Diabetes and Your Skin
For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause serious complications, including skin problems. In fact, as many as a third of people with diabetes will have a skin condition 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 in a person with diabetes can turn into a serious problem with potentially severe consequences.
Skin Conditions Linked to Diabetes
- Scleredema diabeticorum: This condition causes a thickening of the skin on the back of the neck and upper back. This condition is rare but can affect people with type 2 diabetes. The treatment is to bring your blood glucose level under control. Lotions and moisturizers may help soften the skin.
- Vitiligo: Vitiligo is a condition that affects skin coloration. With vitiligo, the special cells that make pigment (the substance that controls skin color) are destroyed, resulting in patches of discolored skin. Vitiligo often affects the chest and abdomen, but may be found on the face around the mouth, nostrils, and eyes. This condition is more commonly associated with type 1 diabetes. Current treatment options for vitiligo include topical steroids, ultraviolet light treatments, and micropigmentation (tattooing). You should use sunscreen with a SPF of 30 or higher to prevent sunburn on the discolored skin.
Problems associated with insulin resistance
- Acanthosis nigricans: This is a condition that results in the darkening and thickening of certain areas of the skin especially in the skin folds. The skin becomes tan or brown and is sometimes slightly raised and described as velvety. Most often the condition, which typically looks like a small wart, appears on the sides or back of the neck, the armpits, under the breast, and groin. Occasionally the top of the knuckles will have a particularly unusual appearance. 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. There are other conditions that also are known to cause acanthosis nigricans, including acromegaly and Cushing's syndrome. This condition is a skin manifestation of insulin resistance in most people.
Problems associated with reduced blood supply to the skin
- Skin problems linked to atherosclerosis: Atherosclerosis is the narrowing of blood vessels from a thickening of the vessel walls due to plaque buildup. 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 blood to the skin. When the blood vessels supplying the skin become narrow, changes occur to the skin due to a lack of oxygen, such as hair loss, thinning and shiny skin especially on the shins, thickened and discolored toenails, and cold skin. Because blood carries the white blood cells that help fight infection, legs and feet affected by atherosclerosis heal more slowly when they are injured.
- Necrobiosis lipoidica dibeticorum: Necrobiosis lipoidica dibeticorum (NLD) is caused by changes in the collagen and fat content underneath the skin. The overlaying skin area becomes thinned and reddened. Most lesions are found on the lower parts of the legs and can ulcerate if subjected to trauma. Lesions have fairly well defined borders between normal skin and affected lesions 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 doctor for treatment.
- Diabetic dermopathy: Also called shin spots, this condition develops as a result of changes to the blood vessels that supply the skin. Dermopathy appears as a shiny round or oval lesion of thin skin over the front lower parts of the lower legs. The patches do not hurt, although rarely they can be itchy or cause burning. Treatment generally is not necessary.
- Digital sclerosis: Digital sclerosis is a condition in which the skin on your toes, fingers, and hands becomes 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: This condition may occur when triglycerides rise to extremely high levels. Severe resistance to insulin makes it difficult for the body to clear the fat from the blood. With extreme elevations in these blood fats, people are at risk for pancreatitis, an inflammation of the pancreas. Eruptive xanthomas appear as firm, yellow, waxy pea-like bumps on the skin. The bumps -- which are surrounded by red halos and are itchy -- usually are found on the eyes, elbows, face and buttocks. They also can be seen on the back side of the arms and legs as well as in the creases of the extremities. Treatment for eruptive xanthomatosis consists of controlling the level of fats in your blood. The skin eruptions will resolve over several weeks. Drugs that control different types of fats in the blood (lipid-lowering drugs) may also be needed.