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 crop of new skin tags appearing over a few months is a different observation from a handful accumulating over a decade, and the two deserve different responses. The usual explanations for a genuine increase are weight gain, pregnancy or hormonal change, and — the one that matters most — insulin resistance. The tags themselves remain harmless. The value lies in what a change of pace may be indicating, and that depends on how many, how fast, and where.
First: How Sudden Is Sudden?
Almost nobody notices a skin tag on the day it forms. What is usually described as “sudden” is the moment a threshold is crossed — a collar catches, a necklace snags, or a photograph shows a cluster that was not obvious in the mirror. Working out what actually happened means separating the appearance rate from the noticing event.
Three patterns cover most cases, and they carry different weight:
| Pattern | What it usually reflects | Reasonable response |
|---|---|---|
| A few tags accumulating over several years | Baseline biology — friction, genetics and age. Tags are found in about 46% of adults and become more common with each decade | Removal if they are a nuisance; nothing further |
| A distinct crop over six to twelve months, especially on the neck or underarms | The pattern most associated with metabolic change, particularly insulin resistance | Worth raising with a GP alongside removal |
| A rapid increase during pregnancy | Hormonal change plus weight and skin folding — expected and benign | Reassurance; removal deferred if preferred |
The distinction that matters is not the total number of tags you have. It is whether the rate has changed.
What Changed in the Last Year?
Where the rate has genuinely increased, something usually accounts for it. Working back through the previous twelve months answers the question more often than any test does:
- Weight. The commonest single explanation, and it acts through two separate routes — more skin folds and more friction, plus the metabolic changes that accompany weight gain.
- Pregnancy. A classic trigger, typically in the second and third trimesters. Some tags settle afterwards; most persist. Timing of removal is covered in skin tag removal during pregnancy.
- Hormonal transition. Perimenopause and menopause, and conditions such as polycystic ovary syndrome, which works through the same insulin pathway.
- Blood sugar drifting. Often silent, which is precisely why the skin sign is useful.
- A change in what rubs. A new uniform collar, a heavier necklace worn daily, a bra that fits differently, a job involving a strap. Mechanical causes are easy to overlook because they feel too mundane to matter.
If none of these apply and the increase is modest, baseline biology remains the likeliest answer. The mechanism — why friction and growth signalling produce tags in the first place — is set out in what really causes skin tags.
How Many Counts as “A Lot”?
This is the question patients most want answered and the one most articles avoid. The published work provides a usable anchor: in a case-control study, patients with more than 30 skin tags had diabetes rates above 50% (Rasi et al., International Journal of Dermatology, 2007). A 2023 meta-analysis confirmed a significant association between skin tags and insulin resistance overall (Zohora et al., Int J Dermatol), and neck and axillary tags remain associated with insulin resistance even after correction for weight (Tamega et al., An Bras Dermatol, 2010).
Two qualifiers keep that in proportion. Tags are common in the general population, so most people with several have nothing metabolically wrong. And the association is with the pattern rather than any single lesion — a dozen new tags across the neck carries more information than one large tag anywhere.
One additional sign raises the index of suspicion considerably: acanthosis nigricans, the darker, velvety skin change that appears at the back of the neck or in the armpits. Tags and acanthosis are found together often enough to be described as twin signs of high circulating insulin (Barbato et al., An Bras Dermatol, 2012). If both are present in the same area, the combination is a stronger prompt than either alone.
What to Do, in Order
“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.”— Mr Onur Gilleard, Consultant Plastic Surgeon
- Have the lesions confirmed as tags. This comes first, always. A crop of soft stalked tags is one thing; a single firm, pigmented or bleeding lesion among them is another matter entirely.
- Ask your GP for an HbA1c if the increase has been noticeable over months, particularly with neck or underarm clustering, or alongside weight gain. It is a single blood test.
- Address the friction you can control — collars, straps, jewellery, keeping folds dry. This does not remove what is there but influences the rate of new ones.
- Have them removed when it suits you. There is no clinical urgency for a confirmed benign tag, and removal is unaffected by whether the metabolic question is resolved first.
