Hyderabad: Doctors in Hyderabad are reporting an increase in cases of acanthosis nigricans among children, adolescents and adults. The condition causes dark, thick and velvety patches of skin, commonly around the neck, underarms and other body folds. Health experts said acanthosis nigricans is frequently associated with obesity and insulin resistance and may serve as an early warning sign of pre-diabetes or Type-2 diabetes. People with the condition are at a higher risk of developing Type 2 diabetes than those without it. Though it can occasionally be linked to certain cancers, doctors said the cases being seen currently are largely associated with obesity and metabolic disorders.In one such case, a nine-year-old obese boy had a dark patch on his neck that his family mistook for accumulated dirt. He had a sedentary routine and frequently consumed sugary drinks and processed snacks. “Tests revealed elevated fasting blood sugar and insulin resistance. Following medical counselling, dietary changes and regular exercise, his sugar levels improved and the skin changes gradually reduced,” said Dr Ravi Shanker, senior endocrinologist.“Parents should not dismiss sudden darkening of the neck as dirt or a cosmetic problem. In an overweight child, it demand a medical evaluation, including blood sugar testing,” said Dr B Narahari, paediatrician and president of the Telangana Government Doctors’ Association (TGGDA).Doctors also highlighted that the rise in obesity was contributing to a corresponding increase in acanthosis nigricans. “The two conditions often go hand in hand. As obesity increases among children, teenagers, young adults and middle-aged people, insulin resistance and acanthosis nigricans are also likely to rise,” added Dr Shanker. He explained that insulin resistance causes the body to produce higher levels of insulin. “Excess insulin can stimulate skin cells, leading to characteristic thickening and pigmentation. Acanthosis nigricans does not confirm diabetes, but it is an important clinical clue,” he added.According to NFHS-5 data, 40.2% of men and 41.7% of women in urban Telangana were overweight or obese. It also found high blood sugar levels among 21.4% of urban men and 18.4% of urban women. A 2026 study of urban Hyderabad also found obesity among 37% of adults and 44% of elderly participants, while diabetes affected 25–26% of the elderly. Dermatologist Dr Karishni Chittarvu, former general secretary of the Telangana Senior Doctors’ Association (TSRDA), said she sees five to six such cases daily. Most of my patients are between 15 and 25 years old. However, I am now also seeing children below 10 with obesity and related health problems. Some children have very high blood sugar levels and need to be referred to an endocrinologist,” she added.Doctors suggested patients to walk briskly for at least 20 minutes every day with an aim for at least 5,000 steps. “Moreover, people should have a calorie-controlled diet that is rich in protein and a target of losing at least 10% of their body weight. They should not use bleaching creams or aggressively scrubbing the affected skin,” said Dr Karishni.
