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Dr Wu
Dr Wu, Dermatologist
Category: Dermatology
Satisfied Customers: 1835
Experience:  Board certified family doctor
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I have dark pigmentation along my jaw line, starting just to

Customer Question

I have dark pigmentation along my jaw line, starting just to each side of my chin then angling downwards & backwards along my neck. I've had it for years, looking as if I'd made a bad job of putting on make-up, but seems to be getting more prominent/darker & I'm wondering (a) what is causing it and (b) is there anything that I can do, or get done, which will remove it.

Any help much appreciated.
Submitted: 8 years ago.
Category: Dermatology
Expert:  Dr Wu replied 8 years ago.

Thank you for submitting your question.

You may have a condition known as acanthosis nigricans. Acanthosis nigricans is a skin condition characterized by dark, thick, velvety skin in body folds and creases. Most often, acanthosis nigricans affects your armpits, groin and neck.

Acanthosis nigricans is often associated with conditions that increase your insulin level, such as type 2 diabetes or being overweight. If your insulin level is too high, the extra insulin may trigger activity in your skin cells. This may cause the characteristic skin changes. In some cases, acanthosis nigricans is inherited.

There's no specific treatment for acanthosis nigricans. Treating any underlying conditions may cause the skin changes to fade, however. If you're overweight, losing excess pounds can help.

I understand that you have already tried skin-whitening products and microdermabrasion. Retin-A is another commonly-used product to treat this condition. Fish oil supplements may also be helpful. Laser therapy is costly but can usually decrease the amount of pigmentation.

I hope this answers your question.

Customer: replied 8 years ago.

The dark pigmentation has not made my skin thick or velvety, and it is not in a body fold or crease.

I am not overweight and I am not diabetic.

Expert:  Dr Wu replied 8 years ago.
Hyperpigmentation is generally caused by the following:
-hormonal changes
-history of acne/scarring, some kind of injury to the skin
-chronic inflammation
-sun damage

You did not mention any history of acne/surgery/scarring in the area. Acanthosis nigricans is the most common cause of darkened skin in the neck area. Another possibility is a form of melasma, which again can darken a large area of skin. Although more common on the face, the neck area can be affected as well. This is caused by a change in estrogen level.

Laser therapy in general is the most effective way in treating hyperpigmentation regardless of the cause.
Customer: replied 8 years ago.

There is no history of acne/scarring/surgery in the area.

Having researched both acanthosis nigricans & melasma online, and seen images which I can compare to my pigmentation, it seems that melasma is more likely. Although the onset predates me taking HRT, I believe it has become more noticable since then.

It does not appear to be widely accepted that laser therapy is effective in such cases (see

Expert:  Dr Wu replied 8 years ago.
The usual treatment for melasma include bleaching agents like hydroquinone, chemical peels, and IPL laser. Chemical peels can be an option for you- less costly than IPL, but will likely require 5+ sessions.