Acanthosis nigricans or Neglected nipples (AN) is a skin disorder characterized by dark patches of skin that have a thick, velvety texture. Patches are usually seen in the folds of the body, such as the armpits, groin, neck, elbows, knees, knuckles, lips, palms, and soles of the feet.

Acanthosis nigricans is not a disease but a sign of other underlying conditions, typically occurring in people who have diabetes or who are obese. Causes may include:

• High levels of insulin: Acanthosis nigricans can be caused by high levels of insulin in the blood associated with obesity or polycystic ovarian disease.
• Medications: Certain medications such as allopathic oral contraceptive pills, horm
• one therapy, thyroid medications, bodybuilding supplements, and chemotherapy drugs can increase the risk of acanthosis nigricans.

Other possible causes of Acanthosis nigricans:

• • Stomach cancer.
  • Adrenal gland disorders (Cushing syndrome).
  • Pituitary gland disorders.
  • Low thyroid hormone levels.
  • High doses of niacin (an allopathic drug).

Allopathic treatment for acanthosis nigricans

Treatment of acanthosis nigricans involves treating the underlying cause, along with cosmetic treatments to reduce the appearance of dark patches.

Doctors may recommend starting a weight loss program and discontinuing or changing certain medications. They may also prescribe medications to treat underlying conditions, for example medications to lower insulin levels if the condition is caused by high insulin levels.

While the hyperpigmentation usually fades once the underlying condition is treated, there are several cosmetic treatments (medical and home remedies) that can help the patches disappear faster.

Acanthosis nigricans (AN) develops sporadically or in association with obesity, insulin-resistance and dark pigmentary phenotype. Unusual clinical presentations of AN may be diagnostically vexing.

Objectives: The aim of the report is to present unusual clinical and dermoscopic pictures of hyperkeratotic, brownish lesions of the nipples resembling acanthosis nigricans.

Patients/Methods: Data including clinical and dermoscopic features of two patients with the “neglected nipples”: acanthosis nigricans-like (AN-like) hyperpigmented plaques caused by avoidance of nipple cleansing.

Results: Beside the anamnestic clue, presentation of AN-like plaques in the “neglected nipples” is limited to the breasts, in the absence of involvement of other flexural sites classically affected by AN.

Dermoscopy aids the exclusion of a tumor, as it reveals exclusively structureless, brown-gray-black hyperkeratosis in the absence of criteria associated with melanocytic or non-melanocytic skin neoplasms of the nipple.

The “neglected breasts” are easily treated by keratolytic creams and hygiene. Conclusions: The “neglected nipples” condition, presenting as bilateral AN-like papules and plaques of the nipples, is due to avoidance of cleansing of the nipple area, resulting in accumulation of keratotic cellular debris.

How to lighten patches at home

Alpha hydroxy acids (AHAs) and beta hydroxy acids (BHAs)

Regular exfoliation with AHAs and BHAs can help make the skin smoother, softer, and brighter. AHAs and BHAs help reduce pigmentation and fine lines, remove excessive sebum and dead skin cells, unclog pores, and gently remove existing blackheads and whiteheads. They also cleanse the skin of dirt and makeup. Glycolic acid and lactic acid are the most popular AHAs, and salicylic acid is the most popular BHA.

Since overdoing it can irritate the skin and cause you to break out, doctors recommend using AHAs and BHAs every other day or 2 times a week. Always do a patch test first and start with a lower strength (1%-2%) serum and gradually increase the strength if your skin tolerates it well. If you experience an allergic reaction, discontinue use.

Serums containing vitamins C and E (like “Umaiza“) also help with skin pigmentation and keep the skin hydrated, which helps increase cell turnover. Certain acids and vitamin C can cause increased sun sensitivity and should only be applied at night.

Topical retinoids for Acanthosis nigricans

Retinoids are highly effective in removing stubborn pigmentation and also help improve skin texture. However, retinoids should be used with caution, since they can cause visible peeling, dryness, burning, redness, and increased sun sensitivity as the skin adjusts, which may take 4-6 weeks.

You can start applying low-strength over-the-counter retinoids 2-3 times a week, gradually increasing the strength and frequency of usage. Higher strengths of retinoids require a doctor’s prescription.

