PCOS and Acanthosis Nigricans

Some women with PCOS have a condition called "acanthosis nigricans", which is a skin disorder characterized by darkish, velvety skin in body folds and creases, especially the neck, groin or armpits. Sometimes, the lips, palms, soles of feet, belly button or other areas may be affected. Pedunculated skin tags are often present.

Acanthosis nigricans usually appears slowly and doesn't cause any symptoms beyond the skin.

Acanthosis nigricans is typically classified into 2 types: benign (not cancerous) and malignant (cancerous).

People with the malignant form of acanthosis nigricans tend to be thin and over 40 years of age, and their eruption is of recent origin. Abdominal adenocarcinoma is the most common cancer associated with malignant acanthosis nigricans.

Most individuals have the benign form and are very overweight or obese. Some also have chronic diseases such as polycystic ovarian syndrome, Cushing's syndrome or diabetes.

The presence of acanthosis nigricans is a predictor of abnormal glucose tolerance in women who have PCOS. If this describes you, then you need to change your diet and increase your exercise in order to improve your blood sugar control and normalize your insulin levels.

Top

What Causes It?

 

The most common cause would be insulin resistance, or the body's inability to efficiently utilize the hormone insulin. Insulin resistance is also a leading cause of polycystic ovary syndrome.

Obesity can lead to acanthosis nigricans, as can many endocrine disorders such as polycystic ovary syndrome. Acanthosis nigricans is frequently found in people with diabetes.

Some drugs, such as human growth hormone or oral contraceptives, may also contribute to acanthosis nigricans.

People with cancers of the gastrointestinal or genitourinary tracts or with lymphoma may develop acanthosis nigricans.

It is more common among people of African descent.

Treatment

Local treatment of the affected skin is not very effective. However, Retin-A, 15% urea, alpha hydroxyacid, and salicylic acid are some medications that may provide some relief.

If you have PCOS and acanthosis nigricans, you probably also have insulin resistance and are likely to be overweight. The most effective long term treatment for this combination of symptoms is to improve your diet for PCOS, get more exercise, reduce chronic stress, and take selected nutritional supplements as indicated.

You can also take medications such as metformin.

A diagnostic workup with your doctor is also advisable to rule out the possibility that a tumor may be involved.

Top