Raechele Cochran Gathers, MD
Have you ever noticed, on yourself or someone else, darker, dirty looking skin on the back of the neck, under the arms, or over the tops of the hands? Well, it’s not dirt. It’s a common skin condition called acanthosis nigricans.
What is Acanthosis Nigricans?
Acanthosis nigricans is a velvety thickening and darkening of the skin that often occurs around the neck, the armpits and between the breasts. Unlike dirt, which you can wash away, acanthosis nigricans can’t be removed by scrubbing the skin. Acanthosis nigricans can occur in all ethnic groups, but African Americans, along with Hispanics, Native Americans or those with Caribbean ancestry may be more prone to developing acanthosis nigricans.
The most common area of the body to notice the darker velvety skin is on the neck, especially the back of the neck. However, acanthosis nigricans can also be commonly seen in the armpits, between and under the breasts, on the cheeks and even on the tops of the hands. You can also see acanthosis nigricans on the elbows, knees, and groin area among others.
What Causes Acanthosis Nigricans?
Acanthosis nigricans is commonly associated with being overweight. Acanthosis nigricans can also sometimes be associated with a serious underlying medical condition. Our bodies often give us clues when something is not quite right. And changes in the skin are often one of the first clues that there is a problem internally!
Acanthosis nigricans can be associated with diabetes or pre-diabetes. Acanthosis nigricans usually develops gradually, over time. When it develops quickly, it can somestimes be a sign of an internal malignancy. Acanthosis nigricans can occur when there is an underlying hormonal abnormality or thyroid condition, and it can even develop after taking certain medications like steroids or birth control pills.
Causes of Acanthosis Nigricans
- Obesity
- Diabetes or pre-diabetes
- Family history
- Hormonal or thyroid disease
- Medication that you’re taking
- Cancer
Keep in mind, some people with acanthosis nigricans are completely healthy, and the condition can also sometimes run in a family.
Treatment
If you notice changes in your skin that look like they could be acanthosis nigricans, the first to do is to see your doctor. Remember, sometimes perfectly healthy people can develop acanthosis nigricans, but in other cases, it can indicate an underlying medical condition that should be addressed. Your doctor will examine you, and then will likely do some blood tests and other medical tests to see if you have an underlying condition.
Acanthosis nigricans often improves when the underlying medical issue is treated. People who are overweight often see improvement in acanthosis nigricans as they approach their ideal body weight. Those that have diabetes or pre-diabetes often see skin improvement after these conditions are brought under control. Sometimes, acanthosis nigricans can remain even when after the underlying condition is treated.
Other Treatment Options
- Skin bleaching creams
- Retinoid medications
- Chemical peels
- Ammonium lactate cream
- Laser treatments
Conclusion
It is important to be aware that skin is the window to your health. Don’t ignore changes in your skin, and be watchful of the skin of those that you love. If you are noticing skin changes that you find concerning, reach out to your physician for an evaluation.
Featured Images: Lazzarini R et al. Acantose nigricante maligna: realato de caso, Yuste-Chaves M et al. Cutaneous alerts in systemic malignancy, American Academy of Dermatology National Library of Dermatology Teaching Slides
