Question: Our daughter (age 1) has a skin tag just in front of her ear (a preauricular tag). She is for sure the cutest and sweetest kid, but her skin tag is kind of silly looking because it sticks straight out from her head.
It doesn’t affect her hearing in any way and is just a superficial abnormality. But we are wondering what the psychological wisdom is about either keeping it and letting her decide OR removing it and sparing her the grief.
We’ve had a lot of feedback from both sides and don’t know how to make up our minds.
Answer: Skin tags are completely harmless but, as
described here, can affect appearance. They sometimes reabsorb spontaneously, but the removal procedure is so easy and safe that I can think of no reason not to have the tag removed.
Typically, a dermatologist or Ear, Nose and Throat specialist would be the expert who could recommend and carry out the removal. There is no particular risk to leaving a skin tag in place, but there are no notable benefits, either. The type of procedure used for removal varies depending in part on where it is exactly and how big. Often, the removal can be done with a bit of local anesthetic and a second or two of cutting with a scalpel or laser; some physicians may opt to freeze the tag. Large tags may require general anesthesia, which obviously has its own risks and might merit more deliberation about the relative risk versus benefit.
Children typically grow accustomed to nearly anything, but others—peers and adults—are apt to notice a skin tag on the face and react to it. If you as parents are calm and matter-of-fact about the decision to remove it, an infant or toddler is not at all likely to have a significant psychological reaction to the procedure, and there will be no need for a decision about removing it later on. Delaying until the child is a toddler runs the risk that he or she will be reacting not to keeping or losing the skin tag but to “fear of the unknown,” i.e., worry that whatever is being done will hurt. In general, young children are not apt to understand the various options and what they might mean over the long term. Making the decision on the child’s behalf seems both kinder and far less likely to lead to psychological issues than would delay. There is much debate about what children “remember” about things that happen to them before language develops. But evidence suggests that pain can leave a lasting impression, so practitioners now use procedures that minimize or eliminate pain.
There will be many opportunities in the future for your child to participate in decision making about things that affect all sorts of aspects of his or her life. In this instance, the decision to remove it seems clear—the procedure is safe, and the results are sufficiently advantageous—so it is hard to see a benefit to delaying.
Dr. Glen Elliott is an author and internationally known expert in psychiatric disorders in children and adolescents at the Children’s Health Council (CHC). Based in Palo Alto, CHC provides expert support to children with learning differences, anxiety and depression, ADHD and autism. Learn more at www.chconline.org.