Hemorrhoids skin tag occur after external hemorrhoids have turned into thrombosed external hemorrhoids.
Then when or if the thrombosed external hemorrhoid has managed to heal itself, is when in many cases a piece of skin is left hanging (flopping) this is known as a hemorrhoid tag.
The good news with these skin tags is that usually there is no pain associated. However in a lot of cases they are taking up space in the middle of the anus thus making it difficult to clean the area properly.
In this picture the lines show the three different tags
They also may cause an irritating itch. In some instances they may also bleed, due to rubbing them too much. Basically they could just become an irritating nuisance.
Some people may even feel embarrassment to engage in sexual activities.
If you have many skin tags or have a rather big tag, which causes you the above mentioned problems, then removal will be the only remedy.
However this article from different people is also a good read before you take any decisions as to what you want to do.