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).
- Symmetrical darkening (hyperpigmentation) and thickening (hyperkeratosis) of the skin.
- Streaks of black lines which are dark and have a roughened and velvety texture.
- No pain or discomfort, but might occasionally itch.
- The skin around these areas may look rough and dark.
- 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.
- 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.
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.
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 lymphomaiXCancer of the lymphatic system, the body’s defense system, that can be environmentally or genetically induced. or cancers associated with the gastrointestinal or genitourinary tractiXThe system that includes all the organs of the urinary system and the genitals. (8)(9).
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 (10).
- 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 syndromeiXA condition where the female body produces increased male hormone resulting in multiple cysts on the ovaries. , and Cushing’s syndromeiXHormonal disorder caused by excessive amounts of cortisol or the stress hormone in the blood. (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 (11).
- 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 (11).
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.
Frequently Asked Questions
1. Can puberty cause acanthosis nigricans?
While there is no direct association between puberty and acanthosis nigricans, children may develop acanthosis nigricans due to pubertal changes because of the fluctuations in hormone levels and obesity (12).
2. Do acanthosis nigricans spread in children?
No, acanthosis nigricans cannot spread to other individuals or other parts of the body (13).
3. Is acanthosis nigricans a fungus?
No. Acanthosis nigricans is not a fungal infection; however, a study showed that nigricans with severe papillomatosis are susceptible to developing fungal infections (14).
4. Can you wash off acanthosis nigricans in children?
No. Acanthosis nigricans in children might look like a dirty skin area, but it cannot be washed off. Instead, regular exercise, a healthy diet, and weight control can help improve skin pigmentation.
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.
Infographic: Facts About Acanthosis Nigricans In Children
Acanthosis nigricans in children can be due to various reasons. Lifestyle and dietary modifications may help some children get rid of it. However, a few children may require additional medications and evaluations from their pediatrician. Go through the infographic to learn more facts about acanthosis nigricans in children.
- Acanthosis nigricans (AN) is a skin condition commonly found in preteens that is associated with increased insulin and diabetes.
- AN can be caused by either insulin inheritance or it may be hereditary.
- Symptoms of AN can be observed as hyperpigmentation and thickening of the skin in the form of black streaks, rough, and velvety lines.
- The condition can be treated with medications for underlying conditions as well as topical treatments.
- AN can be prevented by reducing sugar intake, maintaining a balanced diet, engaging in regular exercise, and managing weight.
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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: WHO GETS AND CAUSES; American Academy of Dermatology Association
9. Acanthosis Nigricans; DermNet
10. Alan R. Sinaiko, Sonia Caprio; Insulin Resistance; NCBI
11. Nupur U Patel, et al.; Current treatment options for acanthosis nigricans; NCBI
12. Christine M. Burt Solorzano and Christopher R. McCartney; Obesity and the pubertal transition in girls and boys; NCBI
13. Acanthosis Nigricans; Cleveland Clinic
14. Jung JW et al.; Relationship Between Acanthosis Nigricans and Fungal Infection: Clinical and Histopathological findings; Journal of mycology and infection