Causes and treatment of a black neck

The skin on the neck, whether due to hormones, sun exposure or other skin-related conditions, is prone to darkening. A person whose neck darkenes or turns black may also notice changes in their skin’s texture, such as thickening or feeling softer than the skin around.

Although most causes of a black neck are not medical emergencies, seeing a doctor for a proper diagnosis is often the best choice.

In this article , we look at the potential causes and possible treatments of a black neck.

Causes

Black neck
Acanthosis nigricans can cause dark, thick skin on the neck.

Possible causes of a black neck include:

Acanthosis nigricans

Acanthosis nigricans can cause dark, thick skin at the neck. The skin can be velvet-like in texture.

This condition may suddenly appear, but it is not contagious, nor does it pose a risk to a person’s health.

People with obesity and those with diabetes are at higher risk for the condition.

In rare cases, acanthosis nigricans can indicate a more serious underlying medical condition, such as cancer of the stomach or liver.

Dermatitis neglecta

Dermatitis neglecta is a skin condition that occurs when a person has buildup on their skin of dead skin cells, oil, sweat and bacteria. Debris buildup causes discolouration and plaques on the skin.

The neck is a commonplace for the development of dermatitis neglecta, often due to insufficient soap, water and friction cleansing to remove excess skin cells.

Dyskeratosis congenita

Dyskeratosis congenita, also known as the Zinsser-Engman-Cole syndrome, causes hyperpigmentation of the neck skin. The neck may look dirty.

The condition can cause white patches inside the mouth, ridging of the fingernails, and sparse eyelashes, in addition to dark patches on the neck.

Erythema dyschromicum perstans

Erythema dyschromicum perstans, or ashy dermatosis, causes irregularly shaped skin patches on the neck and upper arms that are slate-gray, dark blue, or black. Patches may appear sometimes on the torso.

The condition is benign, and indicates no underlying medical problems.

High blood insulin levels

When an individual has chronically high levels of insulin they may experience areas of hyperpigmentation on the neck, especially on the back of the neck. This occurrence is common among women suffering from polycystic ovary syndrome ( PCOS).

Lichen planus pigmentosus (LPP)

LPP is an inflammatory condition that causes the development of scarring on body areas. Symptoms include black to grey-brown patches on face and neck. None of the patches are itchy.

Tinea versicolor

Tinea versicolor is an infection of the fungus Mallassezia furfur. While the skin naturally contains this type of yeast, too much of it or overgrowth can cause dark patches on the neck , back, chest and arms.

When a person has recently been exposed to the sun, the skin may appear especially dark. The skin patches will itch, too.

Diagnosis

A doctor may take a skin sample while inspecting the neck.
A doctor may take a skin sample while inspecting the neck.

A doctor will diagnose a black neck cause by asking someone about their medical history and any recent changes in medication or lifestyle habits, such as exposure to sun.

They inspect the neck visually, and can refer the person to a dermatologist if the cause is not clear.

A doctor may also perform some of the tests below to determine a possible underlying cause:

  • Blood tests: A test may be carried out for blood sugar or hormone levels.
  • Skin sample: A skin scraping or biopsy may be done to determine if fungal cells are present.

Treatment

Once the cause of the black neck is determined by a doctor they will recommend condition-specific solutions.

Treatments for each of these conditions could include:

  • Tinea versicolor: A doctor will usually treat fungal infections with antifungal ointments that can be applied to the skin. Severe cases may require oral anti-fungal medications.
  • Dermatitis neglectans: Scrubbing with soap and water can often reduce the appearance of a black neck from dermatitis neglectans. A person may wish to soak the neck in a bath or apply a hot compress to loosen stubborn debris.
  • Acanthosis nigricans: While there are skin-lightening creams and scrubs that promise to reduce skin darkening associated with acanthosis nigricans, these are usually ineffective. Addressing the underlying causes may help, such as managing blood sugar levels and losing weight.
  • Hyperpigmentation: Treatment for hyperpigmentation may include topical tretinoin, a form of retinoic acid that encourages skin cell turnover. Laser therapies may also help to reduce the incidence of hyperpigmentation.

Other treatments will depend on the underlying state and overall health of a person.

Home remedies

Exfoliating scrubs can help reduce black neck by removing dead skin.
Exfoliating scrubs can help reduce black neck by removing dead skin.

Positive skincare and lifestyle practices can help to minimize black neck incidence. An individual can take preventive steps with:

  • washing the skin with soap and water twice daily
  • using exfoliating scrubs to help get rid of dead skin
  • applying sunscreen daily
  • eating a healthful diet with plenty of fruits and vegetables

Many manufacturers claim that their products can help to lighten the skin but research has found no conclusive evidence to support the effectiveness of the following ingredients:

  • arbutin
  • azelaic acid
  • kojic acid
  • licorice
  • mulberry
  • turmeric
  • vitamin C

It’s possible, though, that applying products at home could yield some results. A person should always first apply a new product to a small area or test patch, and wait 24 hours to ensure that the substance is not allergic or sensitive.

Outlook

A black or hyperpigmented neck can be troubling, but it is often treatable. If a person is uncertain of the cause of black neck or has symptoms such as scratching and pain, they should see a proper consultation with their doctor.

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