- Causes of diabetes-related skin problems
- What are the symptoms of skin conditions?
- How can diabetes affect your skin?
- Bacterial infections
- Fungal Infection
- Diabetic dermopathy
- Necrobiosis lipoidica diabeticorum
- Acanthosis nigricans
- Digital sclerosis
- Eruptive xanthomatosis
- Bullosis diabeticorum
- Dry Skin
- Diabetic rash
- How can you manage your diabetes to avoid the effects on your skin?
- Treatment options
Diabetes mellitus affects more than just blood sugar levels. Everybody’s system is dependent on healthy blood flow through blood vessels and arteries.
Over time, high blood sugar damages these vessels and arteries, which can cause complications.
The integumentary system involves our skin, which protects our bodies from drying out and from the outside elements. The integumentary system is also our largest organ, so it’s imperative!
Having diabetes can cause skin complications, from dryness to skin infections.
Learning about diabetic skin conditions as well as how to prevent them, is useful for those wanting to avoid these problems from happening.
Causes of diabetes-related skin problems
Uncontrolled diabetes can result in hyperglacemia (high blood glucose) which tends to be associated with poor circulation and which reduces blood flow to the skin. It can also cause damage to blood vessels and nerves, as well as affect the ability of white blood cells to fight off infection.
Decreased blood circulation can also lead to changes in the skin’s collagen, affecting the skin’s texture, appearance, and ability to heal.
Diabetic neuropathy can cause decreased sensation. This makes skin more prone to wounds that may not be felt and therefore come to your attention at a later stage.
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What are the symptoms of skin conditions?
Between 51.1 and 97 percent of people with diabetes will experience a related skin condition, according to a recent literature review. Although the symptoms will vary depending on the skin condition, there are some common symptoms that people with diabetes should be aware of, including:
- changes in their skin
- injuries or irritation to the skin surrounding insulin injection sites
- cuts or wounds that are slow to heal
- cuts or wounds that appear infected
How can diabetes affect your skin?
The skin is supplied with blood by many small vessels. These vessels can become damaged due to high blood sugar, which impairs their ability to provide the skin with the nourishment it needs to be healthy.
People with diabetes have a more difficult time fighting off infections since high blood sugar levels allow bacteria to grow more quickly. Bacterial infections can occur as styes, boils, carbuncles, and infections of the nails. Infections usually present as being red, hot, and painful, and often require antibiotic treatment.
The most common bacteria that cause skin infections are Staphylococcus, or staph, and Streptococcus, or strep.
Serious bacterial infections can cause deep tissue infections called carbuncles. These may need to be pierced by a doctor and drained.
Other common bacterial infections include:
- infections around the eyes
- infections around the fingernails and toenails
People with diabetes are at increased risk of developing fungus from the bacteria Candida albicans. Fungal infections can cause itchy red rashes and scaling. They can occur in warm, moist areas of the skin, such as skin folds near joints.
Yeast fungus thrives in the following areas:
- in the warm folds of the skin
- under the breasts
- in the groin
- in the armpits
- in the corners of the mouth
- under the foreskin of the penis
Diabetic dermopathy is a result of changes to the blood vessels of the skin. This results in painless scaly patches that are light brown or red, often occurring on the front of the legs.
Necrobiosis lipoidica diabeticorum
Occasionally itchy and painful, this condition is a result of changing blood vessels in the skin. It presents as raised, waxy yellow patches with a blue/purple border. It often occurs on the lower legs. Light brown, oval, and circular patches are also a hallmark of necrobiosis lipoidica diabeticorum (NLD).
This condition is rarer than diabetic dermopathy.
As long as the sores don’t open, no treatment is required. It affects adult women more often than men, and also tends to occur on the legs.
These dark, thickened, velvety areas of skin occur as a result of insulin resistance and are often seen in people diagnosed with diabetes. Having acanthosis nigricans is also a risk factor for developing diabetes since insulin resistance can cause diabetes.
