Dark underarms, dark patches on your neck, and dark circles on your inner thighs are often simply viewed as a cosmetic problem, like tanning or razor burn. While some of these patches can seem like a beauty issue, they can also mark a serious body/systemic issue. These dark patches can indicate body problems, specifically an issue with your hormone level or metabolic response. Let’s discuss why this happens, what it all means, and when to be worried.

Why Does a Darkening of the Skin Occur?
Dark patches in areas such as your underarms, or folds of your neck or groin, are frequently associated with a condition called Acanthosis Nigricans (AN). This is not merely a skin condition but is a warning from your body. Some of the health problems that and signal a problem of the body include:
-In diabetes, when the body fails to use insulin properly, this is often linked to insulin resistance
-PCOS (Polycystic Ovary Syndrome) is a women’s endocrine change/hormone disorder
-Metabolic syndrome Type 2 diabetes as your blood sugar is elevated
-Obesity, which may worsen your condition.

A 2019 study in the Journal of Clinical and Aesthetic Dermatology found 74% of people with acanthosis nigricans had insulin dependence flat out. This is often caused by an elevation in insulin which ramp up skin cells to grow faster and develop a more pigmented pigment.

What Causes Dark Underarms?
Dark underarms are not the result of grime, poor hygiene or sun damage. The answer is biological. Here are some contributors:

Friction: Tight clothes or regular shaving can create friction and irritate the skin which invokes low-grade inflammation which worsens the darkening.

Hormonal problems: Hormonal issues, such as increased melanin- producing hormones from PCOS, can increase the levels of melanin, the pigment that darkens the skin.

Obesity: Extra weight creates more skin folds and also increases insulin levels, which increases the rate of pigmentation.

These mechanisms combine to darken the skin in skin-fold areas like armpits or necks.

When Should You See a Doctor?
If you have only dark armpits, it might not be too serious. But if you identify additional dark patches in many areas (neck, knuckles, groin), that should spark a response to take action. If you also recognize any of the following symptoms, you should consult your doctor, not just dermatologist:

Women with irregular menstrual cycles
Feeling exhausted
Gaining weight unexpectedly

These may indicate serious health concerns, such as diabetes or PCOS. Your physician will likely want to run a few tests to check:
Blood glucose or HbA1c: To test for diabetes and insulin resistance
Hormones: To test for PCOS or other hormonal issues
Thyroid: To check the function of your thyroid

How do you manage darkened skin in the underarm area?
While darkened skin in the underarm area may be a health indicator, you can take a few measures to manage dark skin under your arms:
Weight management: Weight loss can lead to lower insulin levels and potentially less skin darkening
Prescription creams: Topical therapy with retinoids or azelaic acid can lighten the skin through a prescription cream (Speak to your physician who can treat you/ prescribe appropriately).
Use gentle cleansing agents: Where possible, use mild soaps and shaving gels to minimize skin friction and irritation.

Please always consult your physician prior to trying a treatment, as there may be other health issues that warrant investigation.

Darkened armpits are more than just a cosmetic concern, they could be your body’s way of telling you something is wrong. Don’t ignore dark patches on your skin, especially when they appear on different parts of your body or accompany symptoms like fatigue or weight gain. Rather than just addressing discolored skin, you should consult with a doctor about the arrangements of discolored skin, and having the doctor look for insulin resistance, PCOS, or diabetes. Though this seems like a lot to take on, you can improve your skin and health by addressing the root cause and making some small changes, like using gentler products and monitoring your weight. Be aware and take care of your body!

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