Acanthosis Nigricans: Causes, Symptoms and Treatment

Written by Medicover Team and Medically Reviewed by Dr Anusha Nagral Reddy , Dermatologist

Acanthosis Nigricans is a skin condition where certain areas become dark, thick, and velvety. It typically affects areas with skin folds, such as the neck, armpits, and groin.

While it may seem like just a skin issue, it can be an early sign of deeper health problems like:

Insulin resistance
Type 2 diabetes
Polycystic ovary syndrome (PCOS)
Thyroid or hormonal imbalance

In some rare cases, it may even be linked to certain cancers, especially in older adults.

Where Does Acanthosis Nigricans Appear?

These dark patches usually appear in areas where the skin folds or rubs together.

Common Sites Include

Back or sides of the neck
Armpits (underarms)
Groin area
Under the breasts
Elbows, knees, and knuckles
In some cases, the face (especially around the mouth or forehead)

The affected skin may look dirty or tanned, but washing won't remove the dark patches. It may also feel thicker, softer, or slightly raised.

Why This Happens

In most cases, acanthosis nigricans causes are related to the body producing too much insulin. High insulin levels can cause skin cells to grow faster, leading to darkening and thickening.

This is common in people who are:

Overweight or obese
Living with PCOS or diabetes
Using certain medications like steroids or hormonal pills

What are the Acanthosis Nigricans Symptoms and Warning Signs?

Acanthosis Nigricans (AN) is often easy to spot once you know what to look for. Early detection can help you manage the condition better and may also reveal underlying health issues like prediabetes, obesity, or hormonal imbalance.

Common Acanthosis Nigricans Symptoms

Dark patches on the skin, usually brown or black
Skin that feels soft and velvety to the touch
Slow and gradual thickening of the affected areas
Mild itching or irritation (in some cases)

These changes often appear on the neck, underarms, groin, or elbows.

Severe Symptoms of Acanthosis Nigricans

Sudden appearance of new dark patches
Bad body odour from the affected areas
Small skin growths (skin tags) are forming near the dark patches

If you notice rapid changes in your skin or new spots appearing quickly, consult a doctor. These signs may point to a more serious issue like diabetes or, in rare cases, internal cancer.

What Are the Different Types of Acanthosis Nigricans?

Acanthosis Nigricans is not a single condition. It can happen for different reasons, and understanding the type can help guide treatment.

Acanthosis Nigricans Types

Obesity-Related AN

The most common type. Linked to high insulin levels and excess body weight.

Hereditary (Congenital) AN

Appears from birth or early childhood. Usually runs in families.

Drug-Induced AN

Caused by certain medications like steroids, birth control pills, or hormone treatments.

Malignant AN

A rare and severe form. It may be linked to internal cancers, especially stomach or liver cancer. Needs immediate medical attention.

Syndromic AN

Occurs as part of rare genetic syndromes or hormonal disorders like PCOS, thyroid problems, or insulin resistance.

What Are the Common Causes and Risk Factors of Acanthosis Nigricans?

Acanthosis Nigricans is not a disease by itself. Instead, it is often a sign of an underlying condition. It appears as dark, thickened, velvety patches of skin, especially around the neck, underarms, elbows, or groin.

Understanding what causes it and what might increase your chances of developing it can help you take early steps toward better health.

Acanthosis Nigricans Causes

Several medical conditions and lifestyle factors can lead to Acanthosis Nigricans. These include:

High insulin levels: The most common cause is insulin resistance, which happens in people with obesity, type 2 diabetes, or prediabetes.
Hormonal disorders: Conditions like hypothyroidism (underactive thyroid), polycystic ovary syndrome (PCOS), and adrenal or pituitary gland disorders can trigger skin changes.
Certain medications: The long-term use of certain medications such as birth control pills, corticosteroids, or hormone treatments can cause this skin condition.
Growth hormone therapy: Treatment for growth issues in children or adults may sometimes be linked to Acanthosis Nigricans.
Genetics: In some people, especially children, the condition may be present from birth due to inherited traits.
Rare internal malignancies: In rare cases, Acanthosis Nigricans may be associated with certain cancers, especially of the stomach or liver. This is more likely in older adults and is usually accompanied by other serious symptoms.