Homemade mask

Natural ingredients can be applied to the skin 2-3 times a week:

• Yogurt, lemon, and gram flour mask: The mask may be applied over problem areas, left on for 10 minutes, and then washed off. 
  • Yogurt is rich in nutrients and lactic acid, a naturally occurring exfoliating agent.
  • Lemon contains vitamin C that can reduce pigmentation. You may need to dilute the lemon juice (2 parts juice and 1 part water) before adding it to the mask.
  • Gram flour helps thicken the mask, giving it a paste-like consistency. Gram flour also acts as a natural exfoliating scrub that is gentle on the skin, improving skin texture and reducing hyperpigmentation.
• Papaya, banana, lemon, honey, and rice flour mask: These ingredients contain vitamins and minerals that can reduce pigmentation, improve skin texture, and nourish the skin. They may be mashed into a paste, applied all over the affected areas, and washed off after 10 minutes.

Diet, nutrition, and hydration

A healthy, balanced diet rich in fruits and vegetables and adequate hydration (8-10 glasses of fluids per day) are important for skin health because they promote skin cell turnover. You may also consider taking nutritional supplements, especially vitamin C, vitamin B, vitamin E and omega-3 fatty acids.

Sun protection

Sun damage can trigger other pigmentation problems and leads to premature aging. Excessive sun exposure is also a risk factor for skin cancer. Without protection from sun damage, medical and natural treatments to care for the skin are futile.

One of the best ways to protect the skin from sun damage is regular application of sunscreen. The American Academy of Dermatology recommends using a sunscreen that provides broad-spectrum UVA and UVB protection, SPF 30 or higher, and that is water resistant. Sunscreen should be reapplied every 3-4 hours and used daily throughout the year, including colder seasons and cloudy days.

Homeopathic Treatment for Acanthosis nigricans (AN)

Cadmium Sulphuratum

For facial pigmentation that gets worse with exposure to the sun, Cadmium Sulphuratum is the best prescription. The pigmentation varies from yellowish to brownish in colour. Blue circle around eyes. Pigmentation gets worse in the wind. Blue, yellow, sallow, scaly, cracking. Itching; better scratching. Chloasma, yellowish stains on nose and cheeks; worse exposure to sun and wind. Chilblains.

Conium Maculatum

Complexion sickly, pale, and bluish. Shootings, and pricking itching in the skin. Swelling of the glands. Bluish colour of the skin. Painful inflammation of the skin. Nettle-rash in consequence of violent bodily exercise. Pimples, like those in scabies, which become scurfy. Brownish, or red and itching spots, over the whole body. Humid, or scabby and burning tetters. Blackish ulcers, with sanious, sanguineous, and fetid discharge, and tingling tension. Gangrenous ulcers. Ulceration of the bones. Panaris. Petechiae. Reddish and greenish spots.

Argentum Nitricum

Brown, tense and hard skin. Drawing in skin, as from a spider-web or dried albuminous substance withered and dried up. Face  sunken, old, pale, and bluish. Old man’s look; tight drawing of skin over bones. Irregular blotches. Warty granulations. Skin brown, tense, and hard.

Zincum Metalicum

Formication of feet and legs as from bugs crawling over the skin, preventing sleep. Eczema, especially in the anaemic and neurotic. Itching of thighs and hollow of knees. Retrocession of eruptions. Destruction of red blood corpuscles. Repercussed eruptive diseases. Varicose veins. Eczema. Anaemic. Itching of thighs and hollow of knees. Eruptions. Bluish superficial spots.

Arsenicum Album

Itching, burning, swellings; oedema, eruption, papular, dry, rough, scaly; worse cold and scratching. Malignant pustules. Ulcers with offensive discharge. Anthrax. Poisoned wounds. Urticaria, with burning and restlessness. Psoriasis. Scirrhus. Icy coldness of body. Epithelioma of the skin. Gangrenous inflammations.

Pulsatilla Nigricans

Pulsatilla Nigricans is a most effective medicine for facial pigmentation in women with menstrual irregularities. Pigmented spots and freckles on the face. Acne. Amaurosis. Varicose.

