Acanthosis Nigricans

Last reviewed by Dr.Mary on November 16th, 2018.

What is Acanthosis Nigricans?

This is a condition involving the skin and is identifiable by thick, dark, velvety like skin in folds as well as creases of the body. These markings can be light brown-to-black. This condition in the majority of cases, affects the neck, under the breasts, groin area as well as the armpits.


With this skin condition, an individual will of course be worried about the cosmetic appearance of the skin. There are steps that can be used to help lighten the areas which are affected. There is no specific medical treatment – but often by treating any underlying, primary conditions for instance obesity as well as diabetes, can cause this skin condition to go away.

This condition can begin at any age.

Acanthosis Nigricans Causes

This condition of skin may affect individuals who are in all other aspect, healthy or it may be linked with definite medical problems. Often acanthosis nigricans is a congenital disorder which simply means the individual is born with it. The condition can also develop as a consequence of endocrine disorder, as well as obesity. It is very frequently found in those individuals who are diabetics and is very common in individuals from African descent. There are also many other possible causes of this condition, which include:

  • Addison’s disease which is a condition when there is a deficiency of hormones which are produced by the adrenal gland.
  • Hypothyroidism which occurs when the thyroid gland produces low levels of the thyroid hormone.
  • Disorders involving the pituitary gland within the brain.
  • Oral contraceptives

The majority of individuals with this condition have an insulin level which is higher than other individuals of the same weight who do not have acanthosis nigricans. Eating too many sugars and starches can raise the levels of insulin which is a causal condition that causes acanthosis nigricans.

Individuals with certain kinds of cancer may also develop very severe cases of this skin condition – especially those individuals with lymphoma or cancers involving the gastrointestinal or genitourinary tracts.

Causes of acanthosis nigricans can include:

  • Hereditary benign acanthosis nigricans
  • Insulin resistance
  • Diabetes mellitus
  • Cushing’s syndrome
  • HAIR-AN syndrome
  • Hyperandrogenism
  • Ataxia-telangectasia syndrome
  • Bloom syndrome
  • Cardio-facio-cutaneous syndrome
  • Costello syndrome

Following is a partial list of other causes:

  • Donohue syndrome
  • Letis syndrome
  • Lipoatrophic diabetes syndrome
  • Polycystic ovarian syndrome
  • Ruvulcaba-Myhre-Smith syndrome

Acanthosis Nigricans Symptoms

Acanthosis nigricans normally develops very slowly and does not cause any other symptoms than changes to the skin.

Characteristics of Acanthosis Nigricans include:

  • Skin. Dark, velvety, chunky skin
  • Color. Color range from gray to brown to black
  • Darkness. Darker-skinned individuals tend to have darker lesions
  • Slow progression. The changes to the skin appear very slowly often over months or years.
  • Possible itching. The affected skin may rarely itch.
  • Lesions. Pigmented lesions.
  • Skin. Reduced skin turgor
  • Skin. Stretched skin

Acanthosis Nigricans Treatment

An individual should visit with their primary care physician if they notice any skin changes – especially if there is suddenly a change in the skin. This is important especially because many skin changes are caused by underlying condition that are best treated as quickly as possible. Acanthosis nigricans is not a condition which is life-threatening, however, high levels of insulin for example may be a condition known as Hyperinsulinemia which in very extreme cases may lead to hypoglycemia. Hypoglycemia can lead to insulin shock, coma as well as death.

Your physician may be able to diagnose acanthosis nigricans by only looking at the condition of the skin. In some unusual cases, a skin biopsy may be necessary.

If there seems to be no clear reason for acanthosis nigricans, it will probably be necessary to search for an underlying disease. The physician will normally order blood work, an endoscopy or other x-rays in order to eliminate the cause being diabetes or cancer. Looking for cancer is normal especially when the symptoms are found on the palms, soles of the feet, the lips or any other areas not normally affected.

There is no specific treatment for acanthosis nigricans, but treating any condition which is underlying can cause the changes to the skin to fade, such as:

  • Losing excess pounds if obese or overweight

This is where making changes in dietary plan comes into view – for instance cutting back on sugars or starches. Eating a special diet will help reduce any circulating insulin as well as can lead to very rapid improvement of the skin darkening.

  • Lesions which are thick can have a bad odor.

Use antibacterial soaps or topical antibiotic as they may help.

If the individual is concerned about appearance, the doctor can recommend the following treatments:

  • Creams or lotions which are prescription and can lighten the skin in the area affected.
  • Oral medications for instance isotretinoin – Accutane, Sotret
  • Supplements from fish oil
  • Laser therapy or Dermabrasion which can lessen the thickness of certain areas which are affected.
  • If caused by medication, acanthosis nigricans will go away once that medication is stopped.

This condition is somewhat tricky to cure since it is a symptom of a much larger problem. But, a lot of individuals have seen improvement after changing diets and losing weight.

The following treatments which are topical have been used to reduce the appearance of the lesions or markings:

  • Alpha Hydroxyacids
  • Salicylic Acid
  • Retin-A
  • 20% Urea

If this condition does not become cured, the individual may consider getting a skin peel treatment.

Acanthosis Nigricans Prevention

When acanthosis nigricans is related to obesity, management of weight is an important area of prevention. This diet will contribute to reduction of insulin which also can help prevent this skin condition.

Other preventive plans include treating any problems which are medical and are linked to acanthosis nigricans – such as hypothyroidism – and also avoiding any medications that are linked to causing or worsening the condition – such as oral contraceptives.

Acanthosis Nigricans Pictures

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