Talk to Dermatologist on Skin Problem

Dr. Salman Mansoor - Dermatologist

MBBS, D-Derm, DRCP (Derm), MSc (Derm), Diplomat in Aesthetic Medicine (UK), Diplomat American Board of Aesthetic Medicine, MD (USA), Board Certified in Anti-Ageing Medicine (USA) | Karachi

402 Positive Reviews

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have a endocrine refral

Irfan Ahmed Kakezai - Dermatologist

MD, Ph.D. (Medicine), Certified Aesthetician, Masters Of Public Health - USA | Karachi

125 Positive Reviews

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Yes. U need a detail evaluation online or visit clinic for treatment options

Dr. Alina Abid - Dermatologist

MBBS, MCPS, Diploma in American Aesthetic Association & Regenerative Medicine | Multan

321 Positive Reviews

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yes, its totally treatable
kindly book online consultation via marham to get solution

Dr. Khalid Aslam - Dermatologist

MBBS, Dip. Dermatology (Thailand), Dip. Dermatology (Pakistan), Fellow Laser Dermatosurgey (Thailand) | Islamabad

501 Positive Reviews

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book appointment

Dr. Shehla Arshad Khan - General Physician

MBBS, MRCP – UK, ARDMS, Certified in CPR, AED, and First Aid Course, Certified in FamMed essentials | Karachi

8 Positive Reviews

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Local skin treatment (cosmetic improvement only)
Night application:
Tretinoin 0.025% cream Apply thin layer at night, 3–4 times per week
OR
Adapalene 0.1% gel at night
Morning:
Urea 10–20% cream or
Ammonium lactate 12% lotion
These help reduce thick skin.

However underlying pathology must be treated first.

Yes, **acanthosis nigricans** (often appearing as dark, velvety patches on the neck, underarms, groin, or other folds—commonly called "dark neck" or "kala gala" in Pakistan) can be **treated and improved**, but it is not always a simple "cure." It is usually a **sign of an underlying issue** rather than just a skin problem.

The most common cause in Pakistani/South Asian women is **insulin resistance** (linked to prediabetes, type 2 diabetes, PCOS, obesity, or metabolic syndrome). South Asians often develop it at lower BMI levels due to higher body fat distribution. Other causes include hormonal issues (e.g., PCOS, thyroid), certain medications, or rarely, internal conditions like cancer (but this is uncommon in typical cases).

**Key point**: Treating the root cause usually makes the skin patches fade over months (sometimes significantly or completely). Skin-only treatments help cosmetically but work best when combined with addressing the cause.

### Step 1: See a Doctor (Strongly Recommended)
- Consult a **dermatologist** (for skin) and/or **endocrinologist/physician** (for metabolic check).
- Get tested for:
- Fasting blood sugar, HbA1c (for diabetes/prediabetes)
- Fasting insulin or HOMA-IR (insulin resistance)
- Lipid profile, thyroid function
- If PCOS suspected: hormonal panel, ultrasound
- In Karachi, good options include skin clinics like those by Dr. Eram or major hospitals (Aga Khan, Liaquat National, etc.).

### Main Treatment Approaches
1. **Address the Root Cause (Most Effective)**
- **Weight loss** (even 5–10% body weight) → Often dramatically improves or clears patches by lowering insulin levels.
- **Healthy diet**: Low-carb/high-fiber (e.g., more veggies, whole grains like bajra, chickpeas, raw banana; less sugar, refined carbs, fried foods). Focus on Pakistani staples like daal, sabzi, roti from whole atta.
- **Exercise**: 30–45 min daily (brisk walking, yoga, gym). Helps insulin sensitivity.
- **Medications** (if prescribed): Metformin (common for insulin resistance/PCOS) often lightens skin over time. Sometimes rosiglitazone or other insulin-sensitizers.

2. **Skin-Directed Treatments (Cosmetic Improvement)**
- **Topical creams** (prescribed by dermatologist):
- Retinoids (e.g., tretinoin 0.025–0.05%) → Reduce thickness and pigmentation.
- Combinations like tretinoin + hydroquinone + mild steroid (triple cream).
- Keratolytics: Ammonium lactate 12%, salicylic acid, urea, glycolic acid (6–10%).
- Others: Calcipotriol (vitamin D analog), azelaic acid, niacinamide serums.
- **Chemical peels** (e.g., glycolic/salicylic) → Done in clinics, help exfoliate and lighten (PKR 10,000–18,000/session).
- **Laser treatments** (e.g., fractional, pico, Q-switched) → Reduce thickness/pigmentation; multiple sessions needed (PKR 18,000–30,000/session).
- **Gentle exfoliation** at home: Use mild AHA/BHA cleansers or scrubs 2–3x/week.

### Home Remedies & Daily Care (Supportive, Not Primary)
These can help mildly exfoliate/lighten but won't fix the underlying issue alone. Use 2–3x/week; patch test first.
- **Aloe vera gel** → Soothing, mild lightening; apply fresh gel overnight.
- **Apple cider vinegar** (diluted 1:1 with water) → Apply with cotton, rinse after 10 min (exfoliates).
- **Besan + dahi + pinch haldi** → Gentle scrub/mask (similar to what many use for tan).
- **Potato juice** or **tomato pulp** → Mild brightening.
- **Moisturize daily** → Use ceramide-based or light lotion to prevent dryness.
- Avoid harsh scrubbing/bleaches → Can worsen irritation or cause post-inflammatory darkening.

### Realistic Expectations
- Improvement takes **weeks to months** (3–12 months for noticeable change).
- Full clearance is possible with weight loss + treatment, but some residual darkening may remain.
- Recurrence common if lifestyle reverts or insulin resistance persists.

If this is on your neck/underarms and linked to weight/PCOS (common in Pakistani women), starting with diet/exercise + doctor visit gives the best shot. Share more details (e.g., age, weight changes, other symptoms like irregular periods, family diabetes) for more specific suggestions! Take care

I do not know.. Maula Imam Ali As