What is Acanthosis Nigricans: Understanding Causes, Symptoms, Treatments, Home Remedies, and Prevention

What is Acanthosis Nigricans

We have often seen that some people have a lot of darkness on their neck and underarms, especially in teenagers, which does not reduce in any way. And many people also pass comments like “Don’t you clear your neck properly”, which is often embarrassing. Many people apply bleach on it, thinking of cleaning it with a scrubber, but this blackness does not clear.

It is called the black neck, velvet skin in the common language and Acanthosis Nigricans in the medical language. The cause of which may be some other physical medical condition.

Therefore, today we have brought you detailed information about what is Acanthosis Nigricans, its symptoms, factors, treatments and how to get rid of this problem.

Dark neck or Velvet Skin
Dark neck or Velvet Skin

What is Acanthosis Nigricans?

Acanthosis Nigricans is a skin condition characterized by dark, thickened patches of skin that typically appear in body folds and creases[i]. The affected skin may have a velvety texture and can be accompanied by itching and irritation. Acanthosis nigricans is not a disease but a symptom or marker of an underlying health issue.

The condition is most commonly found in the back of the neck, armpits, groin, and inner thighs. In some cases, it can also affect the lips, palms, soles of the feet, and other regions. The darkening and thickness of the skin occurs when the number of skin cells increases, as does the synthesis of melanin, the pigment responsible for skin colour.

As per NIH Study[ii] Acanthosis nigricans is strongly associated with insulin resistance, a condition in which the body’s cells become less responsive to the hormone insulin. This can occur due to obesity, hormonal disorders like polycystic ovary syndrome (PCOS), certain medications, or underlying medical conditions such as diabetes.

While acanthosis nigricans itself is not harmful, it can serve as an indicator of potential health problems. It identifies and addresses the underlying cause of acanthosis nigricans to prevent or manage associated conditions such as diabetes, PCOS, or other hormonal imbalances.

Suppose you notice any changes in your skin, especially the appearance of dark, thickened patches in body folds. In that conditions, it is advisable to consult a healthcare professional or dermatologist for a proper diagnosis and appropriate treatment.


The most prominent symptom of acanthosis nigricans is the appearance of dark, velvety patches of skin. These patches may be thick, rough, and have a slightly raised texture. Common areas affected by acanthosis nigricans include the back of the neck, armpits, groin, and inner thighs[iii]. In some cases, the condition may also affect the lips, palms, soles of the feet, and other areas.

Other signs and symptoms may include:

  1. Itching and irritation in the affected areas.
  2. Skin tags: Small, benign growths on the skin’s surface.
  3. Hyperpigmentation: Darkening of the skin in areas not typically affected by acanthosis nigricans.
  4. Brown or black skin patches on the neck may look like hard pigmentation, which may feel velvety to the touch.
Acanthosis Nigricans Causes
Acanthosis Nigricans Causes

Acanthosis Nigricans Causes

The root cause of acanthosis nigricans is thought to be insulin resistance, Insulin is a hormone that controls blood sugar levels in our bodies; when our bodies gain resistance to its effects, they create more insulin to compensate. This excess insulin can trigger the production of skin cells and melanin, which causes the skin to darken and thicken.

Acanthosis nigricans can also be caused by several other factors, including:

  1. Obesity: Excess weight and body fat can contribute to insulin resistance, making obesity a common risk factor for acanthosis nigricans.[iv]
  2. Hormonal disorders: Certain hormonal imbalances, such as polycystic ovary syndrome (PCOS) or adrenal gland disorders, can develop acanthosis nigricans[v].
  3. Medications: Some medications, such as oral contraceptives, high-dose niacin, and certain antipsychotics, can cause acanthosis nigricans as a side effect.

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Treating acanthosis nigricans involves addressing the underlying cause, managing insulin resistance, and improving the appearance of the affected skin. Here are some common treatment approaches[vi]:

  1. Addressing some underlying conditions: If acanthosis nigricans is caused by some medical condition, such as diabetes or PCOS, treating and managing that condition can help improve the skin condition.
  2. Lifestyle changes: Maintaining a healthy weight through regular exercise and a balanced diet can help improve insulin sensitivity and reduce the severity of acanthosis nigricans.
  3. Topical treatments: Certain creams or lotions containing retinoids, salicylic acid, or alpha hydroxy acids may be prescribed to help lighten and exfoliate the affected skin.
  4. Medications: In some cases, medications like oral retinoids or metformin may be prescribed to improve insulin sensitivity and reduce the severity of acanthosis nigricans.

