Q: I am a 23 years old female suffering from discolouring of skin for the past 10 years. The skin around the neck started turning dark when I was 13 years old. But I neglected it at that time and within 4-5 years, the skin around the mouth, forehead and other exposed areas to sun like hands became dark. At the age of 21, I consulted a dermatologist. He suggested certain medicines because of which other area of my skin also started turning dark and therefore, I discontinued the medicines. I think I have hyper pigmentation or Acanthosis nigricans. Please suggest me a proper mode of treatment for this.

A:Acanthosis nigricans is a disorder that may begin at any age. It causes velvety, light-brown-to-black, markings usually on the neck, under the arms or in the groin. Acanthosis nigricans is most often associated with obesity. Eating too much of the wrong foods, especially starches and sugars, can cause insulin resistance. This will result in elevated insulin levels. Most patients with acanthosis nigricans have a higher insulin level than those of the same weight without acanthosis nigricans. Elevated levels of insulin in most cases probably cause acanthosis nigricans. The elevated insulin levels in the body activate insulin receptors in the skin, forcing it to grow abnormally. Reducing the circulating insulin by dieting or medication can lead to improvement of the skin problem. When acanthosis nigricans develops in people who are not overweight, a medical work-up should be done. Rarely acanthosis nigricans is associated with a tumour, most commonly of the stomach or gut. In these cases acanthosis can bee seen in extra places, such as the lips or hands and is unusually severe. Occasionally acanthosis nigricans is congenital or due to an endocrine (glandular) disorder. Treatment to just improve the appearance includes topical treitoin, 20% urea, alpha hydroxyacids, and lactic or salicylic acid prescriptions. Regular exercise to reduce weight is most essential.