Skin problems are common in people with diabetes. Blood glucose provides an excellent breeding ground for bacteria and fungi, and can reduce the body’s ability to heal itself. These factors put people with diabetes at greater risk for skin problems. In fact, as many as a third of people with diabetes will have a skin disorder related to their disease at some time in their lives. Fortunately, most skin conditions can be prevented and successfully treated if caught early. But if not cared for properly, a minor skin condition can turn into a serious problem with potentially severe consequences.
Some of the problems listed below—such as bacterial infections, fungal infections and itching—are skin conditions that can affect anyone. However, people with diabetes are more prone to getting these conditions, which can lead to serious complications. Some of the conditions listed—such as diabetic dermopathy, necrobiosis lipoidica diabeticorum and eruptive xanthomatosis—occur only in people with diabetes. (Remember, people with diabetes also can develop skin conditions that affect people who do not have diabetes.)
Some common skin conditions include:
Dry skin — If your blood glucose is high, your body loses fluid, causing your skin to become dry. This occurs because the body is turning the water into urine to remove excess glucose from the blood. Your skin also can get dry if the nerves, especially those in your legs and feet, do not get the message to sweat (because of diabetic neuropathy). Sweating helps keep your skin soft and moist. Dry skin can become red and sore, and can crack and peel. Germs can enter through the cracks in your skin and cause an infection. In addition, dry skin usually is itchy, and scratching can lead to breaks in the skin and infection.
Acanthosis nigricans — This is a condition that results in the darkening and thickening of the skin. Often, areas of tan or brown skin, sometimes slightly raised, appear on the sides of the neck, the armpits, and groin. Occasionally, these darkened areas may appear on the hands, elbows, and knees. Acanthosis nigricans usually strikes people who are very overweight. There is no cure for acanthosis nigricans, but losing weight may improve the condition. Acanthosis nigricans usually precedes diabetes.
Atherosclerosis — Atherosclerosis is the narrowing of blood vessels from a thickening of the vessel walls. While atherosclerosis most often is associated with blood vessels in or near the heart, it can affect blood vessels throughout the body, including those that supply the skin. When the blood vessels supplying the skin become narrow, changes occur due to a lack of oxygen. Loss of hair, thinning and shiny skin, thickened and discolored toenails, and cold skin are symptoms of atherosclerosis. Because blood carries the white blood cells that help fight infection, legs and feet affected by atherosclerosis heal slowly when they are injured.
Bullosis diabeticorum (diabetic blisters) — In rare cases, people with diabetes develop blisters that resemble burn blisters. These blisters—called bullosis diabeticorum—can occur on the fingers, hands, toes, feet, legs, or forearms. Diabetic blisters usually are painless and heal on their own. They often occur in people who have diabetic neuropathy. Bringing your blood glucose level under control is the treatment for this condition.
Diabetic dermopathy — Diabetes can affect the small blood vessels of the body that supply the skin with blood. Changes to the blood vessels because of diabetes can cause a skin condition called diabetic dermopathy. Dermopathy appears as scaly patches that are light brown or red, often on the front of the legs. The patches do not hurt, blister or itch, and treatment generally is not necessary. The patches are sometimes called skin spots.
Digital sclerosis — The word "digital" refers to your fingers and toes, and "sclerosis" means hardening. Digital sclerosis, therefore, is a condition in which the skin on your toes, fingers and hands become thick, waxy and tight. Stiffness of the finger joints also may occur. The treatment is to bring your blood glucose level under control. Lotions and moisturizers may help soften the skin.
Eruptive xanthomatosis — Eruptive xanthomatosis can occur in some individuals when blood glucose levels are not well controlled and when triglycerides in the blood rise to extremely high levels. This condition appears as firm, yellow, pea-like bumps on the skin. The bumps—which are surrounded by red halos and are itchy—usually are found on the feet, arms, legs, buttocks and backs of the hands. Treatment for eruptive xanthomatosis consists of controlling your blood glucose level. Lipid-lowering drugs also may be needed.
Itching — Itching skin, also called pruritus, can have many causes, such as a yeast infection, dry skin or poor blood flow. When itching is caused by poor blood flow, the lower legs and feet are most often affected. Using lotion can help to keep your skin soft and moist, and prevent itching due to dry skin.
Necrobiosis lipoidica diabeticorum — Necrobiosis lipoidica diabeticorum (NLD) is caused by changes in the blood vessels and generally affects the lower legs. With NLD, the affected skin becomes raised, yellow and waxy in appearance, often with a purple border. Sometimes, NLD is itchy and painful. As long as the sores do not break open, treatment is not necessary. If the sores do break open, see your health care provider for treatment.
Scleroderma diabeticorum — Like digital sclerosis, this condition causes a thickening of the skin; but scleroderma diabeticorum affects the skin on the back of the neck and upper back. This condition, which is rare, most often affects people with diabetes who are overweight. The treatment is to bring your blood glucose level under control. Lotions and moisturizers may help soften the skin.
Keeping your diabetes under control is the most important factor in preventing the skin-related complications of diabetes. Follow your health care provider’s advice regarding nutrition, exercise, and medication. Keep your blood glucose level within the range recommended by your health care provider. Proper skin care also can help reduce your risk of skin-related problems.
Skin problems are common in people with diabetes. Blood glucose provides an excellent breeding ground for bacteria and fungi, and can reduce the body’s ability to heal itself. These factors put people with diabetes at greater risk for skin problems. In fact, as many as a third of people with diabetes will have a skin disorder related to their disease at some time in their lives. Fortunately,...