What is this brown discoloration on my neck?

 Is my skin trying to tell me something?

The answer to this question is “yes”! Our skin often provides clues to our internal health or lack thereof. One skin change, known as acanthosis nigricans, is common in those who are obese and/or have diabetes. It can signal our body’s internal resistance to insulin.

What are the symptoms?

Acanthosis nigricans is characterized by a dark and velvety skin discoloration in the folds and creases. In those individuals affected, it is commonly seen in the armpits, groin, and back of the neck, but can also be seen on the knees, knuckles and elbows.  The discoloration is not painful and commonly develops slowly over a period of time. Acanthosis nigricans can have a slight odor to it, can itch, and skin tags are common in these areas.

Although the most common reason for developing this skin condition is insulin resistance and obesity, there are other causes of acanthosis nigricans. Other causes include malignancies, certain medications, and hormonal disorders.

It is important for your dermatologist and primary care physician to work together to find the cause of the condition to rule out possible malignancies that can be fast growing.

So what can I do to prevent this skin condition?

You can’t just scrub it more.  The most common risk factors for developing acanthosis nigricans are obesity, race, and family history. Therefore, prevention is targeted at the modifiable risk factors.

The more overweight you are, the greater your risk of developing acanthosis nigricans. Obesity is a risk factor for Type 2 Diabetes, and those with acanthosis nigricans are much more likely to develop Type 2 Diabetes than the general population.  Weight loss and medication can be used to correct insulin resistance.

The ethnic background that has been noted to have the highest incidence is the Native American population. There is also a hereditary or genetic link, as those with a family member who has acanthosis nigricans are more likely to develop it than those who do not have a family member with it.  We know that individuals can not change their ethnic background or genetics, but they can be aware of their increased risk.

What can my dermatologist do to treat this condition?

Treatment is normally targeted at the underlying cause of the acanthosis nigricans. For instance if a medication is triggering the condition, your doctor would stop the medication if they deemed it possible and non-life threatening.  If you are overweight, a program directed by your physician of healthy diet, exercise, and at times medications can help you lose weight.

If the underlying cause is treated, and the condition remains, your dermatologist can prescribe topical creams, antibacterial soaps to help avoid infection in these areas.

Remember, our skin is an amazing organ that does communicate with us. The question is “are we listening?”

To learn more about Acanthosis Nigricans, check out these links!

American Academy of Dermatology article about Acanthosis Nigricans

Dermnetz  article about Acanthosis Nigricans

By Aaron Santmyire APRN-BC, DNP

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