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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Skin tags and warts can look similar but are completely different: a skin tag is a soft, smooth, benign flap of skin on a stalk, caused by friction; a wart is rough, firm and grainy, caused by a contagious virus (HPV). The quickest tells are texture and those tiny black dots warts often have. This guide shows how to tell them apart, why an accurate diagnosis matters, and how each is treated — a skin tag by snip, cautery or CO2 laser, a wart most often by CO2 laser or excision.
London Skin Clinic, led by GMC-registered consultant surgeons, provides expert differential diagnosis and same-day removal. Our ‘See and Treat’ protocol ensures precise identification and tailored treatment for various skin lesions, prioritising safety and aesthetic results. Book a consultation.
Skin Tag vs. Wart: Understanding the Core Differences
Distinguishing between a skin tag and a wart is essential because their causes, characteristics, and treatments differ. A skin tag is a benign, non-contagious skin overgrowth; a wart is a skin infection caused by the contagious Human Papillomavirus (HPV). Accurate medical identification ensures safe, effective removal.
What is a Skin Tag (Acrochordon)?
A skin tag, medically acrochordon, is a soft, benign tumour that hangs off the skin. These growths are composed of loose collagen fibres and blood vessels surrounded by skin. They are typically flesh-coloured or slightly darker and are attached to the body by a thin stalk (a pedunculated lesion). Skin tags commonly appear in areas of friction, such as the neck, armpits, groin, and under the breasts.
What is a Wart (Verruca)?
A wart, or verruca vulgaris, is a growth caused by an infection with a strain of the human papillomavirus (HPV). Unlike skin tags, warts are contagious and can spread to other parts of the body or to other people through direct contact. They typically have a rough, grainy texture and may feature tiny black dots, which are clotted blood vessels. A filiform wart is a specific type that can resemble a skin tag due to its long, thin projection, making the skin tag vs wart distinction challenging for the untrained eye.
View data as table
| Feature | Skin Tag (Acrochordon) | Wart (Verruca) |
|---|---|---|
| Cause | Friction, genetics, hormonal factors | Human Papillomavirus (HPV) infection |
| Texture | Soft, smooth, fleshy | Rough, firm, grainy, sometimes cauliflower-like |
| Appearance | Attached by a thin stalk (pedunculated) | Often flat or raised, may have black dots |
| Contagious? | No | Yes, can spread via contact |
| Common Locations | Neck, armpits, groin, eyelids | Hands, fingers, feet, face |
Skin tag or wart? A quick visual guide from our Harley Street clinic — warts are rough and viral (contagious); skin tags are smooth, soft and caused by friction.
Why Accurate Medical Diagnosis is Non-Negotiable
While many skin growths are benign, some can signify serious conditions. Self-diagnosing or removing a lesion at home is risky. Misidentifying a malignant growth, such as nodular melanoma or basal cell carcinoma, as a harmless skin tag or wart can dangerously delay necessary medical treatment.
The Risks of Self-Diagnosis and At-Home Removal Kits
Over-the-counter removal kits, freezing sprays, and home remedies like tying off a lesion with thread are imprecise and can cause complications:
- Infection: Using non-sterile tools or creating an open wound can introduce bacteria, leading to localised or systemic infections.
- Scarring: Improper removal techniques can damage surrounding healthy tissue, resulting in permanent scarring or changes in skin pigmentation.
- Incomplete Removal: If the base of a wart or tag is not fully removed, it may regrow. For warts, this can also spread the virus.
- Misdiagnosis: The primary risk is failing to identify a lesion that requires urgent medical evaluation. You can learn more about when a skin growth might be a concern in our guide, Are Skin Tags Dangerous?
When to Consult a Specialist: Red Flags and Concerns
Consult a plastic surgeon or dermatologist if a skin lesion has any of the following characteristics:
- Rapid changes in size, shape, or colour.
- Multiple colours within the same growth.
- Asymmetrical shape or irregular borders.
- Bleeding, itching, crusting, or pain.
- Any new growth that appears after the age of 40.
A specialist performs a differential diagnosis to distinguish between conditions and determine the safest course of action.
The Consultant’s Approach: How Experts Differentiate Lesions
GMC-registered plastic surgeons use more than visual inspection for diagnosis. The clinical assessment of a skin tag vs. wart uses advanced techniques to ensure an accurate diagnosis for a safe treatment plan.
Visual Cues and Dermoscopic Examination
Consultants can often distinguish between common lesions by their clinical appearance, but use a dermatoscope for detailed analysis. Dermoscopy is a non-invasive technique that uses a high-powered magnifying lens with a light source to examine skin structures not visible to the naked eye. Under dermoscopy, a wart may reveal dotted or looped blood vessels (thrombosed capillaries), while a skin tag typically shows a uniform, fibrous structure.
The Role of Biopsy and Histopathology for Definitive Diagnosis
If a lesion is atypical or the diagnosis is uncertain, a biopsy is the next step. During a biopsy, a small tissue sample (or the entire lesion) is removed and sent for histopathology. A pathologist examines the tissue under a microscope to identify its cellular makeup. Histopathology is the gold standard for ruling out skin cancer and confirming a growth’s nature. This certainty is crucial before any removal procedure, a principle we cover in our article on the importance of a consultant-led assessment.
