[Question #7217] New Data about HPV and skin tags

8 months ago
Hello Doctors, grandly appreciative of your bodies of work and this remarkable site you maintain.  
My question is in regards to the newer studies finding HPV (especially wart causing strands) DNA via PCR in skin tags.  Does this indicate that skin tags could be infectious like genital warts?  I am 38yo straight male and did not have the benefit of the HPV vaccine, and I suspect after having over 4 partners in my life I could have EVERY strain of HPV... i also (possibly) may have found a skin tag near my arm pit recently.  It is hard to say as it is not really 'stalky' and could be simply be a pore with sebaceous hyperplasia which i occasionaly suffer from...  in any regard my thoughts on hpv was generally, if a wart were to show up or some precancerous tissue, then you would generally want to share that with a partner or potential partner, otherwise invisble hpv is so common, perhaps it wouldnt be worth discussing...
But maybe skin tags now change the game, as that is a physical manifestation of hpv that should be discussed with a partner? How should I view this situation as a responsible sex partner?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
Welcome to the forum. Thanks for your confidence in our services.

I am unaware of any "newer" (or older) studies showing HPV in skin tags. A single report 12 years ago, from India, reported HPV6 or 11 (the main wart causing types) in half of the skin tags they sampled. Another study, a couple years later, found no HPV DNA in a large number of skin tags. Neither report came from a recognized research group. The consensus remains that skin tags are entirely unrelated to HPV -- that the India report was mistaken. The National Library of Medicine website for the world's medical literature (PubMed) shows no more recent studies. If you can cite a scientific report, I'll be happy to look at it. In additoin, I have emails a colleague who is one of the world's top HPV experts -- I'll add a follow-up comment when she replies. In the meantime, I remain confident that skin tags have nothing to do with HPV and that you needn't worry at all about the one you describe. (I can't comment on your uncertainty about skin tag versus "sebaceous hyperplasia". Since you are uncertain yourself, consider seeing a doctor, maybe a dermatologist. OTOH both these conditions are harmless, and if I were you I probably would just live with it without worry.)

I hope these comments are helpful. Let me know if anything isn't clear -- or link me up with the scientific report(s) you are referring to.

HHH, MD
---
---
8 months ago
Thank you for the (very rapid!) response, Dr.H! I believe this study cites the most recent  studies i know of collectively...  hopefully this is helpful.  I look forward to your further reply... let me know also if this link is faulty or insufficient in any way.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6246066/
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
Thanks for the citation. It looks valid, scientifically. It has stimulated discussion between me and Dr. Hook, and we are waiting for the assessment of the HIV expert colleage mentioned in my initial reply. If HPV indeed is associated with many skin tags, it's an intereating new development that may change overall understanding. But even so, I doubt this is important from a standpoint that affects persons with HPV or skin tags. Certainly there is nothing to suggest that HPV is ever transmitted by other than the most intimate contact, and it is hard to believe that non-genital skin infections are important. The thing to keep in mind about tthe many HPV types is that they are universal among humans. All humans carry E. coli in our intestines, staph on our skin, and strep in our throats and on our skin. Onc e in a while, these cause serious and even fatal infections -- but for the most part they are harmless. Much the same for HPV:  look at it as a normal thing to have the virus -- for most of us, several differnt types. That some of them are sexually transmitted eoesn't make them any more serious or worrisome. Everybody is infected, has been, or will be. Happily, the large majority cause no important health outcomes -- and that includes the high-risk (cancer-causing) types. It's just part of life. And vaccination can prevent most of the serious outcomes.

So if I were you, skin tags and atll, it would make no difference at all to me or my loved ones. (Based on my lifestyle at certain times, I assume I have been infected serveral times and still carry HPV DNA. I don't care and neither should you. Whether your non-genital skin tags are related to HPV or not, it should make no difference to you. I doubt you can infect anyone and I see no realy to mention it to sex partners or anyone else. They're all going to have or acqurie HPV anyway/.

I'll let you know if I learn more when we heasr back from our HPV expert colleagues.
---
---
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
We heard back about this from a colleague who is a world-renowned HPV researcher (who must remain unidentified). She is a PhD epidemiologist and prevention expert, not a clinician, and not necessarily an expert in the biology of HPV, although she certainly is more knowlegeable in those areas than me or Dr. Hook. She reacts to the research article you cited.

This is interesting, and not something that I'd previously come across in the literature or otherwise. The data from these few studies does seem to suggest that HPV is detectable in some skin tags - and possibly could play a role in their formation (though my understanding is that once removed, skin tags don't tend to recur in the same location in healthy individuals - is that correct? If so, it seems less likely that HPV plays a causal role.) I agree with Ned that they are unlikely to be an important source of transmission....

To answer her question to me and Dr. Hook, it is indeed correct that skin tags do not recur either immediately after removal or later -- which of course is common with warts. In addition, I am entirely unaware of anyone with skin tags who went on to developed more typical warts in the same general area; nor do the partners of persons with skin tags seem to have an elevated risk of warts or other HPV infections. I suppose this could be happening silently, and maybe someday someone will conduct research on this. But for now, I really wouldn't worry about skin tags. I will continue to advise patients with skin tags not to worry and to assume they do not indicate a transmissible HPV infection.

Let me know if you have any final comments or questions. Thank you for raising this interesting issue; I'll be bookmarking this discussion for use in event of future questions about skin tags.


---