A dark, velvety patch on the neck or underarms is often mistaken for poor hygiene, but it is actually a medical condition known as Acanthosis Nigricans. On January 11, Maharashtra-based homoeopathic physician Dr Sayajirao Gaikwad highlighted this symptom on social media, stressing that the darkened skin is one of the most visible external indicators of insulin resistance rather than a cosmetic or cleanliness issue.

Dr Gaikwad explained the underlying mechanism: when body cells become resistant to insulin, the pancreas compensates by producing higher levels of the hormone. This excess insulin stimulates skin cells and pigment production, resulting in thickened, hyperpigmented patches typically seen on the neck, underarms, and other body folds. He described the condition as an early warning sign for several serious metabolic disorders, including prediabetes, type 2 diabetes, polycystic ovary syndrome (PCOS), fatty liver disease, and metabolic syndrome.

Contrary to common belief, aggressive scrubbing or skin-lightening treatments will not resolve the issue. According to the doctor, the only effective approach is to address the root cause by lowering insulin levels through sustained lifestyle changes. He recommended a strict low-carbohydrate diet, increased intake of protein and healthy fats, gradual weight loss of even 5–10 per cent of body weight, regular resistance training, and adequate sleep as essential steps to reverse insulin resistance and fade the dark patches over time.

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To confirm insulin resistance, Dr Gaikwad advised specific medical tests, including fasting glucose, HbA1c for three-month blood sugar average, fasting insulin levels combined with HOMA-IR calculation, lipid profile (particularly elevated triglycerides and low HDL), and an oral glucose tolerance test with insulin response. He noted that the combination of a dark neck, abdominal obesity, PCOS, and fatty liver often serves as a strong clinical indicator of underlying metabolic dysfunction.

In a related post from last year, Dr Gaikwad shared a practical dietary and lifestyle guide to prevent or reverse early diabetes. Key recommendations include prioritising protein-rich foods at meals, doubling vegetable intake for fibre, aiming for 8,000–10,000 daily steps plus strength training, eliminating sugar and refined carbohydrates, managing stress, ensuring quality sleep, and focusing on small, consistent daily actions rather than extreme diets. He urged individuals noticing such skin changes to act promptly, as early intervention can significantly improve metabolic health.

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