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Diabetic Skin Conditions

Diabetes, or diabetes mellitus, is a group of diseases — which includes type 1 diabetes, type 2 diabetes, prediabetes, and gestational diabetes — that results in an excessive amount of sugar in the blood (high blood glucose). Diabetes can affect every part of the body, including the skin. Consequently, the development or worsening of specific skin problems may be the primary indicator that a person has diabetes. If you develop one of the following skin conditions or a pre-existing dermal complication has become more severe, contact a dermatologist with Advanced Dermatology and Skin Cancer Center. We offer a complete range of comprehensive, individualized dermatology treatments. Contact us for more information about our conditions treated or to schedule an appointment with our dermatology associates.

How Diabetes Affects Skin Health

Diabetes skin problems are a common complication of both type 1 diabetes and type 2 diabetes — approximately a third of patients with diabetes will develop a skin disorder related to the disease at some point during their lifetime. Many skin complications, such as certain types of rashes and blisters, can directly manifest from diabetes or allergic reactions to insulin or diabetes medications. Other types of skin problems, such as fungal infections, skin irritation, and dry skin, can occur in otherwise healthy patients but tend to affect those with diabetes more frequently. 

Hyperglycemia (high blood glucose levels) is behind most skin problems caused by diabetes. An excessive amount of sugar in the blood prompts the body to pull fluid from other cells to produce an adequate amount of urine to remove the sugar, resulting in xerosis (dry skin). Skin that is dry, inflamed, and irritated can likewise result from diabetic neuropathy — a result of nerve damage, particularly in the feet and legs. Early diagnosis and treatment from an experienced skin specialist are key to dealing with diabetes-related skin conditions, managing resulting symptoms, and preventing other health complications.

Acanthosis Nigricans

Among the wide range of diabetic skin conditions linked to diabetes and insulin resistance, acanthosis nigricans results in the darkening and thickening of the skin in some regions of the body, especially in skin folds. These areas of tan or brown-colored, slightly raised skin with a velvety texture appear on the sides of the neck, the armpits, and the groin. It may occur on the hands, elbows, and knees. This condition affects both otherwise healthy patients and those with certain medical conditions, but it is commonly found in those with diabetes. Because acanthosis nigricans is a sign of insulin resistance, it may be the first sign of prediabetes or type 2 diabetes, and it is especially common in patients with obesity. Treatment for acanthosis nigricans focuses on remediating the underlying issues from which it results. Weight loss is the most effective form of treatment, while skin treatments can reduce skin patch visibility.

Bacterial Infections

There are many different types of bacterial infections that commonly affect the skin of those with diabetes. Skin infections with Staphylococcus bacteria are more common and more severe in patients with untreated diabetes or diabetes that is not under control. These bacteria can result in boils (an inflamed nodule from a hair follicle), styes (infections of the glands within the eyelids), and bacterial nail infections. The vast majority of bacterial infections require medical treatment with antibiotics in the form of oral medications or topical treatments.

Bullosis Diabeticorum (Diabetic Blisters)

In rare cases, patients with diabetes develop diabetic blisters that resemble blisters on burned skin. These blisters — called bullosis diabeticorum — may develop on the fingers, hands, toes, feet, legs, or arms. Diabetic blisters are usually painless and may or may not require professional treatment to heal. These blisters often occur in patients with diabetic neuropathy. If you believe you have diabetic blisters or you're suffering from another type of diabetes-related skin condition, contact our office today to schedule a dermatology appointment for treatment.

Fungal Infections

Candida albicans, a yeast-like fungus, is responsible for a significant portion of fungal infections that cause skin problems in patients with diabetes. The fungus causes the development of itchy, red rashes surrounded by tiny blisters and scales on the skin. The four most common fungal infections are jock itch — red, itchy skin on genitals and on the skin inside of the thighs —  athlete’s foot — red, itchy rashes on the skin between the toes — ringworm — ring-shaped, scaly patches that can itch or blister and appear on the feet, groin, chest, abdomen, scalp, or nails — and vaginal infection that causes itching and irritation to the affected portions of skin. These infections usually occur in warm, moist folds of the skin. Treatment of fungal infections involves removing moisture and keeping the affected areas of skin dry with a combination of topical steroids and antifungal medications. If you think you have a yeast or fungal infection, contact Advanced Dermatology and Skin Cancer Center for treatment.

