Why Does My Neck Appear Dark? – Acanthosis Nigricans

Many times, we come across people who have dark skin pigmentation around their necks. We had a patient with a similar problem who stated that he feels he has a dirt magnet around the neck. Despite bathing twice a day, the dirt around his neck won’t go away. Initially, he thought that it was a reaction to the gold chain he was wearing. However, it persisted despite stopping the use of the chain. To lighten it, he used to scrub the skin hard until it became sore. Disappointed, he decided to seek treatment for it. Also, he had similar pigmentation over his underarms and groins.

He was surprised when we told him that it is not dirt but a medical condition called Acanthosis Nigricans.

What is Acanthosis Nigricans?

It is a condition where a person develops brown to dark-colored velvety pigmentation and thickening of the skin in the body folds, particularly on the back and sides of the neck, underarms, and groins.

What Causes Acanthosis?

It is not a disease in itself but a sign of some underlying health issue/disease condition.

1. Insulin Resistance: Pancreas secretes a hormone called Insulin that helps carry glucose inside the body cells. When these cells do not respond to insulin, the condition is called insulin resistance. This, later on, leads to Diabetes Mellitus. Insulin resistance may lead to this skin condition.

2. Polycystic Ovarian Syndrome: Commonly observed in females where there is a failure to release mature eggs from the ovaries that, later, turn into cysts inside the ovaries. This is associated with weight gain and increased levels of androgen. It can be the cause of acanthosis nigricans.

3. Hormonal Disorders: Hormonal disorders such as Cushing’s syndrome, Hypothyroidism, Addison’s disease, etc. can lead to the condition.

4. Obesity 

5. Drug-Induced: Prednisolone and other corticosteroids, Nicotinic acid, Oral contraceptives, Insulin, and other hormone therapies can cause this skin condition. The condition usually resolves after stopping the medicines.

6. Hereditary

7. Acral Acanthosis: It is observed on the upper surface of hands and feet in people who are dark-skinned and otherwise healthy.

8. Cancer: Acanthosis can also be a sign of underlying cancerous conditions, particularly cancers of the digestive system and urinary and genital organs.

What Are the Signs of Acanthosis?

Here are some common signs of acanthosis nigricans.

1. Darkening and thickening of the skin on the back and sides of the neck, underarms, and groins
2. If associated with insulin resistance and obesity, the person can also have skin tags on the body folds, particularly on the neck and underarms.
3. People with cancer can have severe and big patches of Acanthosis inside their mouths that would spread rapidly.
4. It can be associated with itching.

How to Know the Reason Behind my Acanthosis?

Visit a physician.

• The physician will ask you for some details to know the history of the onset and progress of your problem. Also, he will ask you some questions to know about the underlying medical conditions you have.
• He will examine you.
• He may prescribe you a series of tests to know the extent of hormonal imbalance and rule out the possibilities of cancer.

Treatment for Acanthosis Nigricans:

Since Acanthosis is just a sign of underlying health conditions, there is no treatment to address it alone. Treating the underlying condition will help to lighten up the pigmentation.

1. Your doctor may suggest treatment according to the underlying health condition that you have.
2. He may change the prescription if your present medicines are causing Acanthosis.
3. Lose weight if you are overweight.

What Skincare Should I Follow for Acanthosis?

1. Use a mild soap for the skin.
2. Avoid scrubbing the affected parts as it may lead to more thickening of the skin.
3. If you are overweight, wipe the skin folds dry, and use some talcum powder, as there could be chances of fungal infection in these skin folds, particularly over the underarms and groins.

What Diet Should I Follow for Acanthosis?

If you have Acanthosis because of being overweight, following these helpful tips may help you alleviate it.

1. Have 5-7 servings of vegetables and fruits in your diet.
2. Replace the foods having simple carbohydrates in your diet with foods having complex ones which include whole-wheat flour with bran, whole pulses, brown rice, etc.
3. Reduce the serving size. Prefer to eat 6 small meals instead of having 3 big meals.
4. Avoid food items made from refined flour, such as biscuits and bakery products.
5. Avoid processed foods, such as processed cheese, ready to cook food, breakfast cereals, and others.
6. Avoid aerated drinks and sugary fruits.
7. Reduce the amount of ghee, butter, margarine, and oils in your diet. Switch to healthy oils, such as olive oil.
8. Make a habit to exercise 30 minutes every day.
9. Practice meditation for stress-relief as stress is linked with obesity.

Now that you know these diet tips to follow to alleviate acanthosis nigricans, make sure you follow them if you happen to suffer from the skin condition and obtain relief.