Fire or the blade?
July 21, 2023 11:51 PM Subscribe
I have a large number of skin tags on my upper and lower eyelids. I have two options for their removal.
I'm hoping people will chime in either with their personal experience or medical advice, as I'm unsure about which option to choose.
Option 1: Surgical removal
I've had a consultation with an eye surgeon. His approach is to cut them off. Apparently no stitches are required. The eye area will be frozen. I'll likely develop black eyes as part of the healing process.
He has never worked on me before. He did a similar procedure for a close relative, and it was fine, although I don't think it was as thorough a job as it could have been (but that was also a much larger growth that needed to be removed.) Estimated cost: north of $500.
Option 2: Dermatological procedure
When visiting my dermatologist I asked if there was anything I could do to prevent future skin tags (and, as expected, there isn't), but he told me that he could easily remove the existing ones the same way he was removing other moles on my face, by burning them off with a small wand. There would be no freezing applied.
He has removed facial moles for me in the past and I trust him with those procedures, including one on the side of my nose near the eye. But I'm worried about heat being applied directly to the eye lid and possibly damaging the eye. I'm also concerned about the sensitivity of the eyelids and possibly flinching. Again, I don't want to do anything that will harm my vision.
Cost: south of $100
I can afford the more expensive option (although I think he's overcharging), but I'm never in favour of spending money needlessly if I don't have to, so while cost is a factor, it's not the main one. In order of priority, I want to prevent anything from harming my vision, and have the growths removed in a way that will prevent scarring or other kinds of skin damage that may bother me in the future.
Which option would you pick and why?
I'm hoping people will chime in either with their personal experience or medical advice, as I'm unsure about which option to choose.
Option 1: Surgical removal
I've had a consultation with an eye surgeon. His approach is to cut them off. Apparently no stitches are required. The eye area will be frozen. I'll likely develop black eyes as part of the healing process.
He has never worked on me before. He did a similar procedure for a close relative, and it was fine, although I don't think it was as thorough a job as it could have been (but that was also a much larger growth that needed to be removed.) Estimated cost: north of $500.
Option 2: Dermatological procedure
When visiting my dermatologist I asked if there was anything I could do to prevent future skin tags (and, as expected, there isn't), but he told me that he could easily remove the existing ones the same way he was removing other moles on my face, by burning them off with a small wand. There would be no freezing applied.
He has removed facial moles for me in the past and I trust him with those procedures, including one on the side of my nose near the eye. But I'm worried about heat being applied directly to the eye lid and possibly damaging the eye. I'm also concerned about the sensitivity of the eyelids and possibly flinching. Again, I don't want to do anything that will harm my vision.
Cost: south of $100
I can afford the more expensive option (although I think he's overcharging), but I'm never in favour of spending money needlessly if I don't have to, so while cost is a factor, it's not the main one. In order of priority, I want to prevent anything from harming my vision, and have the growths removed in a way that will prevent scarring or other kinds of skin damage that may bother me in the future.
Which option would you pick and why?
I would get a second opinion from both another surgeon and another dermatologist. I absolutely do not fuck around and find out with my eyes or anything nearby. Then depending on those second opinions/information gathering I would make my choice.
Generally speaking I and my family members have had better aesthetic results when working with a dermatologist and better functional results when working with a surgeon. This makes sense, considering their respective areas of expertise. Since skin tags are usually just an aesthetic thing, I might err on the side of the derm in this case. Unless yours are interfering with your vision or at risk of infection, then I’d err on the side of the surgeon. I’m just talking out the way I would rationalize whichever choice I would make in your situation, when realistically it would come down to two things: vibes and money.
On the vibes side, go for the person whose practice makes you the least uncomfortable, and whose demeanor you feel matches you expectations for the job. If neither of them do, find someone else. On the money side, unfortunately for things like this a lot of the time more expensive does mean better. I might try to find the fanciest dermatologist around and ask for a consultation just to get a quote and an idea of what the ceiling is for non-surgical options and compare that to the surgeon’s bill. Or, speak to a couple surgeons to get a better scope of the expected cost that way and help gauge your trust in the one you’ve talked with already.
posted by Mizu at 2:16 AM on July 22, 2023 [4 favorites]
Generally speaking I and my family members have had better aesthetic results when working with a dermatologist and better functional results when working with a surgeon. This makes sense, considering their respective areas of expertise. Since skin tags are usually just an aesthetic thing, I might err on the side of the derm in this case. Unless yours are interfering with your vision or at risk of infection, then I’d err on the side of the surgeon. I’m just talking out the way I would rationalize whichever choice I would make in your situation, when realistically it would come down to two things: vibes and money.
On the vibes side, go for the person whose practice makes you the least uncomfortable, and whose demeanor you feel matches you expectations for the job. If neither of them do, find someone else. On the money side, unfortunately for things like this a lot of the time more expensive does mean better. I might try to find the fanciest dermatologist around and ask for a consultation just to get a quote and an idea of what the ceiling is for non-surgical options and compare that to the surgeon’s bill. Or, speak to a couple surgeons to get a better scope of the expected cost that way and help gauge your trust in the one you’ve talked with already.
posted by Mizu at 2:16 AM on July 22, 2023 [4 favorites]
My friend has had this exact burn off procedure for skin tags around her eye lids. It's done with a little hand cautery tool.
They all grew back almost immediately. Her take a week later: "this is bullshit, I feel like I got scammed."
I know it is absolutely possible to successfully remove skin tags with a hand caut, but I suspect with the thinness of the skin on the eyes you can't actually burn them off deep enough to get the root. (Speculative. I say this as a person who doesn't have skin tags, but has had a number of moles removed, and the ones that have been taken off flat without getting the root have all grown back.)
