Diabetes and Skin Complications
Diabetes can affect every part of the body, including the skin.
In fact, skin problems are sometimes the first sign that a person has diabetes.
Some are cause for concern, while others may simply be a cosmetic issue (harmless). Regardless, you should keep an eye out for changes in your skin and talk to your doctor about any concerns you have—it’s better to be safe than sorry. Luckily, most skin conditions can be prevented or easily treated if caught early.
Some of these problems are skin conditions anyone can have, but people with diabetes get more easily. These include bacterial infections, fungal infections, and itching. Other skin problems happen mostly, or only, to people with diabetes. These include diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic blisters, and eruptive xanthomatosis. Expand the items below to learn more about each skin condition and discover helpful skin care tips.
General skin conditions
Several kinds of bacterial infections occur in people with diabetes:
- Styes (infections of the glands of the eyelid)
- Folliculitis (infections of the hair follicles)
- Carbuncles (deep infections of the skin and the tissue underneath)
- Infections around the nails
Inflamed tissues are usually hot, swollen, red, and painful. Several different organisms can cause infections, the most common being Staphylococcus bacteria, also called staph.
Bacterial infections were once life threatening, especially for people with diabetes. Today, death is rare, thanks to antibiotics and better methods of blood glucose (blood sugar) control.
But even today, people with diabetes have more bacterial infections than other people do. Doctors believe people with diabetes can reduce their chances of these infections by practicing good skin care.
If you think you have a bacterial infection, see your doctor.
The culprit in fungal infections of people with diabetes is often Candida albicans. This yeast-like fungus can create itchy rashes of moist, red areas surrounded by tiny blisters and scales. These infections often occur in warm, moist folds of the skin. Problem areas are under the breasts, around the nails, between fingers and toes, in the corners of the mouth, under the foreskin (in uncircumcised men), and in the armpits and groin.
Common fungal infections include jock itch, athlete's foot, ringworm (a ring-shaped itchy patch), and vaginal infection that causes itching.
If you think you have a yeast or fungal infection, call your doctor.
Localized itching is often caused by diabetes. It can be caused by a yeast infection, dry skin, or poor circulation. When poor circulation is the cause of itching, the itchiest areas may be the lower parts of the legs.
You may be able to treat itching yourself. Limit how often you bathe, particularly when the humidity is low. Use mild soap with moisturizer and apply skin cream after bathing.
Good skin care
There are several things you can do to prevent skin problems:
- Keep your diabetes well managed. People with high glucose levels tend to have dry skin and less ability to fend off harmful bacteria. Both conditions increase the risk of infection.
- Keep skin clean and dry.
- Avoid very hot baths and showers. If your skin is dry, don't use bubble baths. Moisturizing soaps may help. Afterward, use a standard skin lotion, but don't put lotions between toes. The extra moisture there can encourage fungus to grow.
- Prevent dry skin. Scratching dry or itchy skin can open it up and allow infection to set in. Moisturize your skin to prevent chapping, especially in cold or windy weather.
- Treat cuts right away. Wash minor cuts with soap and water. Only use an antibiotic cream or ointment if your doctor says it's okay. Cover minor cuts with sterile gauze. See a doctor right away if you get a major cut, burn, or infection.
- During cold, dry months, keep your home more humid. Bathe less during this weather, if possible.
- Use mild shampoos.
- Do not use feminine hygiene sprays.
- See a dermatologist (skin doctor) about skin problems if you are not able to solve them yourself.
- Take good care of your feet. Check them every day for sores and cuts. Wear broad, flat shoes that fit well. Check your shoes for foreign objects before putting them on.
- Talk to your doctor or dermatologist if you are not able to solve a skin problem yourself.
Diabetes-related skin conditions
Acanthosis nigricans is a condition in which tan or brown raised areas appear on the sides of the neck, armpits, and groin. Sometimes they also occur on the hands, elbows, and knees.
Acanthosis nigricans usually strikes people who are very overweight. The best treatment is to lose weight. Some creams can help the spots look better.
Diabetes can cause changes in the small blood vessels. These changes can cause skin problems called diabetic dermopathy.
Dermopathy often looks like light brown, scaly patches. These patches may be oval or circular. Some people mistake them for age spots. This disorder most often occurs on the front of both legs. But the legs may not be affected to the same degree. The patches do not hurt, open up, or itch.
Dermopathy is harmless and doesn't need to be treated.
Another disease that may be caused by changes in the blood vessels is necrobiosis lipoidica diabeticorum (NLD). NLD causes spots similar to diabetic dermopathy, but they are fewer, larger, and deeper.
NLD often starts as a dull, red, raised area. After a while, it looks like a shiny scar with a violet border. The blood vessels under the skin may become easier to see. Sometimes NLD is itchy and painful. Sometimes the spots crack open.
NLD is a rare condition. Adult women are the most likely to get it. As long as the sores do not break open, you do not need to have it treated. But if you get open sores, see your doctor for treatment.
Allergic skin reactions can occur in response to medicines, such as insulin or diabetes pills. You should see your doctor if you think you are having a reaction to a medicine. Be on the lookout for rashes, depressions, or bumps at the sites where you inject insulin.
Rarely, people with diabetes erupt in blisters. Diabetic blisters can occur on the backs of fingers, hands, toes, feet, and sometimes on legs or forearms. These sores look like burn blisters and often occur in people who have diabetic neuropathy. They are sometimes large, but they are painless and have no redness around them. They heal by themselves, usually without scars, in about three weeks. The only treatment is to bring blood glucose levels under control.
Eruptive xanthomatosis is another condition caused by diabetes that's out of control. It consists of firm, yellow, pea-like enlargements in the skin. Each bump has a red halo and may itch. This condition occurs most often on the backs of hands, feet, arms, legs, and buttocks.
The disorder usually occurs in young men with type 1 diabetes. The person often has high levels of cholesterol and fat in the blood. Like diabetic blisters, these bumps disappear when diabetes control is restored.
Sometimes, people with diabetes develop tight, thick, waxy skin on the backs of their hands. Sometimes skin on the toes and forehead also becomes thick. The finger joints become stiff and can no longer move the way they should. Rarely, knees, ankles, or elbows also get stiff.
This condition happens to about one third of people who have type 1 diabetes. The only treatment is to bring blood glucose levels under control.
In disseminated granuloma annulare, the person has sharply defined ring- or arc-shaped raised areas on the skin. These rashes occur most often on parts of the body far from the torso (for example, the fingers or ears). But sometimes the raised areas occur on the torso. They can be red, red-brown, or skin-colored.
See your doctor if you get rashes like this. There are medications that can help clear up this condition.