Acanthosis Nigricans: Causes, Symptoms, and Expert Treatments

December 6, 2023

Acanthosis Nigricans on the neck of a dermatology patient

Many people have never heard of acanthosis nigricans, and this relatively rare condition isn’t something most need to worry about. According to Dr. Araya “Jay” Zaesim of U.S. Dermatology Partners in Lee’s Summit, Missouri, and Overland Park, Kansas, “While acanthosis nigricans is rare, the symptoms can be startling, so it’s better for people to be aware of the common symptoms of this condition. This is especially true for those with diabetes, dark skin tone, excessive body weight, polycystic ovary syndrome (PCOS), and other common risk factors for acanthosis nigricans since they are most likely to develop this condition.” In this blog, you can learn more about acanthosis nigricans from Dr. Zaesim.

What is Acanthosis Nigricans?

Acanthosis nigricans causes skin thickening (hyperkeratosis) and darkening (hyperpigmentation). The skin may also take on a velvety texture. In most cases, acanthosis nigricans develops in skin folds like the armpits, groin, knee, or elbow. At first, it may appear that a dye or chemical has coated the skin, and many people attempt to scrub away the discoloration before realizing what it is.

Unraveling the Causes

The following causes of acanthosis nigricans are often uncovered by dermatologists during diagnostic consultations:

  • Genetics – People who have family members with acanthosis nigricans are at significantly higher risk for this condition.
  • Insulin resistance – Developing acanthosis nigricans is often related to pre-diabetes, diabetes, and PCOS all of which impact insulin production.
  • Hormonal imbalance – Thyroid disease, issues with adrenal gland function, and PCOS all negatively impact hormone levels, which can trigger acanthosis nigricans flare-ups.
  • Medications – Birth control pills, corticosteroids, and niacin have all been linked to acanthosis nigricans flare-ups.
  • Cancer – While rare, acanthosis nigricans can also be a symptom of cancer. Specifically, lymphoma and cancers of the stomach, liver, and colon may cause acanthosis nigricans to flare up. This is more likely if symptoms appear very quickly.

Recognizing the Symptoms

The specific symptoms of acanthosis nigricans are unique to the individual, but some of the most common symptoms include:

  • Brown or black patches of discolored skin
  • Thickened skin
  • Velvety texture
  • Itching
  • An unusual or bad odor
  • Skin tags

Acanthosis nigricans symptoms typically develop relatively slowly over several months or even years. Quickly forming acanthosis nigricans symptoms can be a warning sign of cancer, but whether this condition is a warning sign of cancer or not, it’s always essential to visit your dermatologist as soon as you notice signs of acanthosis nigricans to begin planning treatment to manage this condition.

Professional Treatment Options

Treatment for acanthosis nigricans should be carefully planned by working with a board-certified dermatologist to ensure the right medications and procedures are utilized. Your dermatologist will create a personalized treatment plan to address the symptoms of acanthosis nigricans and clear your skin. Some common treatments for acanthosis nigricans include:

  • Skin lightening – There are numerous topical treatment options to lighten patches of hyperpigmented skin, but you should always use products recommended or prescribed by your dermatologist.
  • Evening skin tone and texture – Oral or topical retinoids may be used to improve the tone and texture of the skin. Once the hyperpigmented areas start to lighten, retinoids provide additional support in restoring the natural, healthy skin tone and texture.
  • Addressing bacteria – The odor and itch are often related to a bacterial infection, so oral or topical antibiotics may be prescribed.
  • Removing thickened skin – Laser treatment may be recommended to remove thick patches of skin. Laser therapy can be especially beneficial since it’s able to target and remove the specific skin cells that are impacted by acanthosis nigricans.
  • Alleviating pain – Over-the-counter pain relievers are typically recommended to manage any discomfort.
  • Cleaning the affected area – Bacteria may accumulate on skin impacted by acanthosis nigricans, leading to worsened symptoms. For this reason, it’s important to keep skin clean and dry. Use a gentle cleanser in the area several times each day. ZO Skin Health Gentle Cleanser is a great option to thoroughly cleanse skin without drying or irritating.

While treatments for acanthosis nigricans may address the symptoms of this skin condition, they are not necessarily enough to completely clear skin. Instead, you’ll need to combine these treatments with the management of underlying conditions that are known to cause acanthosis nigricans.

Preventing and Managing Acanthosis Nigricans

In addition to the treatments explored above, it’s also important to address and manage the underlying causes of acanthosis nigricans. Specifically, those who experience acanthosis nigricans flare-ups should:

  • Work to maintain a healthy body weight. For many, weight loss significantly improves the symptoms of acanthosis nigricans. Some even achieve complete skin clarity after losing weight.
  • Manage diabetes and other causes of insulin resistance. Stabilizing insulin levels and keeping the other symptoms of these conditions in check minimizes the risk of acanthosis nigricans and improves overall health.
  • Understand changes in hormone levels related to thyroid disease, PCOS, and adrenal gland dysfunction that may trigger acanthosis nigricans flare-ups and work with medical professionals to stabilize hormone levels.
  • Review your medications with a physician. There are numerous medications and even supplements linked to acanthosis nigricans, so make sure you aren’t taking any of these medications.

Receive an Accurate Diagnosis & Effective Treatment

When it comes to diagnosis and treatment planning, Dr. Zaesim says, “No one ever suspects acanthosis nigricans right away. People will often use harsh sugar scrubs or chemical peels on their skin in an attempt to remove the impacted skin, and they’re confused when nothing changes. This uncommon skin condition requires an expert eye to diagnose accurately. If you notice warning signs of acanthosis nigricans, a dermatologist can help diagnose this condition with certainty and provide effective treatment options to clear up symptoms and improve overall skin health.”

Partner with a Professional

If you’ve noticed any of the common warning signs of acanthosis nigricans, don’t hesitate to reach out to a dermatologist to schedule a consultation. During this initial visit, your dermatologist can provide an accurate diagnosis, answer your questions, and talk through treatment options if necessary. When you’re ready to get started, simply fill out the online scheduling form. Once the U.S. Dermatology Partners team hears from you, they’ll be in touch to finalize the details of your visit.

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