Home Remedies and Prevention of Acanthosis Nigricans

While home remedies cannot cure acanthosis nigricans, they can help improve the condition and prevent it from worsening. Please note that these remedies should be used with medical guidance and treatment. Here are some home remedies and prevention strategies for acanthosis nigricans[vii]:

  1. Maintain a healthy weight: Obesity is strongly associated with insulin resistance and acanthosis nigricans. Losing and maintaining a healthy body weight can improve insulin sensitivity and reduce the severity of the condition. Focus on a balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins. Regular exercise, such as brisk walking or swimming, can help manage weight and improve overall health.
  2. Sugar and carbohydrate control: Limiting sugary foods and refined carbohydrate consumption can help regulate blood sugar levels and reduce insulin resistance. Opt for healthier alternatives like whole grains, legumes, and low-glycemic index foods.
  3. Topical treatments: Although not a cure, specific topical treatments may help improve the appearance of the affected skin. Look for creams or lotions containing ingredients like retinoids, salicylic acid, or alpha hydroxy acids, which can help exfoliate and lighten the skin. However, please consult a dermatologist before using any over-the-counter products to ensure they suit your skin type.
  4. Natural moisturizers: Keeping the affected areas well-moisturized can help alleviate discomfort and improve the skin’s texture. Opt for natural moisturizers like aloe vera gel or coconut oil, which have soothing and hydrating properties.
  5. Regular skin care routine: Maintain a consistent skincare routine that includes gentle cleansing and regular exfoliation (light exfoliation) to help remove dead skin cells and improve the texture of the affected areas. Avoid harsh soaps and abrasive scrubs that can further irritate the skin.
  6. Avoid tight-fitting clothes: Wearing loose-fitting clothing can minimize friction and irritation in the affected areas. This can help prevent further darkening and thickening of the skin.
  7. Regular monitoring and follow-up: Keep a close eye on any changes in the appearance or severity of acanthosis nigricans. Regularly consult a healthcare professional or dermatologist to monitor progress, adjust treatment if necessary, and address any concerns.

Remember, home remedies and prevention strategies may vary depending on individual circumstances. It is advisedl to consult with a dermatologist for personalized advice and guidance based on your specific condition and needs.

In children, acanthosis nigricans is often associated with similar causes to adults. The primary reason for acanthosis nigricans in kids is insulin resistance. This excess insulin stimulates the growth of skin cells and the production of melanin, resulting in the characteristic dark, thickened patches of skin.

The following are common Factors of Acanthosis Nigricans in children:

  1. Obesity: Excess weight and obesity are significant risk factors for children’s insulin resistance and acanthosis nigricans. The accumulation of body fat can contribute to metabolic changes and insulin dysfunction.
  2. Genetic Factors: Some cases of acanthosis nigricans in children may have a genetic component. Specific genetic syndromes, such as type A insulin resistance syndrome, can cause early-onset acanthosis nigricans.
  3. Hormonal Disorders: Conditions like polycystic ovary syndrome (PCOS) and adrenal gland disorders can disrupt hormone balance in children, leading to insulin resistance and acanthosis nigricans.
  4. Medications: Certain medications, such as high-dose niacin or corticosteroids, can induce acanthosis nigricans as a side effect in children.
  5. Rare Underlying Conditions: In some rare cases, acanthosis nigricans in children may be associated with underlying medical conditions like insulinoma (a tumour of the insulin-producing cells in the pancreas) or certain hormone-secreting tumours.

If a child exhibits signs of acanthosis nigricans, it is crucial to consult a paediatrician or dermatologist for a proper evaluation. The healthcare professional will assess the child’s medical history, and may order additional tests to the contributing factors. Treatment will address the underlying cause, promote a healthy lifestyle, and manage associated conditions like obesity or hormonal imbalances.

It is important to note that acanthosis nigricans in children should not be ignored, as it may indicate the presence of underlying health issues that require attention and management.

[i] Crouzon syndrome with acanthosis nigricans – MedlinePlus. https://medlineplus.gov/genetics/condition/crouzon-syndrome-with-acanthosis-nigricans/

[ii] https://www.ncbi.nlm.nih.gov/books/NBK431057/

[iii] https://www.mayoclinic.org/diseases-conditions/acanthosis-nigricans/symptoms-causes/syc-20368983

[iv] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5179206/

[v] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334071/

[vi] https://www.lybrate.com/topic/acanthosis-nigricans

[vii] https://www.lybrate.com/topic/acanthosis-nigricans#:~:text=Diet%20modification%3A%20Eating%20a%20healthy,weight%20as%20part%20of%20treatment.

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