01/02/2026
We got a call last week from someone inquiring about a chemical peel for "underarm discoloration". We had to tell them that we could't guarantee results.
HERE'S WHY:
This skin change is your body’s way of telling us insulin levels are too high. We can improve how it looks, but the real fix comes from lowering insulin resistance. When we address that, the skin almost always improves.
Acanthosis Nigricans (AN) is most commonly caused by insulin resistance, but can also be caused by PCOS, thyroid disorders, and Cushing's.
It can also be caused by medications such as birth control pills, steroids, niacin and growth hormone.
Yes, we CAN do chemical peels for treatment of AN, but if we don't treat the underlying cause, it will almost ALWAYS come back.
So, how DO we treat AN?
We start with lab testing...
And once we have a diagnosis, we have a starting point, but generally:
- Weight loss (even 5–10% can visibly improve AN)
- Low-glycemic / insulin-lowering diet
- Exercise (improves insulin sensitivity independent of weight loss)
Medications:
- Metformin
- GLP-1 agonists (semaglutide, tirzepatide)
- Berberine and Inositol
👉 This is the only intervention that can truly reverse AN long-term.
Once we have treated the hormonal disorder, the skin often improves within months.
And once he hormonal disorder is controlled, THEN we can improve texture and pigmentation using:
- Keratolytics
- Retinoids
- Azelaic, Kojic or Tranexamic Acid
- Hydroquinone
⚠️In-office / Procedural Options are best used after metabolic issues are addressed, otherwise results are temporary.
These procedures include:
- Chemical Peels
- Laser & energy devices
- Microneedling WITH Radiofrequency (not microneedling alone)
What Does NOT Work Well
❌ Bleaching creams alone
❌ Aggressive scrubbing
❌ Lasers without metabolic control
❌ Short-term fixes without insulin management
If you have questions like these, feel free to text us a pic, recommendations are hard to make over the phone.
🏥Chapter One Wellness
📍1700 N. Broad St, Globe AZ
➡️Across from Auto Zone
⌚M, W, Th, Fri 9 am - 5 pm
☎️928.813.2522 (TEXT/CALL)
🌐chapteronewellness.com
📧chapteronewellness@gmail
