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Monday, July 21, 2014

Dental Floss Doesn't Remove Skin Tags, But Thanks For Trying

After over 17 years in practice it gets difficult to surprise me or for me to see things I haven't seen before.  But today it happened.  It caused more of a sigh and face-palm than a true surprise, but it was still a variation that was new to me.
One of my other doctors saw a dog that has been a regular at our clinic for years.  He is an older beagle and generally in pretty good health.  He has had a rather large and long, but otherwise benign, skin tag for a long time.  We have talked to them about removing it while he was under anesthesia for a routine dental cleaning, but they had always declined.  It seems as if they had an inkling to try it themselves.
Today they brought him in to remove the dental floss they had placed around it. Yes, you read that correctly.  Dental floss.  About a month ago they had tied it tightly around the base of the skin tag, hoping that it would cut off blood supply and cause the tag to fall off without surgery.  The floss dug into the skin and tag, but didn't actually result in enough blood occlusion to cause the tissue to die and slough off.  But it did dig in enoug that they couldn't remove it themselves.  So our doctor had to use some suture scissors to get underneath it, cut it loose, and then clean the infected tissue around it.  All while the skin tag flapped around like it always had.

While this may be the first time I've seen dental floss used, this is an old (and rather bad) way to try and remove masses or even castrate an animal.  Usually rubber bands are used tightly around the offending growth or testicles, constricting the blood supply and eventually causing the tissue to fall off because the cells have died.  For some reason some people think that this is a perfectly acceptable substitution for surgery.

Using floss, string, or rubber bands in this way is one of the worst things you can do.  If the tissue is large enough, such as the scrotum and testicles, there will be pain and discomfort.  Would any man feel fine with having his family jewels tied off and left to rot for a month or two?  If the procedure actually does work, it's doing so because the tissues are dying from lack of blood supply.  It is literally dying and rotting off the body.  Who thinks this is a good thing?  There is a big risk of infection or having more tissue than desired be affected.  In the case of a mass or polyp you leave the base in the skin so it has a chance of regrowing.  In order to completely resolve the problem you have to cut away the attached skin, not just remove the dangling part.

Thankfully this was a relatively minor irritation and the dog is going to be fine.  And he's coming in later this week to have the skin tag properly removed.


  1. I have heard of people trying to dock their pups by similar methods. Cruel to say the least...

    1. why does it cost so much if its so easy. we got tested for 200.00 wth update shoots 2.
      estimate for removel is 900.00,, i ask why so much...
      i dont have it,nor can i charge it... and its really 2 inches long..raw from liking it yeah...this is not cool.
      what does a person do...

    2. Because depending on the size, you will need to either sedate the dog or do full general anesthesia. There is also the vet's time, surgical instruments, suture, submitting it to a lab for biopsy, and so on.

  2. I notice Amazon has skin tag removal kits that incorporate the use of rubber bands to remove skin tags on humans, with hundreds of reviews describing success. Why can't this method be used on dogs?

    1. That's the first time I've heard of this product. I would imagine that it would only work on very small skin tags/warts, while the ones on dogs are often larger. Honestly, I wouldn't recommend this for humans or dogs. I am concerned about situations like the one I blogged about, where it digs into the skin but doesn't actually effectively remove the blood supply.

  3. This is a joke. Sutures and sterilizing surgical equipment does not justify a $900 bill. That's how much an anesthesiologist would charge a human for a one hour surgery. You also don't have to send anything to a lab because most cases are benign Unless there is reasonable suspicion.

    1. We don't know what kind of mass Unknown was talking about. It could very well have been a large mass rather than a small polyp, and could easily have justified a $900 bill.

  4. Honestly the sedations and pain meds that Vets almost always use and bill for whether the dog actually needs them or not CAN be as comparably dangerous as home remedies. Most farmers, equestrian enthusiasts, licensed breeders, etc. are aware that first-line remedies are often best administered at home, with clinical responses being more appropriate only when rare contingencies arise (like in the case Dr. Bern cited above).

    I took my dog to a vet to get his skin tag removed: and I had to pick him up an hour later anathetized but uncut because the electrical power to the vet failed and they did not have an uninteruptable power supply for their Operating Room (a relatively small investment for the sake of due diligence).

    I removed the skin tag at home (I have only basic first aid training, renewed annually, no medical licenses or the like), then I used the $800 I saved to take myself, wife, and lovely dog on a weekend beach vacation at a nice resort hotel, had a fantastic meal at a white table restaurant, and tipped generously.

    My two cents: If your own life history seems to confirm that you have at least a decent sense judgement, a good hold on logic/reason, and fairly steady hands, then this is PROBABLY (not probably is not definitely) something you can manage at home without involving a vet.

    Dr Bern: Regarding biopsies and possible cancers, any growth COULD be malignant. However, there is a list of visual, tactile, and olfactory characteristics that are more common in tumorous growths. If none of these characteristics are present, then the likelihood of maglignancy hardly justifies the cost of a biopsy.

    I am sympathetic to your perspective that the high price of skin tag removal is justified, Doctor, but clearly the price point is much higher than the value perceived for a large swath of potential consumers.

    You wrote of the sighing and face-palming reaction you had to these customers. If I were those same customers, and read this blog post, especially after parting with nearly one thousand dollars cash for your services, I'd be looking for a new professional who understands that patient-care provider respect must be reciprocal.

    1. Adam, I would challenge you on your generalization that vets use certain medications whether or not the patient needs it. On what information do you base this statement? I would also give you a corollary that home remedies can be as dangerous as veterinary drugs.

      As far as a power supply just for the operating room....Most veterinary clinics operate on a shoestring budget and vets aren't getting rich, despite what many people seem to believe. Such a power source is pretty expensive and is not typically considered a justifiable expense considering how rarely a complete power outage happens. I've never known a general practice to have something like this.

      Skin tags are NEVER something that you should do at home. There is risk of infection, pain to the pet, and if you don't get the entire skin in this area (which requires cutting that part of the skin out....just the surface won't do) it will likely grow back.

      Adam I would also unequivocally say that you are wrong about it being easy to tell that a growth is malignant based only on looking at it. Yes, there are certain polyps and papillomas that can be easily visually identified. But there are plenty more that can't be, and even I have been surprised when a biopsy report has come back malignant. Believe me as someone with 20 years of clinical experience, you often CANNOT tell by looking that something is malignant.

      Lastly, I'm not face-palming the clients who spend money to get the masses properly removed. It's the ones who do what you are saying that bother me. And if they won't listen to a medical professional over a layperson, I'me fine with them not coming to me.


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