<p>Acanthosis Nigricans is characterised by hyperpigmented, hyperkeratotic, dark, rough patches or plaques distributed in intertriginous areas. Hyperkeratosis is the main concern that leads to the darkening of the skin. Numerous treatment options are available. Topical retinoids are first-line therapy given to treat hyperpigmented plaques where the limiting factor is skin irritation. To combat this, combinational therapies have come into existence and are being used. In this state-of-the-art review, the authors summarize the pathophysiology of AN, provide an update on combinational treatment strategies, and describe the other therapeutic options that have been advantageous so far in the literature for this disease. The paper aims to review the use of retinoids as a first line treatment option as well as combinational approaches to treat acanthosis nigricans skin condition.</p>