Q: What is the difference between skin tags, warts, moles, and liver spots? Some of the liver spots on my face are darker and scaly. My dermatologist has checked them and tells me it is just more of the same spots that I have on my back, arms and legs. I have had many removed by her but it costs a lot of money. The itchy liver spots on my back are covered by my insurance but no others. Are there any proven home remedies that I can use on skin tags and moles?

A: Skin tags are literally flaps or tags of skin that appear on the body. The most commonly affected areas are the neck, underarms, eyelids, under the breasts and the groin folds. Anyone can develop skin tags at any point during their lifetime but the most prone individuals are the elderly and women. Weight gain can be a factor.

Fortunately the lesions are very common and harmless so nothing need be done unless the tag is especially large or in a place that causes pain due to pressure and rubbing, such as under the strap of a bra or belt. Removal is easily done by a family physician or dermatologist in the office either by scalpel, cryosurgery (freezing) or electrosurgery (burning with electrical current). Home remedies include tying dental floss or thread tightly around the tag to remove the blood flow, covering the lesion with clear nail polish and more.

Moles are skin growths that are typically black or brown and can occur alone or in groups anywhere on the body. Most appear between early childhood and age 30. It is common to have between 10 and 40 moles by adulthood. Moles slowly change over time, becoming darker and/or raised. It is also common for hairs to develop on the lesion. In some instances, they may even disappear over time.

There are several types of moles. Congenital nevi (those that appear at birth) may be more likely to develop into melanoma (cancer). Dysplastic nevi are moles that are larger than a pencil eraser with irregular borders and coloring. These, too, are more likely than common moles to develop into melanomas. Individuals with these type usually have more than 100 such lesions over their bodies. Any mole may become cancerous so it is important to check on them, either through a yearly dermatological visit or by a primary care physician. If any change is noticed (shape or size, bleeding, scabbing, oozing, etc.) then an appointment should be made with a physician or dermatologist for a professional inspection and possible testing if appropriate.

That said, most moles are harmless, and like skin tags, don’t need to be removed or otherwise treated unless cosmetic reasons, such as if a large lesion appears on the face or if the mole(s) causes pain such as from rubbing against clothing or jewelry.

Warts are the result of an infection by the human papillomavirus (HPV). There are more than 60 strains such as common, plantar or genital types. Based on your question, I assume you mean common warts so that is what will be discussed in this column.

Common warts appear on the hands, fingers and near the fingernails. Contrary to popular belief, warts are not a result of uncleanliness or touching frogs, but rather direct contact (either person-to-person or person-to-object) with the virus.

Treatment depends on the location, size, type and severity of the wart. Plantar warts which appear on the bottoms of the feet are much more difficult to treat than are common warts. Genital warts can be cured and it is true that many recur but it is equally true that up to 20% will resolve spontaneously. Depending on their size, either a medication can be placed on them or they can be frozen or surgically removed. Common warts are generally harmless and may disappear without treatment. Several OTC options are available such as home-freezing agents, medicated bandages, and medicated liquid which is applied then bandaged over. Home remedies include duct-tape, garlic and more. For large, persistent or recurring warts, a dermatologist can offer more advanced treatments such as freezing with liquid nitrogen, surgical removal (via scalpel or laser), prescription medications, and cantharidin which causes the skin blister around the wart allowing the physician to remove the dead portion of skin and the wart.

Liver spots (a misnomer) most commonly appear on individuals over the age of 40. They are brown or black flat lesions that appear on sun exposed skin such as the hands, arms, face and shoulders. They are harmless but because many people may not be able to differentiate between liver spots and moles, it is best to play it safe and have them checked by a health care professional. Treatment is not needed; however, freezing, laser removal and bleaching creams/lotions are available by a dermatologist for cosmetic reasons.

Because your liver spots itch and some are scaly, they may not be liver spots at all. Seborrheic keratoses are similar skin growths that are more likely to cause itching and scaling. I recommend you return to your dermatologist to discuss your situation and to the find what your lesions really are.