Here in this article, I have discussed the causes and management of dirty non-cleanable darkness over the neck and underarms, which is known as Acanthosis nigricans.
Acanthosis nigricans is characterized by the occurrence of velvety brownish skin mainly involving intertriginous areas, or body folds like the neck, axilla, anogenital, and groin areas. In this condition, it should be noted that the pigmentation is not due to increased melanin (pigments synthesized by melanocytes), but because of hyperkeratosis, that means due to abnormal thickening of the outermost layer of the skin.
It may be related to obesity, heredity, diabetes, drug-induced such as Nicotinic acid, OCPs - oral contraceptive pills, and corticosteroids or may be a cutaneous manifestation of some internal malignancy such as adenocarcinoma of the gastrointestinal tract or genitourinary tract or lymphoma.
Acanthosis nigricans starts as pigmentation, dryness, and roughness of the skin with small palpable thickened grain like elevation which gives it a velvety texture.
Types of Acanthosis Nigricans:
Broadly, it can be divided into two types:
In benign form, skin lesions may be present at birth but usually, develop during childhood or puberty. They may be less severe, involve one side of the body, progress very slowly when compared to malignant one.
The lesions are more severe and more extensive. Pigmentation is more prominent and is not confined to thickening of the outermost layer of the skin in skin folds only, but also involves palms, nails, and hair. Irritation is common. The mucous membranes and mucocutaneous junctions are involved in 50 percent of cases, and warty thickening around the lips and eyes are the most common presenting symptoms. Removal of the tumor may be associated with regression of the clinical sign.
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In hereditary acanthosis nigricans, lesions tend to increase gradually before stabilizing and retreats on their own. There is no specific therapy for acanthosis nigricans. Treatments to enhance appearance include dermabrasion, topical retinoids, and laser therapy.
Acanthosis nigricans can be caused by:
- Insulin Resistance - Insulin is a hormone that helps control blood sugar. Insulin resistance, if not treated, can cause type 2 diabetes.
- Hormonal Disorders - Certain hormone disorders such as underactive thyroids, ovarian cysts, or problems with the adrenal glands can produce the skin's darkening.
- Drugs and Supplements - Certain medications like steroids, birth control pills, or overuse of over-the-counter drugs can cause acanthosis.
- Cancer - Acanthosis is also associated with cancerous tumors, especially internal organs like the colon and stomach.
Acanthosis nigricans look brown to black, velvety, and thick patches of skin in skin folds and wrinkles usually seen under the neck, armpit, skin creases, and under the breast.
Researchers discovered that people with the skin condition acanthosis nigricans are at high chances of type 2 diabetes. Acanthosis nigricans usually indicate the presence of diabetes or pre-diabetes, so if you notice it, be certain to show your doctor right away so that you can be examined for diabetes or pre-diabetes.
Acanthosis nigricans can be prevented by:
- Managing your weight when it is related to obesity.
- Correction of diet that contributes to minimize insulin.
- Treating medical conditions like hypothyroidism.
- Avoid medications like birth control pills that worsen the conditions.
Acanthosis nigricans is considered bad because it is a common skin finding correlated with Insulin resistance or the syndrome that may lead to type 2 diabetes.
The medication that can cause acanthosis nigricans are:
- Birth control pills.
- High-dose niacin.
Natural ways to treat Acanthosis Nigricans are:
- A healthy diet.
- Doing some exercises.
- Coconut oil with camphor.
- Tea tree essential oil.
- Lemon juice.
- Yogurt and lime juice.
- Almond scrub.
- Losing weight.
- Managing the diet.
- Walnut scrubs.
- Orange peel.
- Baking soda.
Acanthosis nigricans is caused due to insulin resistance. Therefore, exercise and weight loss are the primary mode of treatment. Metformin is an excellent drug used to reduce Insulin resistance, and if you lose weight while on Metformin, the acanthosis may partially revert, but it might not entirely disappear.
Hormonal imbalance can wreak destruction on the skin, and women who have Polycystic Ovarian Syndrome (PCOS) are predisposed to acne, skin tags, and acanthosis nigricans. These skin conditions are not fatal, but they can make women as embarrassed and self-conscious.
Acanthosis Nigricans due to cancer can be treated by eliminating the tumor and following therapies to treat cancer may remove Acanthosis Nigricans. Additionally, the treating physician may suggest the following if Acanthosis Nigricans start to affect the patient cosmetically or if a foul odor is coming from the skin. The methods of removing are:
Prescription creams to remove the affected skin areas.
Antibacterial soaps need to be used smoothly on the affected skin.
- Topical antibiotics.
- Oral acne medications can relieve Acanthosis Nigricans.
- Topical retinoids.
- Laser therapy.
Acanthosis nigricans can be caused in children due to high blood insulin levels, a condition usually associated with diabetes, overweight, or obesity.
Last reviewed at:
11 Jan 2019 - 2 min read
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