leaves you unsure what it is. 10
A dermatologist can help identify and remove concerning or bothersome growths. A primary care or metabolic clinician can help evaluate blood sugar, blood pressure, cholesterol, PCOS concerns, and other cardiometabolic risks. 7
Insulin resistance means the body’s cells do not respond normally to insulin. The body may make more insulin to keep blood glucose in range, and over time this can raise the risk of prediabetes and type 2 diabetes. 7
Some people have no symptoms. Possible warning signs include increased thirst, frequent urination, blurred vision, unexplained weight loss, fatigue, and recurrent infections. Blood testing is the only way to diagnose diabetes or prediabetes. 7
It is safer to have a clinician confirm the diagnosis and discuss removal. Home removal can cause bleeding, infection, scarring, or delay assessment of a growth that is not actually a skin tag. 10
3-min quiz
Start a clinician-reviewed metabolic care conversation
If you are concerned about skin tags, blood sugar, or weight-related metabolic risk, start with an online eligibility questionnaire. Our providers prescribe only when clinically appropriate, and a prescription is not guaranteed. See current details for semaglutide and tirzepatide.
References
- 1.Mathur SK, Bhargava P. Insulin resistance and skin tags. Dermatology. 1997.
- 2.Crook M. Skin tags: a useful clinical sign for insulin resistance? European Journal of Dermatology. 2012.
- 3.García Hidalgo L. Dermatological complications of obesity. American Journal of Clinical Dermatology. 2002.
- 4.Tamega AA, Aranha AM, Guiotoku MM, et al. Association between skin tags and insulin resistance. Anais Brasileiros de Dermatologia. 2010.
- 5.Hermanns-Lê T, Scheen A, Piérard GE. Acanthosis nigricans associated with insulin resistance: pathophysiology and management. American Journal of Clinical Dermatology. 2004.
- 6.Barbato MT, Criado PR, Silva AK, et al. Association of acanthosis nigricans and skin tags with insulin resistance. Anais Brasileiros de Dermatologia. 2012.
- 7.American Diabetes Association Professional Practice Committee. Standards of Care in Diabetes—2026. Diabetes Care. 2026.
- 8.Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine. 2002.
- 9.Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine. 2021.
- 10.Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine. 2022.
About this article
Chia Health Editorial Team — Evidence-reviewed health education
This article is for educational purposes only and is not a substitute for individualized medical advice. Talk to a licensed clinician before starting, stopping, or changing any prescription.
AI tools may assist with research and drafting. Chia's editorial team reviews source use, clarity, treatment information, and safety framing before publication. A clinician is named only after explicit sign-off. Read our editorial standards.
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