Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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A single skin tag means nothing. But a cluster of new tags — especially on the neck and armpits — is a recognised skin marker of insulin resistance, the metabolic state underlying type 2 diabetes. The evidence is solid: a 2023 meta-analysis confirmed the association, and in one case-control study patients with more than 30 tags had a diabetes rate above 50%. This isn’t a reason to panic — it’s a reason to have a simple HbA1c blood test. This guide explains the mechanism, what the evidence actually says, whether better control makes tags disappear (it doesn’t), and where removal fits in.
Why Insulin Resistance Causes Skin Tags
When the body becomes resistant to insulin, blood levels of insulin and a related growth factor (IGF-1) rise. Both stimulate the skin’s surface cells (keratinocytes) and the fibroblasts beneath them to proliferate — and in the folds where skin already rubs on skin, that extra growth signal produces the soft, stalked overgrowths we call skin tags. That’s why tags cluster exactly where friction and insulin effects overlap: the neck, armpits, groin and under the breasts. The tags themselves remain completely harmless — they’re a signal, not a disease.
What the Evidence Actually Shows
This is one area where the research is genuinely strong rather than anecdotal, which is worth being precise about:
- A 2023 meta-analysis confirmed a significant association between skin tags and insulin resistance (Zohora et al., Int J Dermatol 2023).
- In a case-control study, patients with more than 30 skin tags had a diabetes rate of over 50% (Rasi et al., Int J Dermatol 2007).
- Neck and axillary tags remain independently associated with insulin resistance even after adjusting for body weight (Tamega et al., An Bras Dermatol 2010) — so this isn’t simply “a marker of being heavier”.
- For context on how common tags are generally: a classic European study found them in 46% of adults, most often in the armpits and neck, increasing with age (Banik & Lubach, Dermatologica 1987).
The honest reading: not every skin tag means diabetes — they’re very common in the general population. But a sudden crop of them, particularly around the neck, is worth a blood-sugar check.
The Twin Sign: Acanthosis Nigricans
Skin tags often appear alongside acanthosis nigricans — velvety, darkened, slightly thickened skin, typically at the back and sides of the neck, in the armpits and other flexures. The two are so consistently found together in insulin resistance that they’re sometimes described as “twin signs” of metabolic dysfunction (Barbato et al., An Bras Dermatol 2012), and for the same reason: excess insulin acting on IGF-1 receptors in the skin drives both the pigmented thickening and the stalked tags, in the same body folds.
Practically, if you have darkened velvety patches on your neck and a crop of tags, that combination is a stronger prompt for a metabolic review than either alone.
Neck and Armpit Clusters
Location matters. Isolated tags anywhere are unremarkable; clusters on the neck and in the armpits are the pattern most strongly linked to insulin resistance — and, as above, that link holds even after accounting for weight. In clinic, a patient arriving with a fresh crop of neck tags over months rather than years is the profile where Mr Gilleard routinely suggests a blood-sugar check, alongside removing the tags that bother them. Sudden multiplication is covered further in why am I getting so many skin tags? and the broader signal in what skin tags can warn of.
What to Do — the HbA1c Conversation
Here’s exactly how Mr Gilleard frames it with patients:
“Skin tags themselves are harmless, but a cluster of new ones can be the skin’s way of hinting at insulin resistance. It’s worth a simple HbA1c blood test with your GP. If it’s normal you’ve lost nothing, and if it’s not, you’ve caught something early.”
That’s the whole action: ask your GP about an HbA1c (a blood test showing average blood sugar over about three months), and mention the tags and any velvety neck darkening. No panic, no self-diagnosis — just a test that either reassures you or catches something at a stage where it’s very manageable.
A man in his forties came in with a crop of new tags on his neck that had appeared over about a year. They were removed, and he was advised to ask for an HbA1c — which came back in the pre-diabetic range. Two years on, having lost weight, he has had almost no new tags.
Does Better Control Make Tags Disappear?
No — and it’s important to be straight about this. Existing tags don’t vanish with better metabolic control; once formed, they stay until they’re removed. What may change is the tendency to form new ones: because raised insulin appears to drive their growth, weight loss and improved insulin sensitivity plausibly reduce how many new tags appear — as in the case above. That said, this hasn’t been proven in clinical trials, so it’s a reasonable expectation rather than a promise. Equally, no cream or supplement prevents them.
Where Removal Fits In
Removing skin tags is purely about comfort and appearance — it has no effect on insulin resistance or diabetes risk, and new tags can form while the underlying driver persists. That’s not a reason to leave ones that catch on collars and jewellery. In clinic, small tags are removed by snip excision or hyfrecation under local anaesthetic in seconds, with no stitches, and we can treat up to around 20–30 small tags in a single visit — the limit being anaesthetic dose and comfort rather than technique, which makes clusters very practical to clear in one go. We don’t use freezing for tags, as it risks permanent pale patches on the neck. Removal is £200 for the first tag, £125 for each additional tag, consultation £100. Book an assessment or call 0203 916 6200.
One safety note that applies to everyone with many tags: have anything that doesn’t look like its neighbours — firm, pigmented, growing, or bleeding unprovoked — examined rather than simply removed. Diabetes also means slower healing, so home removal is a particularly bad idea — see what goes wrong.
Your Questions, Answered
- Do skin tags mean I have diabetes?
- Not on their own — tags are very common, found in around 46% of adults. But multiple new tags, especially neck and armpit clusters, are associated with insulin resistance: a 2023 meta-analysis confirmed the link, and patients with more than 30 tags had a diabetes rate above 50% in one case-control study. A sudden crop is worth an HbA1c check.
- What test should I ask for?
- An HbA1c blood test with your GP — it shows your average blood sugar over about three months. Mention the tags and any velvety darkening of the neck. If it’s normal you’ve lost nothing; if it’s raised, you’ve caught it early.
- What is the velvety dark skin on my neck?
- That’s likely acanthosis nigricans, another skin marker of insulin resistance. Tags and acanthosis nigricans are so often found together that they’re described as “twin signs” of metabolic dysfunction — the combination is a stronger prompt for a metabolic review than either alone.
- Will my skin tags disappear if I lose weight or control my blood sugar?
- Existing tags won’t disappear — once formed they stay until removed. Improved insulin sensitivity and weight loss may reduce how many new ones appear, though that hasn’t been proven in trials. No cream or supplement removes or prevents them.
- Is it just because I’m overweight?
- Not entirely. Weight contributes through friction and metabolic effects, but neck and axillary tags remain independently associated with insulin resistance after adjusting for weight (Tamega et al., 2010) — which is why the tags themselves are treated as a signal worth checking.
- Can lots of tags be removed in one session?
- Yes — up to around 20–30 small tags in a single visit under local anaesthetic, limited by anaesthetic dose and your comfort rather than technique. Larger formal excisions are limited to a few per session. Removal is for comfort and appearance; it doesn’t change the underlying tendency.
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