Risk Factors That Increase the Chances of Developing It

Some individuals are more likely to develop Acanthosis Nigricans due to their underlying health conditions, lifestyle, or genetic background. These risk factors include:

Being overweight or obese: Excess body weight is the strongest risk factor, especially in children and young adults.
Family history: If close family members have had Acanthosis Nigricans, the chances of developing it are higher.
Ethnicity and skin tone: People with darker skin tones, especially those of African, Hispanic, Native American, South Asian, or Caribbean origin, are more prone to this condition.
Metabolic syndrome: Having multiple risk factors like high blood pressure, high blood sugar, and excess body fat can increase your risk.
Insulin resistance: Conditions like prediabetes and type 2 diabetes are strongly linked to this skin change.

Why Awareness Matters

Knowing what can cause Acanthosis Nigricans and who is at risk allows you to take action early.

If you notice dark patches of thickened skin, especially if you have other risk factors, it's a good idea to consult a doctor.

A simple skin check and blood test can help detect insulin resistance or other underlying health issues before they become serious.

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How Is Acanthosis Nigricans Diagnosed?

Acanthosis Nigricans is often easy for doctors to identify with a simple physical exam.

The dark, velvety patches on the skin, usually around the neck, armpits, or groin, are usually clear indicators of the condition.

Common Diagnostic Methods at Medicover Hospitals

Physical Examination

A dermatologist or general physician will examine the affected areas to check for common signs and patterns of Acanthosis Nigricans.

Blood Tests

These are done to check for high blood sugar, insulin resistance, thyroid function, or other hormonal imbalances.

Skin Biopsy (Rare)

If the diagnosis is unclear or if the skin changes seem unusual, a small sample of skin may be tested in the lab. This helps rule out more serious causes, like cancer.

What Are the Treatment Options for Acanthosis Nigricans?

While Acanthosis Nigricans can affect a person's appearance and confidence, the good news is that it is treatable, especially when the root cause is addressed.

Acanthosis Nigricans Treatment Options Available at Medicover

Weight Management Programs

If insulin resistance or obesity is a factor, we offer medically supervised weight loss plans. These include customised diet charts, exercise guidance, and regular follow-ups.

Lifestyle Counseling

Our experts help patients build sustainable routines involving balanced meals, physical activity, and healthier habits.

Blood Sugar Control

If diabetes is diagnosed, treatment may include oral medicines or insulin to regulate blood sugar levels.

Topical Treatments

Retinoid creams, skin-lightening agents, or exfoliating lotions may help improve the skin's texture and tone over time.

Laser Therapy and Dermabrasion

In select cases, cosmetic procedures such as laser treatment can help reduce the appearance of thickened patches.

Antibiotic Creams or Tablets

These may be prescribed if the skin becomes irritated, has an odor, or shows signs of infection.

Medicine Review

If a certain medicine is found to be causing the condition, our doctors may suggest switching to an alternative, safer option.

What to Expect During Recovery

Every patient's recovery journey is different. For many, skin changes begin to improve within 2 to 6 months once the underlying cause is managed. Consistency in treatment and follow-up visits is key.

Visible results depend on the severity of the condition and how well other health issues, such as blood sugar or hormone levels, are controlled.

When to See a Doctor?

Knowing when to seek medical help for Acanthosis Nigricans is important. Early consultation can prevent complications and help detect underlying health issues like prediabetes, thyroid problems, or hormonal imbalance before they get worse.

See a doctor if you notice

New dark patches or changes in skin texture
Skin that becomes itchy, smells bad, or feels irritated.
Skin thickening in folds like the neck, armpits, or groin
Sudden changes in skin without an obvious reason
A personal or family history of obesity, diabetes, or hormone-related conditions

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Who is at Higher Risk for Acanthosis Nigricans?

You may be in a high-risk group if you have any of the following:

Obesity or overweight, excess weight increases insulin resistance.
Family history of diabetes or insulin resistance
Polycystic Ovary Syndrome (PCOS) or other hormonal disorders
Type 2 diabetes or prediabetes
Thyroid disorders, such as hypothyroidism
Long-term use of certain medications like steroids or birth control pills
Dark patches are appearing suddenly and spreading quickly.

