How to treat Acanthosis Nigricans | Dr Davin Lim

Can prescription creams fade dark underarm skin?
Creams have a marginal effect on dark underarms. Your medical dermatologist will guide you. Three types of creams can be used, depending on the cause.
Calcineurin inhibitors such a tacrolimus or pimecrolimus (Protopic or Elidel). This group of creams do not have the long-term side effects of steroids. They can be effective in preventing post inflammatory hyperpigmentation.
Vitamin D creams can be effective in some cases of acanthosis nigricans (about 15% of cases).
Pigment inhibitors are used when Ashy dermatosis is in the remission phases. They include hydroquinone, arbutin, azelaic acid, ascorbic acid & cysteamine. Creams are marginally effective & ideally should be combined with lasers & medical therapy.
Corticosteroids to reduce inflammation. Example: Advantan Fatty ointment. This is used in a pulse manner (your dermatologist will guide you). Steroid creams are only useful in the very early phase of Ashy, even then, their use is controversial as it is used more commonly in other skin conditions that may look like Ashy- e.g. lichen planus pigmentosus.
Botox is an injection, not a cream. It can be very effective in prevention of post-inflammatory hyperpigmentation, especially in cases of friction induced pigment due to excessive sweating or hyperhidrosis.
Dermatologists at The Melasma Clinic are procedural, namely we perform procedures such as lasers & peels. Though we can provide second options, diagnose & investigate all forms of axillary hyperpigmentation, we do not provide ongoing medical management as this entails frequent visits, follow ups & prescriptive medications. We refer patients to Cutis Dermatology in Brisbane, or the Skin Hospital in Sydney for joint management with a medical dermatologist.
What results can I expect from lasers?
Lasers work best for cases of post inflammatory hyperpigmentation once the source of inflammation has subsided. Most patients can expect a reduction of pigmentation by up to 50-80% within a few sessions, spaced 4 weeks apart.
The Melasma Clinic has the most advanced lasers for pigment, including the Picoway & Picosure Pro. Genetic cases may require 10 sessions with a success rate of only 20%, whilst conditions such as acanthosis nigricans do not respond well to lasers.

[@nepick0]

Thank you! This was so informative! I’m a medical aesthetician & I’ve always referred patients who seem to be experiencing this condition to their dermatologist. I’m glad that I now have a better understanding.

[@tracyl.8497]

I always thought this was a pre diabetes or high insulin levels ??

[@Lotetree-olivepalm]

Doctor really like your indepth knowledge and analysis . I don't know what it's in my knees seems like black psoriasis. Used nyclobate brand (Clobasatol propionate ) . Saw some improvement. Also used salicylic acid and tretinoin.So far nyclobate worked best . I have. Also incision mark on my belly due to my two surgeries . Feel really bad about myself. Used silicone patch , antiscar ( which is a gel of allium cepa, heparin , allantoin ) .No improvement at all . Using these for 1 years .

[@clairewyndham1971]

Is the beginning of this in the folds of the skin generally?

[@SilmarAparicio]

QUESTION: for RF Micro needling, which method would allow me to see better results for severe atrophic, box scar, and rolling scars. Insulated or non insulated? (Im hispanic)

[@alishapatel2282]

What if you’re not overweight though?

[@favourdoris4826]

Sir how can I learn more cause am a big fan of you. Please I would really want to acquire more knowledge, am an Aesthetician.❤

[@favourdoris4826]

What is the difference between acanthosis nigrican and hyperpigmentation?

[@db-gb5xi]

It's usually dark, thick patches.

[@Akash__7321]

Please share your Location because I want to take treatment for open pores and acne scars 🙏

[@adrenalinedopamine8924]

Do high estrogen cause acanthosis nigracine