Translate this page into:
Surgical pearl: A simple technique to prevent involuntary eyelid movement during skin tag removal
*Corresponding author: Michaela Mifsud, Department of Dermatology, Mater Dei Hospital, Msida, Malta. michaelamifsud18@gmail.com
-
Received: ,
Accepted: ,
How to cite this article: Mifsud M, Young J, Mercieca L. Surgical pearl: A simple technique to prevent involuntary eyelid movement during skin tag removal. J Cutan Aesthet Surg. doi: 10.25259/JCAS_11_2025
Abstract
Periorbital skin tags are small, benign growths that commonly occur on the eyelids, often causing esthetic concerns for patients. They are typically caused by friction, trauma, or genetic predisposition and are more common in older adults. Periorbital skin tags can be painful, cosmetically unappealing and may cause functional difficulties, such as eyelid irritation and interference with vision. Current treatment options include electrosurgery, snip or shave excision, and cryotherapy, but these methods can be challenging due to the location and delicate nature of the area. We propose a straightforward technique that can enhance the efficacy and safety of skin tag removal in this region.
Keywords
Acrochordon
Cautery
Eyelids
Skin tags
PROBLEM STATEMENT
Skin tag removal is commonly requested and electrosurgery is the preferred method of removal due to its precision and ease of use.1,2 Despite being a simple cosmetic procedure, periorbital skin tags may pose a degree of difficulty due to unintentional eyelid movements as a result of the involuntary contraction of the orbicularis oculi muscle [Figure 1]. This, in turn, makes it difficult to maintain a stable grasp of the skin tag for optimal removal and may lead to inadvertent burning of the surrounding skin. Although local anesthetic injection may be used to avoid this problem, it is not feasible when multiple skin tags are present.
- Skin tag visible over the lateral aspect of the left lower eyelid.
RECOMMENDED SOLUTION
The area is pre-anesthetized using a topical anesthetic in the form of 5% emulsion lidocaine/prilocaine. Then, the patient is asked to close his eyes shut forcefully, and gentle skin traction is applied to allow for complete visualization of the skin tag. Once the skin tag is secured with forceps, a disposable sharp-tipped electrode is applied to its base, and electrodessication (ConMed Hyfrecator® 2000 Electrosurgical System) is performed. This effectively removes the lesion while simultaneously achieving hemostasis [Figure 2 and Video 1]. By maximizing the contraction of the orbicularis oculi, along with applying gentle skin traction using a finger of the forceps-holding hand, the visibility of the acrochordon is enhanced while minimizing eyelid movement and procedural disruption, thereby ensuring a stable working surface.
- Skin tag secured with forceps after asking the patient to squeeze his eyes shut and gentle downward skin traction applied.
Video 1:
Video 1:Demonstration of above-mentioned technique.Authors’ contributions:
All authors contributed equally to the conception, design, drafting and revision of this article.
Ethical approval:
Institutional Review Board approval is not required.
Declaration of patient consent:
The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship: Nil.
References
- Acrochordon. 2021. Treasure Island, FL: StatPearls Publishing; Available from: https://www.ncbi.nlm.nih.gov/books/NBK448169/2 [Last accessed on 2021 Mar 29]
- [Google Scholar]
- Skin tags. 2020. Treasure Island, FL: StatPearls Publishing; Available from: https://www.ncbi.nlm.nih.gov/books/nbk547724 [Last accessed on 2020 Sep 25]
- [Google Scholar]