Diabetic Skin Care

What Makes Diabetic Skin Different?

Diabetic Skin Problems

General Skin Problems

Skin Problems Linked to Diabetes, Insulin Resistance, and Reduced Blood Supply to the Skin

Tips for Taking Care of Diabetic Skin and Diabetic Feet

Skin Care

Foot Care

What Makes Diabetic Skin Different?

Diabetes is one of the most wide-spread and fastest growing diseases in the United States. Globally it affects more than 246 million people. More than 8% of Americans are diabetic and approximately 33% of people with diabetes will develop skin problems caused or affected by their condition at some point. Diabetic skin differs from “normal” skin and is more prone to skin problems due to four main reasons:

  1. High blood sugar levels can weaken the immune system defense. And, high blood sugar can actually feed germs once you have an infection and make the infection worse.
  2. People with diabetes experience narrowing of the blood vessels, including those that supply blood to the dermal layer. This narrowing affects micro-circulation, which facilitates the delivery of oxygen and nutrients to the skin. The result is a thinning of the skin, loss of skin elasticity, and dehydration of the skin. Dry, flaking, and thinning skin can cause persistent discomfort and give the skin an overall unhealthy appearance.
  3. People with diabetes often have low blood circulation in their extremities. Low blood flow means the body isn’t able to mobilize normal immune defenses, oxygen and nutrients that promote the body’s ability to fight infection and heal.
  4. People with diabetes can suffer from nerve damage – also called diabetic neuropathy – which results in lack of sensation, especially in the feet. This can result in injuries going undetected – and open sore (called a foot ulcer) can remain undetected and lead to infection. Additionally, some types of diabetic neuropathy can actually lead to dry, cracked skin. The cracked skin can then serves as a point of entry for infection.

Diabetic Skin Problems

Some of the most common skin problems experienced by diabetics are not exclusive to their condition. Meaning, anyone can have them. However, because of the health issues caused by the disease, people with diabetes experience them more often, can experience more severe cases, and can take longer to heal. Other skin conditions occur exclusively, or almost exclusive, in people with diabetes Below you will find a detailed list of general skin problems linked to diabetes as well as specific conditions related to the disease, insulin resistance, and reduced blood supply to the skin caused by the condition.

General Skin Problems

Bacterial Infections: Bacterial skin issues that bother diabetics include styes, nail infections, boils, and carbuncles. These infections are usually marked by red, hot, painful, and swollen skin around the infected area.

Fungal Infections:  The most common fungal infection in people living with diabetes is one called Candida albicans – characterized by a red, itchy rash that is often surrounded by small blisters and scales. Fungal infections can be found in areas that are warm and moist, like armpits, skin folds, and between toes. Fungal infections common to diabetics are athlete’s foot, vaginal infections, ringworm, and jock itch.

Itchy Skin: Itchy skin can be caused by many different things, but for people living with diabetes the usual culprits are dry skin and poor circulation. Often times, due to poor circulation in the extremities, the lower legs are the itchiest part of the body.

Skin Problems Linked to Diabetes, Insulin Resistance, and Reduced Blood Supply to the Skin

Diabetic Dermopathy: Often referred to as “shin spots”, this skin condition is caused by changes in the small blood vessels that supply nutrients and oxygen to the skin. Diabetic dermopathy is characterized by oval, or circular, light brown scaly patches, often on the front of the legs.

Necrobiosis Diabeticorum: Also believed to be caused by changes in the small blood vessels, necrobiosis lipoidica diabeticorum, or NLD, causes spots on the shins similar to diabetic dermopathy, except there are less spots and the spots are usually larger and deeper. Also, these spots have more clearly defined borders and can look like a shiny scar with a violet border. NLD can be itchy and painful, and can ulcerate or crack open.

Atheroscleroisis: is the hardening of the arteries due to plaque build-up. It can also affect blood vessels that supply blood to the skin. When this happens, the oxygen supply to the skin suffers and can cause the skin to become hairless, thin and shiny. It can also make the skin and toes cold, and toenails to thicken and/or discolor. Exercise can causes pain in the calf muscles because the muscles are not getting enough oxygen and infections in the legs heal more slowly.

Bullosis Diabeticorum (Diabetic Blisters): Similar in appearance to burn blisters, some diabetics will develop diabetic blisters. This is a rare condition, and the blisters can occur on the hands, toes, feet, backs of fingers and in a few cases on the legs and forearms. 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 sugar levels under control.

Digital Sclerosis:  As indicated by the name (digital refers to your fingers and toes and sclerosis means hardening), digital sclerosis is when the skin on your fingers, hands, and toes hardens. Skin can become thick, tight, and sometimes waxy. In some cases, joints become stiff and it becomes difficult to move. In rare cases digital sclerosis can affect the knees, ankles, and elbows. This condition is common in people with Type 1 diabetes, affecting approximately 1/3 of Type 1 diabetics, and the use of lotions and moisturizers may help to soften the skin.

Acanthosis Nigricans:  Is a skin condition that results in the darkening and thickening of areas of the skin – particularly in skin folds – and is most common in individuals who are overweight. The skin becomes tan or brown and can be slightly raised and usually occurs on the sides of the neck, armpits, under the breasts, and groin. Though, sometimes it occurs on the hands, elbows, and knees.

Scleroderma diabeticorum: Similar to digital sclerosis, scleroderma diabeticorum causes thickening of the skin; however, instead of affecting your digits, it affects the skin on the back of your neck and upper back.  This rare condition usually affects people who are overweight, or who have type 2 diabetes. Also like digital sclerosis, lotions and moisturizers may help to soften the skin.

Vitiligo: Is a skin condition that affects skin coloration. More common in individuals with type 1 diabetes than type 2 diabetes, cells that make melanin (pigment) are destroyed leaving patches of discolored skin. Seen most often on the chest and abdomen, this condition can also affect the face around the mouth, nostrils, and eyes. Since the damaged skin has no natural sun protection, it is important that people suffering from vitiligo wear sunblock with a minimum SPF of 30.

Tips for Taking Care of Diabetic Skin and Diabetic Feet

The most important thing a diabetic can do is maintain healthy blood sugar levels.  The most important measure someone with diabetes can take to prevent infections is to perform routine checks of their skin, particularly their feet. Here is a list of tips to help maintain healthy skin.

Skin Care

  • Wash with a mild soap to avoid over-drying your skin.
  • After washing, dry thoroughly paying special attention to places where water can hide like under the arms, under the breasts, and between the legs and toes.
  • Keep skin moist by using a lotion or cream. Be sure that the formula does not include salicylic acid or other potentially harmful ingredients.
  • Drink lots of fluids to keep skin moist and healthy.
  • Yeast infections can often be avoided by good hygienic care and eating foods with active cultures, such as yogurt containing acidophilus, can be helpful for preventing yeast infections.
  • Check skin for dry, red, or sore spots that might lead to an infection.

Foot Care

  • Wear socks and shoes at all times to help avoid injury.
  • Keep your skin moisturized at all times to avoid cracking, which can lead to infection.
  • Since diabetic neuropathy can make it hard to sense injury, examine your feet daily. Look for cuts, sores, blisters, redness, calluses or other problems.
  • Meticulously maintain your feet so that minor scrapes do not turn into ulcerated infections and watch closely for any symptoms of infection.

We gathered this information from several expert sites on diabetes, including the American Diabetes Association, the Cleveland Clinic Foundation, and the American Medical Association. All 3 organizations have comprehensive information relating to the skin conditions described above.

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