Atherosclerosis

Atherosclerosis is a serious health condition caused by the narrowing of blood vessels after vessel walls thicken due to buildup of plaque. This condition is most often associated with blood vessels either in or near the heart, but it can also affect blood vessels throughout the body, including those that supply blood to the skin. As the skin’s blood vessels narrow, changes to the skin — including hair loss, thinning skin, shiny skin, thickened and discolored toenails, and cold skin — can occur due to a lack of oxygen. Patients affected by atherosclerosis heal more slowly when injured due to a depleted supply of white blood cells, which help fight infection. Patients with diabetic neuropathy are more likely to have foot injuries due to a loss of sensation to pain, cold, heat, or pressure.

Diabetic Dermopathy

Also commonly referred to as shin spots, diabetic dermopathy develops as a result of changes to the blood vessels that supply the skin with blood and oxygen. Dermopathy typically appears as shiny, round, or oval lesions of thin skin that are light brown or red, often on the front of the legs. This condition usually affects both legs but not necessarily to an equal degree. The patches do not hurt, blister, or itch, and professional treatment is generally not required, but patients may seek treatment to help alleviate symptoms or reduce the appearance of these diabetic skin lesions. Contact us for more information about this condition.

Necrobiosis Lipoidica Diabeticorum

Necrobiosis lipoidica diabeticorum (NLD) is thought to be caused as a result of changes to collagen and fat contents under the skin. The overlying skin becomes thinned and reddens, while the affected skin becomes raised, yellow and waxy in appearance, often with a blue or purple-colored border. Most lesions are found on the lower parts of the legs and can ulcerate if subjected to trauma. NLD lesions typically have well-defined borders that isolate lesions from surrounding areas of unaffected skin. In some cases, NLD can be itchy and painful. As long as the sores remain unbroken, treatment is not necessary. Contact our dermatologist office if the sores break open or if the lesions cause pain or discomfort.

Allergic Reactions

Almost any type of diabetes medication, including insulin, can trigger an allergic skin reaction and result in redness, rash, swelling, itching, or other symptoms. Allergic reactions to medications occur when the patient has a pre-existing sensitivity to the drug or an active ingredient in the medication, such as a preservative. Patients with diabetes using injectable medication may experience skin reactions that are limited to the area of skin where the needle was inserted. If you believe you have an allergic reaction to diabetes medication, call our dermatology clinic or your primary care physician immediately for instructions on how to remediate allergic reaction symptoms in the short term, as well as to discuss alternative medication options for treating diabetes. Get emergency medical assistance immediately if skin changes from medication are accompanied by difficulty breathing or other severe symptoms.

Disseminated Granuloma Annulare

This condition causes sharply defined and raised arc-shaped or ring-shaped rashes to form on the skin. Granuloma annulare rashes typically develop on the fingers, hands, ears, and feet, but they may also occur on the trunk. The rash may be red, red-brown, or skin-colored. This diabetes-related skin condition usually does not require treatment, but it may become severe enough to warrant seeking treatment from our dermatologists. Treatments may include prescribed medications, such as steroids, to clear up the diabetes rash.

Eruptive Xanthomatosis

Eruptive xanthomatosis may occur when blood sugar levels are not well regulated and when triglycerides rise to extremely high levels. Severe resistance to insulin makes it difficult for the body to clear fat contents from the blood, which results in the development of firm, yellow, pea-like bumps on the skin. The bumps — which are usually surrounded by red halos and can be itchy — are commonly found on the feet, arms, legs, buttocks, and backs of the hands. Treatment for patients with eruptive xanthomatosis comprises prescription medication to lower blood sugar and lipid levels.

