Brief Answer:
Provide more information+photographs

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your concern and I have understood it.

I would keep a possibility of Facial Melanosis with possibility of pseudoacanthosis nigricans on the back and sides of the neck

I would like to gather some more information from you in order to be able to help you better

--Is the band of dark skin on the sides and back of the neck similar in appearance to dark,velvety, thick areas?
--Is the pigmentation on the forehead and sides of the cheek, smooth or is it velvety and raised?
--Can you upload a few pictures of the affected area on neck and forehead?

regards

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Brief Answer:
Facial melanosis; Pseudoacanthosis Nigricans

Detailed Answer:
Hi.

Thanks for the pictures. I would keep a possibility of Melasma/Facial Melanosis and Pseudoacanthosis Nigricans on neck.

For Facial melanosis, I would suggest that you use a broad spectrum sunscreen, that which offers both UV A as well as UV B protection throughout the day.

It is important to select the right sunscreen for desired effects. A sunscreen with minimum 30 spf would be adequate. It should mention both UV B and UV A coverage.

It should be applied in the following quantity:

--3ml for face and neck(a little more than 1/2 teaspoon)
--3ml for each arm(a little more than 1/2 teaspoon).

A sunscreen should be applied every 2-3 hours.

At night you can use a cream containing one or more of the skin lightening agents e.g kojic acid, glycolic acid, or hydroquinone etc once daily at night to gradually fade away the pigmentation.


Pseudoacanthosis Nigricans is a skin disorder in which there is darker, thick, velvety skin in body folds and creases. The skin becomes dark, velvety and thick in areas such as back and sides of neck, armpits, thighs, elbows and knees.

Acanthosis nigricans usually appears slowly and doesn't cause any symptoms other than skin changes.

It typically occurs in individuals younger than age 40, may be genetically inherited, and is associated with obesity OR endocrinopathies, such as hypothyroidism, acromegaly, polycystic ovary disease, insulin-resistant diabetes, or Cushing's disease.

The majority of cases of acanthosis nigricans are associated with obesity OR are otherwise idiopathic. This is likely because of insulin resistance, and more likely to occur in darker-skinned persons. This is also known as Pseudo-Acanthosis Nigricans.

Acanthosis nigricans is likely to improve in circumstances where a known cause is removed. For example, obesity-related acanthosis nigricans will improve with weight loss.

People with acanthosis nigricans in general should be screened for diabetes. Weight loss and controlling blood glucose levels through exercise and diet often improves symptoms.

Topical tretinoin 0.05% cream once daily at night helps to lighten pigmentation along with weight loss, exercise and diet management.

Alpha-Lipoic acid ha been shown to increase insulin sensitivity and thereby reverses the pseudo-acanthosis nigricans which arises as a result of insulin resistance states e.g Obesity and diabetes. It is commercially available for prescription in acanthosis nigricans.

regards

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Brief Answer:
Facial melanosis; Pseudoacanthosis Nigricans

Detailed Answer:
Hi.

Yes, yes, Use kojic acid based cream all over the face, & yes.

regards

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