What Is Dark Neck and How Do You Treat It?

Dark neck is a common condition in which the skin on the neck is noticeably darker than the rest of the body. Also known as “black neck,” dark skin on the neck is typically not a cause for concern and is not contagious. In some cases, it may be a sign of an underlying health issue. 

This article explores the symptoms, causes, and treatments for dark neck. 

What Does Dark Neck Look Like?

Dark neck typically develops on the back of the neck (nape) and may appear as a discolored band or line around the back and sides of the neck. In people with darker skin tones, dark neck may appear leathery.

Symptoms of Dark Neck

The primary symptom of dark neck is darker skin in the folds of the back and sides of the neck. Other dark neck symptoms may include:

• Skin feeling thicker than the surrounding skin
• Skin feeling velvety to the touch 
• Itchiness 
• Skin tags 

Causes of Dark Neck

In some cases, the skin on the neck may appear darker after overexposure to the sun’s ultraviolet (UV) rays or from hormonal changes. Certain skin conditions may cause dark neck, too.

Acanthosis Nigricans

Acanthosis nigricans is a skin condition associated with darkened, thickened skin that may feel velvety. It occurs most often on the neck, groin, armpits, and other areas with skin folds (e.g., knees, elbows). It is not a disease and is not contagious. It is most common in people who have obesity but may also develop in healthy people, particularly those with darker skin tones. 

Common causes of acanthosis nigricans include:

• Type 2 diabetes 
• Cushing’s syndrome (exposure to too much cortisol)
• Polycystic ovarian syndrome (PCOS) (ovarian cysts)
• Hypothyroidism (underactive thyroid gland)
• Certain cancers (e.g., stomach cancer) 

Certain medications, such as steroids or hormonal contraceptives, may also cause acanthosis nigricans. 

Dermatitis Neglecta

Dermatitis neglecta is a skin condition that occurs as a result of poor hygiene. It develops when the skin is not adequately washed or scrubbed, causing sweat, oil, and bacteria to accumulate and form waxy, crusty scales and flakes of skin. It most often occurs in people with physical or mental disabilities, pain, trauma, or previous surgery in the affected area.

It typically evolves over two to four months of improper cleansing and is most commonly seen on the face, neck, trunk, genitals, and surgical sites (e.g., cataract extraction).

Dermatitis neglecta is easily treated by scrubbing the affected areas with soap and water and can be prevented by practicing good personal hygiene.

Drug-Induced Skin Pigmentation

Drug-induced skin pigmentation is a form of hyperpigmentation that may be caused by taking certain medications, including:

• Non-steroidal anti-inflammatory drugs (NSAIDs) 
• Antimalarials
• Antipsychotics 
• Dilantin (phenytoin) 
• Tetracyclines 
• Heavy metals 

About 10–20% of all hyperpigmentation cases result from medications. Discoloration may affect any part of the body, including the neck. Colors range from golden brown to blue-grey depending on the drug involved.

In most cases, hyperpigmentation will fade when you stop taking the medication causing it. In others, it may take years or cause permanent hyperpigmentation. 

Diagnosis

If you have the signs and symptoms of dark neck, it’s important to see your healthcare provider. Though dark neck itself is not a disease, it is often a symptom of an underlying condition that requires diagnosis and treatment. 

Your healthcare provider will perform a thorough physical examination to check the affected areas, including a skin exam. They may order additional testing, such as blood work, to check for diabetes, hypothyroidism, and other conditions based on your symptoms.

Treatment

Treatment for dark neck varies, depending on the cause. When you receive a diagnosis, your treatment plan should address the symptoms of that particular health condition. If the underlying cause is properly treated, dark neck may resolve over time.

In the case of drug-induced skin pigmentation, dark neck may go away when the medication causing it stops. If acanthosis nigricans is the cause of dark neck, weight loss and/or treatment for diabetes may help the skin return to its normal color. 

Sometimes, dark neck may remain, even after the cause has been treated. If you feel self-conscious about the change in your appearance, certain treatment options may help reduce hyperpigmentation. Talk to your healthcare provider or a dermatologist to determine which treatment may be best for you.

Treatment options for dark neck may include:

• Chemical peels
• Topical prescription creams/medications 
• Laser treatments
• Dermabrasion

Summary 

Dark neck, or black neck, is a common condition that may appear as a band or line of skin around the back and sides of the neck that is darker than the surrounding skin. It is not contagious and is generally benign (not harmful), but it may be a sign of an underlying health condition.

Common causes include acanthosis nigricans, dermatitis neglecta, and drug-induced hyperpigmentation. Treatments for dark neck vary depending on the cause. See a healthcare provider for an accurate diagnosis and treatment. 

A Word From Verywell

Dark neck is common, but it may leave you feeling self-conscious. Talk with your healthcare provider about potential treatments to reduce neck hyperpigmentation. Wearing a high-SPF sunscreen and protective clothing when out in the sun may help prevent dark neck from worsening.