Genital Skin Tags or HPV Warts: What’s the Difference?

Genital skin tags and genital warts are two common skin conditions. They can be confused for one another because of where they develop and how they look.

Skin tags are common, harmless growths that often grow in areas where the skin folds, like your neck, eyelids, and groin. They are often oval or egg-shaped and attached to a fleshy stalk.

Genital warts are caused by the human papillomavirus (HPV), which is a common sexually transmitted infection (STI). Genital warts typically look like lesions or bumps that are flat or slightly raised on the skin’s surface. They usually feel rough or bumpy, and they may resemble cauliflower.

Like skin tags, genital warts aren’t dangerous or cancerous, but they are a sign of an infection. Genital warts can go away on their own, but treatment can stop them from growing as well as stop any discomfort they may cause.

Keep reading to learn more about what these bumps look like, what causes them, and how they’re treated.

While these two skin conditions look similar, there are a few distinct characteristics that can help you differentiate between the two.

What do genital skin tags look like?

Skin tags are small, flesh-colored, hanging pieces of skin. They typically do not have any symptoms, such as pain or itching.

What do genital warts look like?

Unlike skin tags, warts have a pearly, bumpy appearance and are usually found in areas where there has been sexual contact, such as the:

• vagina
• penis
• pubic region
• anus
• mouth and throat

They may itch or feel irritated.

Both skin tags and genital warts can develop as a single bump, or they can grow in clusters. It’s possible for additional tags or warts to appear in the same area over time.

These bumps are usually small, which may make identification harder, but there are clear visual differences between the two that may make it easier to recognize what you have.

Genital skin tags

Genital skin tags are soft tissue fibromas — or small, flesh-colored growths.

• They develop on stalks or tiny “limbs” off the surface of your skin.
• When pressed, they’re soft and should bend easily.
• Although most skin tags are small, some can be as large as a pencil eraser. Some people may develop a skin tag that’s the size of a grape or even a fig.
• Skin tags develop rapidly, but they rarely continue to grow after the earliest stages of development.
• It’s possible for a tag to change from flesh-colored to lighter brown, and then to darker brown. This color change is typical and usually isn’t a cause for concern.

Skin tags are very common. They usually develop on your neck, under your armpits, or in between other folds of skin. They can also develop in your groin or on your genitalia.

Vaginal tags are less common. This is due to the moist nature of the vagina. Most tags are caused by friction, and the moist environment prevents this. Skin tags may still develop on the pubis or labia.

Genital warts

Genital warts are flat or slightly raised bumps on the surface of your skin.

• They appear on the:
  • pubis
  • vagina
  • vulva
  • penis
  • anus
• Genital warts may be flesh-colored or a close variation of your skin color. They can also be brown or pink.
• The color of genital warts may shift over time.
• Genital warts may disappear, only to come back in another spot.
• The surface of genital warts may feel bumpy or rough when touched. They’re often described as having a “cauliflower” look.
• They may appear as a single bump, or they can grow in small clusters.
• Sometimes, genital warts can itch or even bleed.

Although these bumps are often mistaken for one another based on visual appearance, they’re caused by entirely different things.

Genital skin tags

Almost half of adults will develop at least one skin tag in their life, but skin tags have no known cause. Several factors can increase your risk for developing them.

The most common risk factors for genital skin tags include:

• Friction. Skin-on-fabric contact from clothing or underwear can cause skin tags to develop. The frequent rubbing between clothes and skin can irritate the delicate skin of the genital area and cause these small growths. Friction from sexual intercourse may also cause genital skin tags.
• Pregnancy. Changes in hormonal levels during pregnancy can increase your risk.
• Obesity. People who are living with obesity are more likely to develop skin tags.
• Type 2 diabetes. Skin tags can be a sign of type 2 diabetes or high insulin levels.
• Age. Skin tags are more common in people age 40 and older.
• Genetics. If you have family members who have skin tags, you may be more likely to develop them.

Genital warts

Unlike genital skin tags, doctors know exactly what causes genital warts: an infection of HPV. This is a type of STI, and it’s highly contagious.

More than 100 types of HPV have been identified. Of those, only a few are responsible for genital warts.

HPV is very common. It’s estimated that more than 80 percent of sexually active individuals will be infected during their lifetime. However, this may or may not be a wart-causing strain. If it is, it may be weeks or months before warts appear.

If you’re not sure about the atypical growths on your genitals, it’s a good idea to contact your doctor. If you suspect those skin spots are genital warts, or if you know you’ve been exposed to HPV, you should contact your doctor right away.

To make a diagnosis, your doctor will conduct a physical exam and look at the bumps or growths. They may perform an STI test. Your doctor may also order a biopsy.

For a biopsy, your doctor will remove one of the growths or bumps. They will freeze the area, which is often done in the office setting. They’ll send the tissue to a laboratory, where it will be examined under a microscope. Your lab technician can usually make a diagnosis based on this visual assessment.

If the results are unclear, your doctor may order blood tests to identify other potential causes.

Genital skin tags and genital warts are treated differently.

Treating skin tags

Many times, skin tags do not need treatment. Unless they become irritated or cause you problems, most doctors will probably just leave them in place.

Treating genital warts

You also do not have to treat genital warts, as many times they go away on their own. But treating them has some benefits, including:

• relieving the itching
• lowering the risk of spreading the virus
• helping you feel confident the warts are not cancer (because treatment clears them up)

If you do decide to treat your genital warts, your doctor will most likely prescribe medication like podofilox or imiquimod.

Removing skin tags or genital warts

If you choose to completely remove genital skin tags or genital warts, your options are frequently the same. These treatments include:

• cryosurgery, which freezes off the warts with liquid nitrogen
• excision, which involves cutting the warts out manually or surgically
• electrocautery, which eliminates the warts with an electrical current
• trichloroacetic acid (TCA), which is applied topically and can be repeated weekly

It still isn’t completely clear why or how skin tags develop, so there’s often no way to prevent them from forming.

You can, however, try to prevent genital warts.

If you’re sexually active, you can decrease your risk for HPV by using a condom or other barrier method. It’s also important to disclose a history of genital warts to any sexual partner and avoid contact with new sexual partners until warts are successfully treated.

You can also get the HPV vaccine. The vaccine helps protect against the most common HPV strains, including strains that cause genital warts or increase your risk for cervical cancer.

Although the vaccine is primarily recommended for teens and young adults, you can still get the vaccine if you’re over age 25. It may still have some protective benefit. Talk with your doctor to make an informed decision.

Treatments for both skin tags and genital warts are highly effective.

However, even with treatment, there’s no guarantee that new skin tags won’t develop.

If you’re dealing with warts, treatment won’t cure you of HPV. The virus will remain in your body, which means you may experience genital wart outbreaks in the future.

Neither genital skin tags nor genital warts are considered serious conditions, and the bumps aren’t likely to become cancerous.

However, you should contact your doctor if you notice any atypical changes. This includes vulvar lesions (lesions on the outside of female genitals) that bleed, itch, or change in size, shape, or appearance. This can be a sign of a more serious condition, such as cancer.