Anyway, based on my friend's experience I would go the surgery route no hesitation.
posted by phunniemee at 4:49 AM on July 22, 2023 [2 favorites]
They all grew back almost immediately. Her take a week later: "this is bullshit, I feel like I got scammed."
I know it is absolutely possible to successfully remove skin tags with a hand caut, but I suspect with the thinness of the skin on the eyes you can't actually burn them off deep enough to get the root. (Speculative. I say this as a person who doesn't have skin tags, but has had a number of moles removed, and the ones that have been taken off flat without getting the root have all grown back.)
Anyway, based on my friend's experience I would go the surgery route no hesitation.
posted by phunniemee at 4:49 AM on July 22, 2023 [2 favorites]
No direct experience but to me there’s a big difference between “near the eye” and “on the eyelid” (especially upper eyelid) which is functionally part of the eye. And the latter definitely suggests eye surgeon rather than dermatologist.
posted by staggernation at 7:39 AM on July 22, 2023 [3 favorites]
posted by staggernation at 7:39 AM on July 22, 2023 [3 favorites]
I went with the freezing process. Everything went smoothly and what was cut off remained cut off.
If I recall correctly the process was about $30 per tag removed (I added two that were pointed out by the technician during the procedure). $500 sounds exorbitant.
posted by Tell Me No Lies at 7:52 AM on July 22, 2023
If I recall correctly the process was about $30 per tag removed (I added two that were pointed out by the technician during the procedure). $500 sounds exorbitant.
posted by Tell Me No Lies at 7:52 AM on July 22, 2023
Eh, I have to disagree that within our current healthcare environment, fatally fucked as it may be (assuming anon is in the US in the absence of other info), $500 is exorbitant for someone to (successfully) operate on an important part of your flesh. You could pay that for someone to talk with you for 20 minutes and write a prescription. Of all the medical problems and specialties where one might consider bargain-hunting, this feels pretty low on the list.
posted by staggernation at 8:15 AM on July 22, 2023 [1 favorite]
posted by staggernation at 8:15 AM on July 22, 2023 [1 favorite]
Research the safety of each method, use the safest option regardless of cost.
posted by theora55 at 8:57 AM on July 22, 2023 [3 favorites]
posted by theora55 at 8:57 AM on July 22, 2023 [3 favorites]
My dermatologist sold me two tubes of pure Retinol, and gave me instructions to put a Q-Tip worth dot on each skin tag "as needed." The two tubes lasted me two years, and only a dab the size of the head of a pin was enough. The cost was around $200, but it was worth it. They do come back, so it's a continuing maintenance issue, but it was easy to do, and they usually disappeared about three days after the initial treatment.
posted by halfbuckaroo at 9:17 AM on July 22, 2023 [1 favorite]
posted by halfbuckaroo at 9:17 AM on July 22, 2023 [1 favorite]
[CW: links to videos of medical procedures]. Dr. Pimple Popper estimates that skin tag removal (on a neck) would cost about $100 back in 2012. Here's another video of Dr. Lee safely removing assorted growths from around the eye with "scissors." Honestly the "scissors" approach sounds much worse than it is (at least under the hands of a skilled doctor.)
posted by oceano at 10:28 AM on July 22, 2023
posted by oceano at 10:28 AM on July 22, 2023
I think anonymous may not be subject to the US healthcare hellscape, given the spelling of "favour" in their Ask and the prices they've been quoted. I second mizu's advice to seek other opinions, and given halfbuckaroo's experience, ask about topical treatments as a less-invasive option for your situation. (Email or call the offices you've visited with this follow-up question.) Also, skin tags can be a sign of insulin resistance; if you haven't had an A1C test in a while, you may want one.
posted by Iris Gambol at 12:24 PM on July 22, 2023 [1 favorite]
posted by Iris Gambol at 12:24 PM on July 22, 2023 [1 favorite]
I have had tags removed both ways, though not near my eye. The cautery tool leaves a little dessicated black dot that eventually washes away. The scissors leave a little open wound, which I imagine would sting badly in this area, especially in a crease.
If it was always safe and advised, I would go with cauterization as it’s less painful. However, the more “professional” and closer to a real doctor the person is, the less likely it is they will use this tool. I associate it with esthetician med spas staffed with nurse practitioners, not surgeons or dermatologists.
posted by Juliet Banana at 10:22 PM on July 22, 2023 [1 favorite]
If it was always safe and advised, I would go with cauterization as it’s less painful. However, the more “professional” and closer to a real doctor the person is, the less likely it is they will use this tool. I associate it with esthetician med spas staffed with nurse practitioners, not surgeons or dermatologists.
posted by Juliet Banana at 10:22 PM on July 22, 2023 [1 favorite]
I had several skin tags around my eyes (on my eyelids, lash line and in the folds of the upper lid) removed just last week by a dermatologist -- I get them a lot. But it was not a burning, she used liquid nitrogen to freeze the skin tags. I've had this done before ... the tags turn dark and then they fall off in a week or two. It's was not painful as she applied a numbing liquid first. I have also had them cut off -- and that left some very minor scarring.
posted by Lescha at 9:16 AM on July 26, 2023
posted by Lescha at 9:16 AM on July 26, 2023
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Logically, I am sure that the burn off method is probably safe or as safe as the surgical method, but as you point out, a flinch here or there will possibly have a material affect on the procedure. I would be asking for a valium or something similar to take before the procedure too.
posted by JohnnyGunn at 2:09 AM on July 22, 2023