If you fall into any of these categories, it's important to consult a dermatologist or endocrinologist early. Timely diagnosis and treatment can help manage the condition and prevent further skin changes.

How Can I Manage Acanthosis Nigricans?

Managing Acanthosis Nigricans self-care involves a combination of treating the skin changes and addressing the underlying cause, which is most often insulin resistance, obesity, or hormonal imbalance.

Steps to Manage Acanthosis Nigricans

Treat the Underlying Cause:

Manage blood sugar: If AN is linked to diabetes or prediabetes, controlling blood sugar through medication, diet, and exercise is essential.
Address hormonal issues: Conditions like PCOS or thyroid disorders should be diagnosed and treated with help from a doctor.
Lose excess weight: For overweight or obese individuals, gradual and healthy weight loss can help improve or even reverse certain skin changes.

Improve Skin Appearance:

Topical creams: Prescription creams, such as retinoids, exfoliating agents (like salicylic acid), or urea-based creams, may help lighten and soften the skin.
Antibacterial or antifungal creams: These are sometimes used to treat irritation or infection.
Laser therapy or chemical peels: In select cases, dermatologists may recommend advanced treatments for cosmetic improvement.

Adopt a Healthy Lifestyle:

Eat a balanced, low-sugar diet.
Stay physically active by aiming for 30 minutes of exercise daily.
Avoid self-medicating with steroids or hormone pills.
Maintain good hygiene and gently cleanse areas where skin changes occur.

Regular Medical Checkups:

Visit an endocrinologist or dermatologist for proper evaluation.
Monitor for any sudden changes in the skin, especially in non-obese individuals, as this may require further testing.

What Precautions Can Help Prevent Acanthosis Nigricans?

Acanthosis Nigricans (AN) is often more than just a skin condition.

Taking early steps toward prevention can reduce the risk of developing AN and help identify any hidden medical concerns before they become serious.

The good news is that many of the steps to prevent AN are also beneficial for your overall health.

Prevention Tips for Acanthosis Nigricans

Some simple and practical habits that can help prevent Acanthosis Nigricans and the conditions associated with it:

Maintain a Healthy Weight: Obesity is one of the most common triggers of AN. Losing even a small amount of weight can help reduce symptoms and prevent new skin changes.
Follow a Balanced, Low-Glycemic Diet: Choose foods that help control blood sugar, such as whole grains, fresh vegetables, legumes, and lean proteins. Avoid excess sugar, white bread, and processed snacks.
Stay Physically Active: Regular exercise improves insulin sensitivity and helps regulate hormone levels. Aim for at least 30 minutes of activity most days of the week.
Monitor Blood Sugar Levels: If you have diabetes, prediabetes, or a family history of these conditions.
Avoid Unsupervised Use of Hormonal Medications: Long-term use of steroids or hormonal treatments should always be done under medical guidance, as they can affect insulin and hormone levels.
Manage Underlying Health Conditions: Conditions such as thyroid disorders, polycystic ovary syndrome (PCOS), and insulin resistance should be regularly monitored and treated to ensure optimal health.

Possible Complications of Acanthosis Nigricans

While AN itself is not harmful, ignoring it may delay important diagnoses.

Type 2 Diabetes: AN is often one of the earliest visible signs of insulin resistance and may appear before diabetes is formally diagnosed.
Hormonal or Endocrine Disorders: Conditions such as PCOS, thyroid dysfunction, or adrenal disorders can also lead to AN.
Rare Risk of Malignancy: In rare cases, sudden or widespread AN in non-obese individuals may point to an internal cancer, especially of the stomach or liver.
Emotional and Social Impact: The dark, thickened skin patches may cause self-consciousness, especially when they appear on the neck, underarms, or face. This can affect confidence and emotional well-being.

Our Experience Treating Acanthosis Nigricans

At Medicover Hospitals, we understand that Acanthosis Nigricans is not just a cosmetic concern; it may reflect deeper health issues that need attention.

Our expert team of dermatologists and endocrinologists work closely together to uncover the root cause of the condition and provide personalised treatment.

From blood sugar management and hormonal evaluation to skincare and lifestyle guidance, we support every patient with care, clarity, and compassion.

We focus not only on improving your skin but also on protecting your long-term health and emotional well-being.

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