Experts believe that the most common cause of a tongue skin tag is friction — small, loose fleshy growths can appear on areas where skin frequently rubs against skin. Age and obesity have been found to increase the likelihood of skin tags developing in individuals. Significant increases in hormone levels are also correlated with skin tag development. In some cases, people can confuse small folds in the plica fimbriata, a natural structure of the tongue, for skin tags; in others, it could be a wart rather than an actual tag. The only serious possible cause for a tongue skin tag is mouth cancer, although these cases are much rarer than others.
The chance a single individual has of developing a tongue skin tag depends on a number of factors. Studies have found that older individuals tend to have them more than young people and overweight individuals have an increased risk of developing the growths over normal-weight or thin people. Heredity also plays a role, as some people can be more prone to having skin tags than others. Tongue skin tags are generally more uncommon than those that develop in other areas, although this could be a result of the tongue tags simply being less noticeable than ones on the neck and other common places.
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Many individuals mistake the plica fimbriata, the small fold of the mucous membrane on the bottom side of the tongue, for a skin tag. The membrane can extend a smaller fold slightly outward, creating a bump that feel like a tongue skin tag. These bumps are naturally-occurring and require no treatment.
Although uncommon, the tongue can develop warts when exposed to human papillomavirus (HPV). These bumps can also be mistaken for tongue skin tags, but differ from the plica fimbriata folds largely because they are highly contagious. Individuals who suspect they have warts inside the mouth should refrain from exposing others to the virus and seek treatment immediately, as warts thrive in the mouth's warm, moist environment. The warts can be cut, cauterized, or frozen off.
If a tongue skin tag appears either reddish or whitish in color and occurs in only one side of the mouth, the patient should have the growth checked by a doctor. Tags that match the description and cause no discomfort might be symptomatic of oral cancer. A tongue skin tag biopsy should be performed to determine whether or not the growth is cancerous. If it is, patients should seek immediate treatment.