My BIL was a pathologist and was frequently asked by his employees to tie off their skin tags. He reports that it was painless for those gals because there should be no nerves in them. They just applied alcohol a few times a day to help dry them up, much as we used to do with umbilical cord stubs. I actually just tied off a huge one on my dog that he had had for years and was so unsightly. I was nervous, but he never seemed bothered by it. After I tied it off with a rubber band, it just necrosed, and when it was mostly dried up, I cut it off. He's still fine. The vet was going to charge over $300 to remove it. Not that folks are like dogs!