Skin Health More Skin Conditions Options for Treating Acanthosis Nigricans By Nicole Galan, RN facebook twitter linkedin Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book." Learn about our editorial process Nicole Galan, RN Medically reviewed by Medically reviewed by Casey Gallagher, MD on February 22, 2020 Casey Gallagher, MD, is board-certified in dermatology and works as a practicing dermatologist and clinical professor. Learn about our Medical Review Board Casey Gallagher, MD Updated on September 17, 2020 Print Acanthosis nigricans is patches of dark, thickened, velvety skin that can appear on the neck, on the thighs, or on the vulva. The condition itself isn't harmful or contagious, although you may not like its appearance. But since it can be a sign of other medical conditions, it is a concern to bring up with your doctor. Rawpixel / Getty Images Acanthosis Nigricans Symptoms Dark, thickened, velvety skin slowly develops in areas of the body where there are skin folds, typically the armpits, groin, and the fold of the neck. Some people call the line on the neck the sugar line or sugar necklace (due to the association with diabetes). The pigmentation may also appear over the joints in the fingers and toes. The skin stays soft, unlike some other syndromes where the skin toughens. Less often, pigmentation will appear on the lips, palms or soles, and more frequently that is associated with those who have cancer. Causes Acanthosis nigricans can be seen in otherwise healthy people, so it is not always related to a medical condition. However, it is associated with these conditions: Obesity: The most common association; losing weight can reverse itGenetic disorders: Including Down syndromeCancers of the digestive tract, liver, kidney, bladder, or lymphoma: This is rarePolycystic ovary syndrome (PCOS) and ovarian cystsMedications: Birth control pills, human growth hormone, high-dose niacin, prednisone, and some other medicationsType 2 diabetes: One 2016 study noted that more than half of children with type 2 diabetes have acanthosis nigricans. Adults with diabetes often develop it as well. Insulin Resistance and Acanthosis Nigricans Insulin resistance means that the body is not responding as well to insulin as it could be (this happens in people with PCOS and people who are pre-diabetic, for example). Insulin causes glucose to be taken into the body cells to be used for energy.Someone with insulin resistance will require larger and larger amounts of insulin to be secreted before glucose is taken into the body tissues, and eventually change the way the body deals with sugar. One of these ways is making extra pigment. Diagnosis Report the symptoms of acanthosis nigricans to your doctor, who will examine your skin and can usually diagnose it based on its appearance. Your doctor will also likely order blood tests for blood sugar level or insulin level. You may also undergo endoscopy or X-rays to check for cancer and other causes. Treatment Primary treatment of acanthosis nigricans aims to correct the underlying cause. Weight loss and reversing insulin resistance are the most effective ways to eliminate any skin changes. It is reversible and will disappear as the cause is treated. There are cosmetic options if acanthosis nigricans is severe or not being managed by weight loss. Treatments include laser therapy, topical retinoids, and dermabrasion. Topical retinoids increase shedding of normal skin cells, which can reduce the appearance of the lesions. Both dermabrasion and laser therapy are procedures that should be performed only by a certified dermatologist. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Kapoor S. Diagnosis and treatment of acanthosis nigricans. Skinmed. 2010;8(3):161-4. American Academy of Dermatology. Acanthosis nigricans: Signs and symptoms. Kota SK, Tripathy PR, Kota SK, Jammula S. Type 2 diabetes mellitus: An unusual association with Down's syndrome. Indian J Hum Genet. 2013;19(3):358-9. doi:10.4103/0971-6866.120818 American Academy of Dermatology. Acanthosis nigricans: Who gets and causes. Bahadursingh S, Mungalsingh C, Seemungal T, Teelucksingh S. Acanthosis nigricans in type 2 diabetes: prevalence, correlates and potential as a simple clinical screening tool - a cross-sectional study in the Caribbean. Diabetol Metab Syndr. 2014;6:77. doi:10.1186/1758-5996-6-77 National Institute of Diabetes and Digestive and Kidney Disease. Insulin resistance and prediabetes. Updated May 2018. Additional Reading Ng HY. Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges. Adolesc Health Med Ther. 2017;8:1-10. doi:10.2147/AHMT.S103396