Mezereum 

Eczema; intolerable itching; chilliness with pruritus. Ulcers itch and burn, surrounded by vesicles and shining, fiery-red areola. Zona, with burning pain. Bones, especially long bones, inflamed and swollen; caries, exostosis; pain worse night, touch, damp weather. Eruptions ulcerate and form thick scabs.

Mercuris Solubus

Almost constantly moist. Persistent dryness of the skin contra indicates mercurius. Excessive odorous viscid perspiration; worse, night. General tendency to free perspiration, but patient is not relieved thereby. Vesicular and pustular eruptions. Ulcers, irregular in shape, edges undefined. Pimples around the main eruption. Itching, worse from warmth of bed. Crusta lactea; yellowish-brown crusts, considerable suppuration. Glands swell every time patient takes cold. Buboes. Orchitis.

Lycopodium Clavatum

Skin ulcers. Abscesses beneath skin. Hives. Violent itching; fissured eruptions. Acne. Chronic eczema associated with urinary, gastric and hepatic disorders; bleeds easily. Skin becomes thick and indurated. Varicose veins, naevi, erectile tumors. Brown spots, freckles. Dry, shrunken, especially palms; hair becomes prematurely gray. Dropsies. Offensive secretions; viscid and offensive perspiration, especially of feet and axilla. Psoriasis.

Clematis Erecta

Obstinate miliary eruptions. Vesicular eruptions on the body. Scaly tetters, yellowish and corrosive, and with redness, heat and swelling. Obstinate tetters, red and moist, with insupportable itching. Itching over the whole body. The tetters (painful, not itching over the whole body) are red and humid while the moon is increasing, and pale and dry when the moon is waning. Burning or tingling, and pulsation in the ulcers, with shootings in the edges when touched. Psoric pustules over the whole body. Painful swelling and induration of the glands.

Berberis Aquifolium

Pimply, dry, rough, scaly. Eruption on scalp extending to face and neck. Tumor of breast, with pain. Psoriasis. Acne. Dry eczema. Pruritus. Glandular induration.

Sepia

Herpes circinatus in isolated spots. Itching; not relieved by scratching; worse in bends of elbows and knees. Chloasma; herpetic eruption on lips, about mouth and nose. Ringworm-like eruption every spring. Urticaria on going in open air; better in warm room. Hyperhidrosis and bromhidrosis. Sweat on feet, worse on toes; intolerable odor. Lentigo in young women. Ichthyosis with offensive odor of skin.

Psorinum – Medicine For Clear/Glowing Skin

Dirty, dingy look. Dry, lusterless, rough hair. Intolerable itching. Herpetic eruptions, especially on scalp and bends of joints with itching; worse, from warmth of bed. Enlarged glands. Sebaceous glands secrete excessively; oily skin. Indolent ulcers, slow to heal. Eczema behind ears. Crusty eruptions all over. Urticaria after every exertion. Pustules near fingernails.

Tellurium Metallicum

Itching of hands and feet. Herpetic spots; ringworm. Ring-shape lesions, offensive odors from affected parts. Barber’s itch. Stinging in skin. Fetid exhalations. Offensive foot-sweat. Eczema, back of ears and occiput. Circular patches of eczema.

Thyroidinum

Chronic psoriasis associated with adiposity. Skin dry, impoverished. Cold hands and feet. Eczema. Uterine fibroids. Brownish swelling. Swelling of glands of stony hardness. Sluggish cases. Jaundice with pruritus. Ichthyosis, lupus. Itching without eruption.

Kalium Sulphuricum

Psoriasis. Eczema; burning, itching, papular eruption. Nettle-rash. Polypi. Epithelioma. Seborrhoea. Favus. Ringworm of scalp or beard with abundant scales.

Sulphur

Unhealthy skin. Dry, scaly, unhealthy skin, every injury suppurates. Freckles. Intense itching, worse at night, heat of bed, scratching and washing. Burning on scratching. Pimply eruption, pustules, cracks, hangnails. Excoriation, especially in folds. Skin disorders after local application. Itching, especially from warmth in evening often recurs in spring-time in damp weather. Varicose veins ulcerate, rupture and bleed.