These patches of skin often occur on the neck, armpits, and groin. They can appear in children as well as adults. This condition typically affects people who are obese and is a marker of insulin resistance. It sometimes goes away when a person loses weight.
Atherosclerosis is the term for narrowing of the arteries. When the arteries supplying the skin become narrowed from diabetes, it can result in skin changes from the lack of oxygen. Signs of atherosclerosis include shiny and cold skin.
Hardening and tightening of the skin of the toes, fingers, and hands can lead to joint stiffness. Lotions can help alleviate the symptoms of digital sclerosis.
Firm, yellow bumps surrounded by a red “halo” are a sign of high blood sugar and uncontrolled triglycerides (blood fat). Cholesterol-lowering drugs can be used to treat this condition.
Vitiligo can affect people with type 1 diabetes. It occurs when the skin pigment cells are damaged, causing patches of discolored skin on the face and around elbows and knees.
Bullosis diabeticorum: A rare condition looking like burn blisters can occur in people with diabetes. They are usually painless and heal by themselves. They typically affect people with diabetic neuropathy. (Diabetic neuropathy causes nerve damage from diabetes. Neuropathy can cause skin issues such as blisters and calluses from reduced sensation and awareness of pain).
Reduced circulation can exacerbate dry skin. Having very high blood sugars can be dehydrating to the body, drawing fluid out of the skin and drying it out. Scratching at an existing rash can damage the skin and exacerbate dryness as well.
In general, a person who has had diabetes for a longer amount of time is more likely to develop complications from it than someone with newly-diagnosed diabetes.
These complications, such as skin issues, are more likely to occur sooner in someone with a history of uncontrolled diabetes compared to someone with well-controlled blood glucose.
One type of diabetic rash is called disseminated granuloma annulare. It appears as a ring-like rash that’s red/brown or skin-colored. It often occurs on the hands, fingers, and feet, but can also occur in other places on the body.
A fungal infection can also appear as a red rash with tiny blisters. Jock itch, athlete’s foot, and ringworm are all fungal infections caused by Candida albicans.
Rashes are typically treated with medications, such as medicated creams or antibiotics, depending on the cause of the rash.
Skin infections caused by the bacteria Staphylococcus can be more serious in people with diabetes. More rarely, a fungal infection caused by Mucormycosis can spread from the nasal cavities to the eyes and brain. This can be potentially fatal but doesn’t necessarily start in the form of a fungal skin infection.
If a diabetic rash begins weeping, oozing, or bleeding, it’s best to have it looked at by a healthcare professional to reduce skin damage and the risk of further infection.
How can you manage your diabetes to avoid the effects on your skin?
There are several things you can do to help manage your diabetes in order to prevent skin complications. Some things you can do to take care of your health include:
- Take your medications as prescribed. Some people take medications for diabetes, and some manage it with lifestyle. It’s important to follow the plan between you and your healthcare provider because your diabetes is different from other people’s diabetes.
- Check your blood sugar regularly. Having a hemoglobin A1c checked every 3-6 months helps identify overall blood sugar control and can help you and your healthcare provider make any necessary adjustments to your treatment plan. Checking blood sugar at home regularly is also very helpful for controlling blood sugars, as you can identify certain trends and triggers that cause high or low blood sugars.
- Eat a healthy diet. Eating a diet rich in plant foods, low in sugars and refined carbohydrates, and being moderate with alcohol consumption are all aspects of a well-rounded, healthy diet.
- Be physically active. The American Diabetes Association recommends moving every 30 minutes (avoid being sedentary), and the Centers for Disease Control and Prevention (CDC) recommends 150 minutes per week of moderate exercises, such as brisk walking. Being active can help improve blood sugars as well as promote healthy blood pressure and cholesterol levels.
Practicing effective skin care
There are several steps you can take to encourage healthy skin and reduce your risk of diabetes-related skin problems. Healthy skin habits include:
- Keeping your blood sugars well-managed. High blood sugars can increase the risk of diabetes complications.
