Acanthosis Nigricans In Kids: Signs, Causes, Pictures & Treatment

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Acanthosis nigricans (AN) in kids often indicates increased blood insulin levels. This condition causes dry and dark patches or streaks of skin on the neck, underarms, and groins. It is often seen in individuals with diabetes and obesity (1).

Although it may cause mild itching, AN is usually harmless and not contagious. According to the American Diabetes Association, acanthosis nigricans indicates insulin resistance and diabetes mellitus in children in preteen years (2) (3).

Read on to know more about the causes, treatment, and ways to prevent acanthosis nigricans in children.

Symptoms Of Acanthosis Nigricans In Children

AN in children is common among adolescents and teens. The symptoms are mostly subtle and often go unnoticed. Here are a few indicators to identify AN in your child (4) (5).

  1. Symmetrical darkening (hyperpigmentation) and thickening (hyperkeratosis) of the skin.
  2. Streaks of black lines which are dark and have a roughened and velvety texture.
  3. No pain or discomfort, but might occasionally itch.
  4. The skin around these areas may look rough and dark.
  5. It commonly occurs around the folds on the skin, such as the neck, underarms, back of the knees, joints of the fingers, and inner thighs. It may also occur in the groin region.
  6. Less frequently, it might occur on the eyelids, face, palms, soles, and nipples.

Pictures Of Acanthosis Nigricans In Children

Pigmentation on the skin may also be due to sunburn or nutrient deficiency. Thus, it is necessary to identify the symptoms of AN. Here are a few pictures that might help. 

Pictures of acanthosis nigricans in kids

Image: Shutterstock

Possible Causes Of Acanthosis Nigricans In Children 

Here are some of the reasons why children could develop dark patches around the neck.

1. Insulin resistance

This is the most common reason for AN. The insulin hormone, secreted by the pancreas, helps the cells use glucose from the bloodstream. During insulin resistance, cells are unable to use insulin for glucose permeability. It leads to excess insulin and glucose in the bloodstream. Insulin resistance may occur due to several health conditions. Obesity or being overweight is one of the significant factors for developing insulin resistance.

Insulin resistance can lead to hyperpigmentation and thickening of the epidermal skin cells, resulting in acanthosis nigricans (6). Resistance to insulin also increases the risk of type II diabetes.

2. Hereditary 

A rare form of AN known as unilateral acanthosis nigricans can occur in a child with a family history of AN. This is characterized by the appearance of lines over the face, chest, scalp, abdomen, back, and thighs. This type of AN may not indicate an underlying endocrine disorder (7).

3. Other causes

Long-term usage of medicines, such as oral contraceptive pills or artificial human growth hormones may cause AN. Rarely, AN could be a symptom of lymphoma or cancers associated with the gastrointestinal or genitourinary tract (8).

Who Are At A Higher Risk Of Developing Acanthosis Nigricans?

Not all children develop acanthosis nigricans; here are some of the risk factors which might increase the chances of developing AN in children.

  • Obesity: Acanthosis nigricans is usually more common among obese children. Studies note that obesity causes a significant accumulation of visceral fat (fat around the abdominal organs) and reduced subcutaneous fat (fat under the skin). This change in the deposition of the fat could affect the way cells use insulin, and, thus, increase the risk of insulin resistance and, eventually, AN (9).
  • Hormonal problems: Children with hormonal problems or imbalances may be at a higher risk of developing AN. A few examples of hormonal problems that may increase the risk of AN are hypothyroidism (underactive thyroid gland), polycystic ovary syndrome, and Cushing’s syndrome (1).

Diagnosis Of Acanthosis Nigricans

A doctor can diagnose AN through physical examination of the affected skin. BMI and body weight may be checked to determine if the child is overweight or obese. Blood and urine tests could help determine the underlying cause, such as insulin resistance, hormonal imbalances, etc.

In rare cases, a small sample of the thickened skin (biopsy) may be collected for lab analysis. Parents should inform the doctor about any prescription medications, supplements, vitamins their child is taking before commencing treatment (5).

Treatment For Acanthosis Nigricans In Children

The treatment of AN can be either treating the underlying cause or topical treatments for the dark patches.

Treating the underlying cause

  • If your doctor has diagnosed obesity as the cause, then they would prescribe exercises and diet to help your child reduce their weight. If obesity is due to an underlying medical condition, such as hypothyroidism, then medications would be prescribed to control it.
  • Medications to keep the blood sugar under control could be prescribed if the child has insulin resistance or type II diabetes.
  • Discontinuing medicines that caused AN and prescribing alternative medications could also be advised (10).

Topical treatments

  • Topical retinoid creams could be used to reduce the pigmentation in the various areas of the skin (consult your doctor if you could apply these in the genital areas).
  • Topical vitamin creams, such as vitamin D analog cream, might be helpful in some cases (10).

Once the underlying cause is treated or managed, the dark and thick streaks fade away. Cosmetic treatment methods, such as laser treatment and skin peels, are not recommended for children.

Can You Prevent Acanthosis Nigricans In Children?

Prevention of AN depends on preventing the underlying cause. If your family has a history of obesity or diabetes, then follow these precautions to reduce the child’s risk of insulin resistance and AN.

  • Control the intake of sugars and refined flour by your children. Do not let them binge eat candies, muffins, pastries, high-sugar drinks, and processed foods.
  • Provide a healthy balanced diet rich in fruits, vegetables, and fiber.
  • Encourage your child to exercise daily. You can let them participate in sports or outdoor games.
  • Monitor their weight and make sure they are within the prescribed ranges.

If your child has any other condition, such as hypothyroidism, then follow the appropriate treatment prescribed by the doctor.

Acanthosis nigricans in kids is a symptom and points towards some underlying issues. These include problems such as metabolic syndrome, which further leads to obesity, raised blood pressure, abnormal lipids levels, and increased cholesterol. The issue indicates that the child has a higher chance of developing diabetes, heart disease, and stroke later. Therefore, it is essential to bring the problem to control at the earliest. You must visit your child’s doctor and begin treatment well within time to avoid further complications.


MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Acanthosis nigricans; NHS UK
2. TM Nithun, P. S. S Ranugha, Jayadev B Betkerur, Veeranna Shastry; Association of acanthosis Nigricans and insulin resistance in indian children and youth – A HOMA2-IR based cross-sectional study; Indian Dermatology Online Journal
3. Common Terms; American Diabetes Association
4. Skin Complications; American Diabetes Association
5. Hak Yung Ng; Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges; NCBI
6. Young Kwon Koh, Jae Hee Lee, Eun Young Kim, and Kyung Rye Moon; Acanthosis Nigricans as a Clinical Predictor of Insulin Resistance in Obese Children; Pediatric Gastroenterology Hepatology and Nutrition
7. Meghana Madhukar Phiske; An approach to acanthosis nigricans; Indian Dermatology Online Journal
8. Acanthosis Nigricans; National Organization for Rare Disorders
9. Alan R. Sinaiko, Sonia Caprio; Insulin Resistance; NCBI
10. Nupur U Patel, et al.; Current treatment options for acanthosis nigricans; NCBI


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Dr Bisny T. Joseph

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has 3+ years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education made... more