Lachesis Mutus

Hot perspiration, bluish, purplish appearance. Boils, carbuncles, ulcers, with bluish, purple surroundings. Dark blisters. Bed-sores, with black edges. Blue-black swellings. Pyemia; dissecting wounds. Purpura, with intense prostration. Senile erysipelas. Wens. Cellulitis. Varicose ulcers.

Thuja Occidentalis

Polypi, tubercles, warts epithelioma, naevi, carbuncles; ulcers, especially in ano-genital region. Freckles and blotches. Perspiration sweet, and strong. Dry skin, with brown spots. Zona; herpetic eruptions. Tearing pains in glands. Glandular enlargement. Nails crippled; brittle and soft. Eruptions only on covered parts; worse after scratching. Very sensitive to touch. Coldness of one side. Sarcoma; polypi. Brown spots on hands and arms.

Hamamelis Virginiana

Bluish chilblains. Phlebitis. Purpura. Varicose veins and ulcers; very sore. Burns. Ecchymosis. Traumatic inflammations.

Calceria Carbonicum

Unhealthy; readily ulcerating; flaccid. Small wounds do not heal readily. Glands swollen. Nettle rash; better in cold air. Warts on face and hands. Petechial eruptions. Chilblains. Boils.

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Bovista

Facial pimples, dark skin or any other skin affections caused by the injudicious use of cosmetic products can benefit from the use of the remedy Bovista which is used to clear the skin. Bovista holds a significant place among homeopathy medicines for the treatment of skin problems consequent to the excessive use of cosmetics. Bovista helps in clearing facial skin and makes it look bright and glowing. It also removes pimples or other afflictions resulting from the use of cosmetics. Bovista lycoperdon has a marked effect on the skin for example eruption like eczema, also upon the circulation, predisposing to haemorrhages; marked languor and lassitude.

Silica Tera

Diseases of bones, caries and necrosis. Silica can stimulate the organism to reabsorb fibrotic conditions and scar-tissue. Swelling of lacrimal duct. Acanthosis nigricans. Fetid discharge from ears. Caries of mastoid. Sensitive to noise. Roaring in ears. Fissures and haemorrhoids, painful, with spasm of sphincter. On skin felons, abscesses, boils, old fistulous ulcers. Cracks at end of fingers. Painless swelling of glands. Rose-colored blotches. Scars suddenly become painful.

Promotes expulsion of foreign bodies from tissues. Every little injury suppurates. Long lasting suppuration and fistulous tracts. Dry fingertips. Eruptions. Crippled nails. Indurated tumors. Abscesses of joints. Side effects of vaccination. Bursa. Lepra, nodes, and coppery spots. Keloid growths. Silica Tera clear skin and for removing scars caused by pimples, acne etc.

Natrum Mur

Greasy, oily, especially on hairy parts. Dry eruptions, especially on margin of hairy scalp and bends of joints. Fever blisters. Urticaria; itch and burn. Crusty eruptions in bends of limbs, margin of scalp, behind ears. Warts on palms of hands. Eczema; raw, red, and inflamed; worse, eating salt, at seashore. Acanthosis nigricans. Affects hair follicles. Alopecia. Hives, itching after exertion. Greasy skin.

Phosphorus

Freckles : pigmentation on skin, occurring due to prolonged exposure to the sun. Acanthosis nigricans.

Freckles is the result of collection of melanin pigment under the skin resulting in discolored spots on the face and other areas exposed to sun.

Wounds bleed very much, even if small; they heal and break out again. Jaundice. Little ulcer outside of large ones. Petechiae. Ecchymosis. Purpura hemorrhagica. Scurvy. Fungus haematodes and excrescences.

Acid Lacticum

Skin harsh and dry, no sweat. Red spots or blotches on various parts of the body, particularly thighs and lower extremities. Itching and burning.

P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).

For proper consultation and treatment, please visit our clinic.

None of above-mentioned medicine(s) is/are the full/complete treatment, but just hints for treatment; every patient has his/her own constitutional medicine.

To order medicine by courier, please send your details at WhatsApp– +923119884588

Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS), Abdominal Surgeries, Oncological surgeries, Gastroenterologist, Specialist Homeopathic Medicines.

  Senior research officer at Dnepropetrovsk state medical academy Ukraine.

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