Diabetes and Your Skin

Want another reason to get your blood sugar levels under control and keep them that way? Doing so can help you avoid many diabetes skin problems.

Still, skin conditions related to this disease are common. As many as 1 out of 3 people with diabetes will have one.  Fortunately, most can be or successfully treated before they turn into a serious problem. The key is to catch them early.

Common Skin Conditions Linked to Diabetes

Itching skin, also called pruritus, can have many causes, such as dry skin, poor blood flow, or a yeast infection. When itching is caused by poor blood flow, you’ll likely feel it in your lower legs and feet. Lotion can help to keep your skin soft and moist, and prevent itching due to dry skin.

Bacterial infections: Staphylococcus skin infections are more common and more serious in people with poorly controlled diabetes. When hair follicles are irritated, these bacteria can cause boils or an inflamed bump.

Other infections include:

  • Styes, which are infections of the eyelid glands
  • Nail infections

Most bacterial infections need to be treated with antibiotic pills. Talk with your doctor.

Fungal infections: Warm, moist folds of the skin are the perfect breeding ground for these infections.



Three common fungal infections are:

  • Jock itch (red, itchy area on the genitals and the inside of the thighs)
  • Athlete's foot (affects the skin between the toes)
  • Ringworm (ring-shaped, scaly patches that can itch or blister and appear on the feet, groin, chest, stomach, scalp, or nails).

A yeast-like fungus called "Candida albicans" causes many of the fungal infections that happen to people with diabetes. Women are likely to get this in their vaginas.

People also tend to get this infection on the corners of their mouth. It feels like small cuts and is called "angular cheilitis."

Onychomycosis is a fungal infection of the fingernails and toenails that is more prevalent among people with diabetes. It causes discoloration, thickening, and separation from the nail bed.

Medicines that kill fungus -- called antifungals -- are usually needed to treat these infections. Talk with your doctor about the right ones to use.

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Acanthosis nigricans: This condition is most common in people with type 2 diabetes. It causes darkened and thickened skin, especially in skin folds. It looks like a small wart. Skin becomes tan or brown. It’s sometimes slightly raised and may look velvety.

It can be found on the sides or back of the neck, the armpits, under the breast, and groin. Sometimes, the top of your knuckles will look strange. This condition usually affects people who are very overweight.

It usually starts before diabetes, and it can be a sign of insulin resistance. While there's no cure, losing weight may help.

Vitiligo: This condition affects your skin color. It's more common with type 1 diabetes. With vitiligo, the cells that make the substance that gives your skin color, melanin, are destroyed.

Patches of skin look discolored. They often appear on the chest and stomach. But they can also show up on the face around the mouth, nose, and eyes. Steroid creams, ultraviolet light treatments, and micropigmentation (tattooing) are a few treatment options. Use sunscreen with an SPF of 30 or higher to prevent sunburn on your discolored skin.

Shin spots (diabetic dermopathy): This condition happens due to changes to the blood vessels in your skin. Dermopathy appears as a shiny round or oval lesion on the thin skin of your shins. The patches don't hurt, and they rarely cause itching or burning. Treatment usually isn't necessary.

Less-Common Conditions

Necrobiosis lipoidica: If you’ve had diabetes for a long time without good control of your blood sugar, you could develop this condition. Poor blood supply to the skin can cause changes in the collagen and fat underneath. The overlaying skin becomes thin and red. Most lesions are found on the lower parts of the legs and can turn into an ulcer if there’s trauma. Lesions have fairly well-defined borders. Sometimes, the condition is itchy and painful. As long as the sores don't break open, you won't need treatment for them. If the sores do break open, see your doctor.

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Digital sclerosis: Due to poor blood flow, the skin on your toes, fingers, and hands becomes thick, waxy, and tight. It can also make your finger joints stiff.  Get your blood sugar under control, because that can help treat this condition. Try lotions and moisturizers to help soften the skin.

When you have issues with your heart or blood vessels:

  • Atherosclerosis: This is the narrowing of blood vessels. They become narrower as the vessel walls get thick from plaque buildup. That can affect blood supply to your skin. When the blood vessels that bring oxygen to the skin become narrow, changes can happen, such as hair loss and thinning, shiny skin (especially on the shins), thickened and discolored toenails, and cold skin. Because blood carries the white blood cells that help fight infection, your legs and feet can heal more slowly when they are injured.
  • Eruptive xanthomatosis: Severe insulin resistance can make it hard for your body to get rid of fat in your blood. When you have very high cholesterol, this skin condition can happen. Firm, yellow, waxy pea-like bumps on the skin are surrounded by red halos and are itchy. These usually show up on the eyes, elbows, face, and buttocks. They also can appear on the back side of the arms and legs. To treat it, your doctor will work to control the level of fats in your blood. The bumps usually go away over several weeks. You might also need drugs that control different types of fats in the blood (lipid-lowering drugs).

Uncommon Conditions

Diabetes-related blisters (bullous diabeticorum): In rare cases, people with diabetes get blisters that resemble burn blisters. These can affect the fingers, hands, toes, feet, legs, or forearms. They're usually painless and they heal on their own. They often happen in people who have severe diabetes and diabetic neuropathy. For treatment, your doctor will help you get your blood sugar levels under control.

Disseminated granuloma annulare: While there is some controversy over whether this condition is connected to diabetes, disseminated granuloma annulare causes sharply defined ring- or arc-shaped areas on the skin. These rashes most often happen on the fingers and ears, but they can appear on the chest and abdomen, too. The rash can be red, red-brown, or skin-colored. Treatment usually isn't needed, but sometimes a steroid medication you put on your skin, such as hydrocortisone, can help.

Scleredema diabeticorum: This condition causes a thickening of the skin on the back of the neck and upper back. It's rare, but it can affect people with type 2 diabetes. The treatment is to bring your blood sugar levels under control. Lotions and moisturizers might help soften your skin.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on December 04, 2016

Sources

SOURCES:

American Diabetes Association: "Skin Complications."

American Family Physician: "Onychomycosis: Current Trends in Diagnosis and Treatment."

 

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