The detail behind step two — what the evidence shows and what the result would mean — is in skin tags and insulin resistance and what skin tags can be a warning for.
What This Does Not Mean
Three limits are worth stating plainly, because this topic attracts overstatement in both directions.
- A crop of tags is not a diagnosis of diabetes
- It is a prompt for a test, nothing more. A normal HbA1c ends the question, and plenty of people with many tags have entirely normal results.
- Improving metabolic control will not clear the tags you already have
- Once formed, a tag remains until it is removed. Weight loss and better insulin sensitivity may reduce how many new ones appear — biologically plausible and consistent with clinical observation, though not demonstrated in clinical trials.
- A rapid increase is not itself dangerous
- The tags are benign whatever their number. What warrants attention is a lesion that does not behave like a tag, which is a different question from how many tags there are.
“If a skin tag is firm, pigmented, growing quickly, bleeding without being caught, or simply doesn’t look like its neighbours, I’d want it examined and possibly biopsied rather than just snipped off.”— Mr Onur Gilleard
In the largest published series of lesions removed as presumed skin tags, five of 1,335 proved malignant on histology (Eads et al., Archives of Dermatology, 1996) — rare, but the reason every lesion is examined before removal. See are skin tags dangerous.
Clearing a Crop
Numbers are rarely the obstacle. Between 20 and 30 small tags can be treated in a single session under local anaesthetic; the limiting factors are anaesthetic dose and patient comfort rather than technique. Larger tags requiring formal excision take longer, so three or four is realistic in one visit. Significant scarring occurs in fewer than 2% of tag removals at this clinic, and snip excision of a narrow-stalked tag frequently leaves no visible mark.
“I had a tag removed and was really nervous, but the team made me feel so comfortable — it was such a simple, quick process. Would definitely recommend.”
| Item | Price |
|---|---|
| Consultation | £100 |
| Skin tag removal (first) | £200 |
| Each additional tag | £125 |
Because each additional tag is charged at a lower rate, clearing a cluster in one visit costs considerably less per lesion than returning repeatedly — the arithmetic is set out in the cost guide, and session limits in how many can be removed at once. Appointments: skin tag removal in Harley Street.
Frequently Asked Questions
- Why have I suddenly got lots of skin tags?
- A genuine increase over months is most often linked to weight gain, pregnancy or hormonal change, or insulin resistance. Friction and genetics set the baseline rate; those factors change it. It is also worth checking whether the tags appeared suddenly or were simply noticed suddenly, since the two point in different directions.
- How many skin tags is too many?
- There is no threshold at which tags become harmful. As a signal, one published case-control study found diabetes rates above 50% in patients with more than 30 tags. What matters more than the total is whether the rate of new ones has increased, and whether they cluster on the neck or in the armpits.
- Does this mean I have diabetes?
- No. It means a simple blood test is worth requesting. Many people with numerous tags have entirely normal results; the association is statistical, not diagnostic. A normal HbA1c closes the question.
- Why are they mostly on my neck and underarms?
- Those are the highest-friction sites, and they are also the sites most associated with insulin resistance in the published studies. In a classic survey, the armpits and neck were the two commonest locations overall.
- What is the dark velvety patch on my neck?
- That may be acanthosis nigricans, a skin change associated with high circulating insulin. Occurring together with a crop of tags in the same area, it strengthens the case for a blood-sugar check considerably. It is worth mentioning to your GP specifically.
- Will they go away if I lose weight?
- Existing tags will not. They remain until removed, regardless of metabolic improvement. Weight loss and better insulin sensitivity may reduce the formation of new ones, which is worth doing on its own merits, but it has not been proven in clinical trials.
- I am pregnant and covered in them. Is that normal?
- Yes. Pregnancy is one of the classic triggers, typically from the second trimester, driven by hormonal change alongside weight and increased skin folding. Some resolve after delivery, though most do not; removal can wait until after the pregnancy if preferred.
- Can they all be removed at once?
- Usually. Twenty to thirty small tags can be treated in a single session under local anaesthetic, with the limits set by anaesthetic dose and comfort rather than technique. Larger tags needing formal excision take longer, so those are done a few at a time.
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