- Keep skin clean and dry.
- Avoid very hot baths and showers, as this can dry out the skin. Also, avoid bubble baths and high-sudsing products, as these can strip the natural oils from the skin.
- Use moisturizing lotions and skin care products to prevent dry skin, especially after bathing. Avoid putting lotion between the toes, though, as this can encourage fungal growth.
- Moisturize chapped skin, especially in the winter. Preventing dry skin can help prevent cracking and itching.
- Treat cuts promptly. Washing with soap and water and treating with antibiotic cream only if necessary is good practice. See your doctor for serious cuts, scrapes, and burns.
- Treat your skin right in colder months by using humidifiers to combat the dry air. Avoid taking extra showers and baths in cold weather, as this can dry skin out.
- Use mild shampoos and skin products and avoid feminine hygiene sprays.
- Visit with a dermatologist regularly for preventive care.
- Practice good foot care. Check your feet daily for wounds or ulcers, and ensure your shoes fit properly. Always check your shoes for any foreign objects before putting them on.
Though there’s no cure for diabetes, there are a variety of treatment options that include prescription medications, alternative remedies, and lifestyle changes that can help manage the condition.
OTC remedies are available for certain types of skin disorders associated with type 2 diabetes. These remedies include:
- nonprescription antifungals
- topical steroid medications, such as those containing 1 percent hydrocortisone
Some skin conditions are severe enough that medical attention and prescription medications are required. Prescription medications and treatments available include:
- antibiotic to treat skin infections
- antifungal medications
- insulin therapy
Natural alternative remedies
Some homeopathic remedies include taking an oatmeal bath, which is known to help reduce skin itchiness.
Other natural treatments include aloe vera gel and calamine lotion, which can help soothe irritated, itchy skin. However, these may not be effective at treating all diabetic rashes, especially those caused by high blood sugar, bacteria, or rashes.
There aren’t established recommendations for supplements for treating a diabetic rash. Some people choose to take supplements to support healthy blood sugar levels, but they aren’t necessarily effective for treating a diabetic rash. Some supplements used for improving blood sugars include:
- Cinnamon is a more well-known supplement for its potential blood sugar-lowering effects. Some studies have found that cinnamon can help lower fasting blood sugar, as well as help promote normal cholesterol and triglyceride levels.
- Aloe vera may help to lower blood sugar and hemoglobin A1c, as well as improve cholesterol levels. There are few studies on this topic, though.
- Chromium is a mineral that is beneficial for insulin action and carbohydrate metabolism. People with diabetes often have lower levels of chromium than people without diabetes. Supplements containing chromium picolinate have been found to improve blood sugar control.
- Fenugreek can help lower blood sugar by increasing insulin levels. Another benefit is that it can also help lower cholesterol levels.
These supplements shouldn’t be used in place of prescribed diabetes medications, as their effectiveness varies from person-to-person.
High blood sugars caused by diabetes can damage the blood vessels supplying the skin. This can cause a variety of skin issues, ranging from shiny, discolored skin to rashes and blisters. High blood sugars also increase the risk of bacterial and fungal infections, which can complicate skin issues.
High blood sugars are also dehydrating, which can lead to dry, itchy skin. The best way to prevent diabetes-related skin issues is to manage your diabetes and keep blood sugars under control.
Following your diabetes care plan and following-up with your healthcare provider regularly is very important for maintaining blood sugars in a healthy range.
Practicing good skin hygiene is also crucial for preventing skin issues. Keeping skin clean and dry, inspecting feet daily, and avoiding harsh skin products can promote healthy skin.
Treatment for diabetes skin issues depends on their cause. Some skin conditions are harmless and clear up on their own, while others require prescription antibiotics or creams.
Having your skin issue looked at by a doctor or dermatologist can ensure it is properly diagnosed and treated. Natural treatments are only recommended if another treatment isn’t advised by a healthcare professional.