Acanthosis nigricans - Knuckles, toes, knees and elbows are dark. What are my surgical options? (photo)

Question

22yr old. Diagnosed with pcos. 14serum insulin,92glucose fasting but def lowered for taking 500mg for months and 1-2meals a day. normal weight. My knuckles, toes, knees and elbows are dark since childhood.have used hydroquinine4, retinols etc with no results same with peels and 5 session reviltes. been 3 weeks of picoway with no result.no one in my family has it but me.i am way too depressed, can't process and losing hope.I am wondering now to surgically remove all. Can i? I won't mind scars all my life

Anna Chacon, MD, FAAD · Answer

Hello,

I’m sorry to hear about your struggles with acanthosis nigricans. It’s understandable to feel frustrated when treatments don’t yield the desired results. However, surgical options for acanthosis nigricans are generally not recommended, as the condition is not typically resolved through surgery. Here are some points to consider:

Underlying Causes: Acanthosis nigricans is often linked to insulin resistance, which you mentioned managing with medication. Continuing to address underlying health issues, such as polycystic ovary syndrome (PCOS) and insulin resistance, is crucial.

Non-Surgical Treatments: While you’ve tried several topical treatments and laser therapies, it might be worth exploring other options or combinations under the guidance of a dermatologist. Sometimes, treatments need to be adjusted or combined with lifestyle changes for better efficacy.

Consult a Specialist: Consider seeking a second opinion from a dermatologist who specializes in pigmentary disorders. They may offer insights into emerging treatments or advanced therapies that might be effective for your case.

Mental Health Support: Feeling depressed and losing hope is understandable, but it’s important to seek support. A mental health professional can provide coping strategies and support during this challenging time.

Surgical Considerations: Surgery is not typically a viable option for acanthosis nigricans, as it does not address the root cause and could lead to significant scarring. It’s important to weigh the risks and benefits thoroughly with a healthcare provider.

Remember, you are not alone, and support is available. I encourage you to continue working with your healthcare team to explore all possible options.

Best regards,

Acanthosis nigricans - Knuckles, toes, knees and elbows are dark. What are my surgical options? (photo)

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Acanthosis nigricans - Knuckles, toes, knees and elbows are dark. What are my surgical options? (photo)

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