Acanthosis Nigricans
Acanthosis Nigricans is a skin condition characterized by dark, discolored, velvety areas in skin folds and body creases. The skin affected by acanthosis nigricans can become thickened. It typically affects the armpits, groin, and neck.
Skin changes in this disease usually occur in people who are obese or diabetic. Children who experience this skin condition are at high risk of developing type 2 diabetes.
Symptoms of Acanthosis Nigricans
Skin discoloration is the only symptom of this disease. Sufferers will find thickening and darkening of the skin in the folds. Changes usually occur slowly.
The main symptoms of this disease are:
- Hyperpigmentation: This occurs when certain areas of the skin become dark, or more pigmented, and can turn grayish, black, or brown.
- Hyperkeratosis: This is when areas of skin become thick and may appear velvety. Then lines on the skin may become deeper and more visible, and wart-like growths may appear.
This disease can also cause additional skin symptoms, such as:
- Drought.
- Rough.
- Itchy.
- Unusual odor.
Malignant disease can cause more severe and widespread skin changes than benign (non-cancerous) conditions. Some people experience these skin changes on only one side of the body. This condition is known as unilateral acanthosis nigricans.
Skin changes usually develop slowly. Sometimes, the condition can be present from birth but usually appears in childhood or adulthood.
This skin condition can occur anywhere, but commonly appears on the:
- Anus.
- Armpit.
- Genitals.
- Inner thigh.
- Back and sides of the neck.
In rare cases, the disease can also appear in:
- Back of the knee.
- Front elbow.
- Knuckles.
- Lips.
- Palm.
- Sole.
- Stomach.
- Under the breast.
Risk Factors for Acanthosis Nigricans
Some risk factors for acanthosis nigricans are:
- Obesity, the higher a person’s weight, the greater the risk of developing this disease.
- Race, some studies show, this disease is more common in Native American races.
- Family history, some types of this disease are hereditary.
Causes of Acanthosis Nigricans
The causes of acanthosis nigricans are often associated with the following conditions:
- Insulin resistance. Most people with acanthosis nigricans also have insulin resistance, which is when the insulin produced by the body cannot work or in other words diabetes occurs.
- Type 2 diabetes. A 2016 study noted that more than half of children with type 2 diabetes have acanthosis nigricans. It can also develop in adults with diabetes.
- Hormonal disorders. Acanthosis nigricans occurs in people who have ovarian cysts, decreased thyroid gland function, and problems with the adrenal glands.
- Certain medications. High doses of niacin, birth control pills, prednisone, and other corticosteroid medications can cause acanthosis nigricans.
- Cancer. Sometimes acanthosis nigricans occurs in conjunction with lymphoma, or when there is a tumor or cancer in the stomach, colon or liver.
- Genetics. Hereditary acanthosis nigricans may be present at birth. However, most people develop this skin condition during childhood or later in life.
- Polycystic ovary syndrome (PCOS) and ovarian cysts. Both conditions are associated with insulin resistance and diabetes.
Diagnosis of Acanthosis Nigricans
This condition is easily recognized by sight. The doctor may also need to check for diabetes or insulin resistance as a cause.
The examination may also include a fasting glucose or insulin test. Your doctor will also need to review the medications you are taking. Some medications are thought to trigger this condition.
In rare cases, your doctor may also need to do other tests. For example:
- Blood tests, which can help confirm or rule out underlying conditions, such as diabetes.
- Skin biopsy, which involves taking a sample of skin tissue.
Acanthosis Nigricans Treatment
Typically, doctors start treating the underlying cause. Once this is under control, the skin changes will gradually improve. Treatment varies depending on the underlying problem, including:
1. Lose weight
People who have this condition, which occurs due to obesity or insulin resistance, need to lose weight. Weight loss can improve skin texture, but discoloration may remain.
2. Stabilize hormones
For people with hormonal disorders, the disease can be cured by controlling the use of drugs, lifestyle changes, and other treatments.
3. Managing diabetes
People with type 2 diabetes may need medication, regular blood sugar monitoring, and dietary and lifestyle modifications. Once insulin levels are stable, symptoms of acanthosis nigricans may resolve.
4. Avoid certain medications
If a particular medication or supplement is causing acanthosis nigricans, your doctor may recommend avoiding it or switching to an alternative. In most cases, the skin will return to normal after stopping the medication.
5. Treating cancer
Malignant acanthosis nigricans may disappear after surgery to remove the cancerous tumor. Other treatments for cancer include chemotherapy and radiation therapy.
6. Cosmetic procedures
To reduce the appearance or odor of acanthosis nigricans, some sufferers can try cosmetic treatments such as:
- Prescription creams to lighten skin or to soften rough skin areas.
- Laser therapy to reduce skin thickening or brighten skin.
- Using antibacterial soap.
- Using topical antibiotics.
- Oral medication.
Cosmetic treatments do not actually address the underlying cause of acanthosis nigricans. However, they may improve the appearance of the skin until other treatments are implemented.
Prevention of Acanthosis Nigricans
You can prevent acanthosis nigricans by maintaining a healthy lifestyle. Losing weight and maintaining a balanced diet greatly affect the development of acanthosis nigricans.
If acanthosis nigricans occurs due to obesity, you can prevent the condition by managing a healthy weight. A healthy diet or eating pattern can maintain blood sugar (insulin) levels and help prevent acanthosis nigricans.
Other preventive measures include:
- Managing medical conditions associated with acanthosis nigricans. Such as thyroid and diabetes.
- Avoiding certain medications, such as birth control pills, can cause or worsen acanthosis nigricans.
Complications of Acanthosis Nigricans
Acanthosis nigricans can cause changes in skin color and skin structure. This can interfere with the sufferer’s self-confidence. In addition, acanthosis nigricans can also increase the risk of developing type 2 diabetes later in life.
If acanthosis nigricans occurs due to certain conditions, such as obesity that is not treated properly, then the possible complications that may arise are:
- Blood sugar increases.
- Sleep apnea or sleep disorders.
- Metabolic syndrome.
- Heart disease.
When to See a Doctor?
Discuss with your doctor if you notice sudden thickening and darkening of your skin. Your doctor will check for underlying causes that require further treatment.