As the obesity problem in the Western world gains momentum, we see more and more expressions of diseases that were once less common. One of these phenomena is acanthosis nigricans.
Essentially, this involves dark spots in the armpits, neck, and sometimes also on the joints of the hands. If this is indeed the issue, it may sometimes be necessary to look for an underlying disease, mainly one related to obesity, such as insulin resistance, polycystic ovary syndrome, diabetes, metabolic syndrome, thyroid disorders, and obesity. A recent American study showed that over 70% of people who suffered from significant obesity exhibited this symptom.
It should be noted that these are not dark spots due to skin dirt, so scrubbing the skin in an attempt to make it smoother and lighter will not help. Additionally, this condition should be distinguished from other common pigmentation issues. Many overweight individuals have pigmentation in the groin and armpits, but this is not the skin disease acanthosis nigricans.
So how do we differentiate?
It is important to understand that this is not just darker skin (pigmentation) but a condition where the skin's surface is rougher and thicker, resembling velvet fabric. This condition is similar to other issues such as melasma (usually in different locations), amyloidosis, drug-induced pigmentation, sensitivity to substances, and constant friction of the skin.
My recommendation is that anyone with a problem of spots should consult a dermatologist for advice, as sometimes this condition resembles other problems, and it is important to diagnose. Once acanthosis nigricans is present, it is crucial to diagnose and mainly to search for the underlying disease if it exists and treat it. Then, the symptoms will fade.
While this condition is usually related to issues of excess weight and diabetes, in rare cases, it can also be a manifestation of a malignant tumor. This condition is very rare. But in any case of widespread pigmentation, the place to go for diagnosis is dermatologists at health clinics.
Treatment, in addition to identifying the cause of the problem and addressing it, also includes weight loss—often this leads to an improvement in symptoms. Additionally, one can use lightening products and lasers for skin brightening, but as long as the underlying problem is not treated, the condition will not improve.
The author is a dermatologist.