Acanthosis nigricans (AN) is usually due to an underlying disorder that must be treated. It is difficult to treat the skin plaques associated with AN without addressing their cause.

Cases of AN that are caused by insulin (hormone that regulates blood sugar) resistance may be improved or resolved by controlling diabetes (condition characterized by the body’s inability to use insulin effectively) risk factors to lower the amount of unused insulin the body. Certain diets can help reduce a person’s level of insulin, which often causes AN symptoms to fade rapidly.

Weight loss can help reduce AN associated with obesity, whereas treatment of underlying tumors (abnormal growths) can help reverse AN associated with cancer. AN that results from the use of medications will usually disappear when the patient ceases using the medication. The inherited or familial form of AN tends to resolve over time.

Topical medications including antibiotics, retinoids and keratolytics (abrasives) have been tried, with varying degrees of success. Some patients may benefit from prescription creams and lotions that help lighten the skin color in the affected areas. Dermabrasion or laser therapy may also be performed to reduce the skin thickness in certain areas.

The prognosis for most types of AN is usually good. However, the prognosis for people with malignant AN is often poor, as the cancer is often very aggressive.