Tailored Removal: Different Treatments for Skin Tags and Warts
After diagnosis, the treatment plan is tailored to the lesion type, size, location, and the patient’s aesthetic goals. Skin tag removal methods differ from those for viral warts. All procedures are performed by consultant plastic surgeons to ensure high standards of care and optimal cosmetic outcomes.
Effective Skin Tag Removal Options
Because skin tags are benign surface growths, their removal is straightforward and focuses on an aesthetic result. Common methods include:
- Cryotherapy: Liquid nitrogen is applied to freeze the tag, causing it to fall off within one to two weeks.
- Surgical Excision: The tag is removed with a scalpel or surgical scissors, often under local anaesthetic. This is ideal for larger tags and ensures complete removal.
- Laser Vaporisation: A CO2 laser ablates the tissue layer by layer, offering a bloodless procedure with minimal scarring, suitable for facial lesions.
Advanced Wart Treatment Modalities
Warts are viral, so treatment aims to remove the growth cleanly while limiting spread. At London Skin Clinic our usual choices are:
- CO2 laser: our first choice for verrucas and facial warts — precise, single-visit, with the least scarring when used conservatively.
- Surgical excision: for a single raised common wart on the hand, limb or trunk, closed with sutures in one visit.
- Curettage & cautery: for filiform and fleshy warts.
- Cryotherapy: used only occasionally for warts — it needs several sessions and can leave pale patches, so we rarely freeze them.
Full options are in our wart & verruca removal guide, and proper aftercare is vital for healing.
View data as table
| Treatment Method | Typical Recovery Time (Days) | Best For |
|---|---|---|
| Cryotherapy | 5 – 14 | Small, clearly defined skin tags and common warts |
| Surgical Excision | 7 – 14 | Large or pedunculated skin tags; suspicious lesions requiring biopsy |
| CO2 Laser Vaporisation | 5 – 10 | Facial skin tags, achieving superior cosmetic results |
| Electrosurgery | 7 – 10 | Small to medium skin tags, providing rapid removal |
Experience Our ‘See and Treat’ Same-Day Service
Our “See and Treat” service for skin tags and other minor lesions includes a consultation, diagnosis by a consultant plastic surgeon, and removal in a single appointment at our clinics in Harley Street, St Albans, or Guildford.
Your Journey to Clearer Skin: What to Expect
The appointment includes a lesion assessment. The consultant discusses the diagnosis, confirms the optimal removal method, and answers questions. If you proceed, removal is performed immediately in our CQC-compliant facilities. Book Same-Day Skin Tag Removal today.
Conclusion
The distinction between a skin tag and a wart is a medical determination with implications for treatment and health. While they can appear similar, their underlying causes—a benign overgrowth versus a viral infection—demand different approaches. A diagnosis from a qualified consultant plastic surgeon or dermatologist ensures safety, rules out serious conditions, and achieves the best aesthetic outcome. If you have a concerning lesion, schedule a professional assessment.
Contact us to schedule your consultation or Book Same-Day Skin Tag Removal with one of our specialists.
Frequently Asked Questions
What does a consultant look for under a dermatoscope to differentiate a skin tag from a wart?
During a diagnostic examination, a consultant like Mr. Onur Gilleard uses a dermatoscope to magnify the lesion. For a skin tag, they will identify a soft, pedunculated (stalk-like) structure with a smooth surface. In contrast, a wart will often reveal a rough, papillomatous surface with tiny black dots, which are thrombosed capillaries (blood vessels), a definitive sign of HPV infection not present in skin tags.
Why can’t I use a skin tag freezing kit from a pharmacy on a wart?
Over-the-counter freezing kits typically reach temperatures of around -57°C, which is often insufficient to fully destroy the viral tissue of a wart. Clinical cryotherapy used by our consultants uses liquid nitrogen at -196°C for a more effective and targeted treatment. Using a pharmacy kit on a wart can lead to incomplete removal, spreading the HPV virus, and increasing the risk of scarring or skin discolouration.
Could a growth that looks like a wart or skin tag ever be a sign of skin cancer?
Yes, although uncommon, certain skin cancers can mimic benign lesions. For instance, a nodular basal cell carcinoma can sometimes resemble a wart or a firm skin tag. This is why a professional medical diagnosis is a critical safety step; our consultant-led ‘See and Treat’ service ensures any suspicious features are identified before any removal procedure is considered.
How does your ‘See and Treat’ service handle a case where the diagnosis is uncertain?
Our ‘See and Treat’ protocol is designed for diagnostic certainty. The initial part of the appointment is a thorough consultation where the consultant provides a definitive diagnosis. If there is any ambiguity in the skin tag vs wart assessment, or if a lesion looks atypical, they will advise on the safest next step, which could be a biopsy rather than immediate cosmetic removal.
Is the removal process different for a skin tag on the eyelid versus a wart on the hand?
Absolutely. A skin tag on a delicate area like an eyelid requires a plastic surgeon’s precision, often using fine surgical scissors or hyfrecation (electrosurgery) to minimise scarring. A common wart on the hand is more robust and may be treated with cryotherapy or laser. The choice of modality is tailored to the diagnosis, location, and aesthetic outcome, which is why an accurate initial assessment is paramount.
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