Itching

Patients with diabetes tend to experience itchy skin more often than those without the condition. Persistent itching and irritation can cause severe agitation and might lead to excessive scratching, which can cause infection, discomfort, and pain. Itching skin — also called pruritus — can have many causes, such as a yeast or bacterial infection, dry skin, or reduced blood flow, among additional causes. When diabetes itching is caused by poor blood flow, the lower legs and feet are most often affected. Some patients with diabetes may develop itchy skin as an adverse side effect of or an allergic reaction to a new medication. If this occurs, contact your physician regarding replacement medications. Skin products that contain fragrance, dyes, and skin-stripping ingredients can dry out the skin or exacerbate skin dryness, leading to itchiness. Our dermatologists can evaluate areas of dry or patchy skin to determine if diabetes or an underlying condition is the cause before prescribing treatment.

Vitiligo

Vitiligo is an autoimmune disease that is more likely to develop in patients with type 1 diabetes than those with type 2 diabetes. This condition affects skin coloration and occurs when the immune system attacks the skin’s melanocytes (melanin-producing skin cells). Melanin is the pigment that determines skin color and also acts as a natural protectant from the sun. Common symptoms of vitiligo are the appearance of milky-white skin patches, loss of pigmentation inside the mouth and in the retinas, and premature hair whitening. Since vitiligo is one of the more infrequent diabetic skin problems, treatment focuses on symptom management and may include medicated topical creams, light therapy, and avoiding sun and ultraviolet (UV) exposure.

Scleroderma Diabeticorum

As with digital sclerosis, scleroderma diabeticorum causes a thickening of the skin. Scleroderma diabeticorum, however, affects the skin on the back of the neck and upper back. While rare, this skin problem affects patients with type 2 diabetes and causes the skin to thicken. Treatment involves regulating blood sugar levels as well as the use of moisturizers and additional types of topical treatments that shed the skin’s top layers in order to reveal newer layers of skin. These medications likewise exfoliate and soften the skin, helping to prevent the thickening from recurring. Contact our office for more information about available treatments.

Digital Sclerosis

A portion of individuals with diabetes may develop digital sclerosis, which is characterized by the development of tight, thick, and waxy skin on the backs of the hands as well as on the toes and forehead. The word “digital” refers to fingers and toes, while “sclerosis” means hardening. Stiffness of the finger joint might likewise occur in diabetic patients with digital sclerosis. Dermatologist-recommended skin care, such as prescribed topical lotions and creams, may be recommended to reduce the appearance and severity of skin affected by digital sclerosis as well as to soften the affected areas of skin. Additional treatment options for digital sclerosis include effective management of the patient’s blood sugar levels.

How To Manage Diabetes Skin Problems

For patients suffering from diabetic skin conditions, keeping their diabetes under control is the most important factor in preventing the development and worsening of skin-related diabetes complications. Maintaining control over blood glucose levels, using proper diabetic skin care, and staying hydrated by drinking plenty of water can help reduce the risk of skin-related problems. The following comprises additional ways to help prevent the occurrence and worsening of diabetes-related skin issues.

  • Keep your diabetes under control. Follow your doctor’s advice about nutrition, exercise, and medication. Keep blood glucose levels within the recommended range.
  • Use dermatologist-approved skincare products. Your skin care regimen should comprise products with healthy, beneficial ingredients that help your skin regulate moisture levels, retain hydration, and support an overall healthy lifestyle.
  • Keep your skin moisturized. Use a dermatologist-approved lotion or cream on the skin after bathing. Be sure to use products that contain no fragrances, dyes, or alcohol-based ingredients in order to ensure your skin remains healthy and hydrated.
  • Keep skin clean and dry. Use warm water and mild, moisture-rich cleansing products when bathing or showering. Dry your skin thoroughly after washing.
  • Perform daily skin inspections. After showering or bathing, inspect your body to ensure you don’t have any dry, red, or sore spots that might become infected.
  • Avoid hot water and long showers. Exposing the skin to hot water for a long period of time will strip the skin of moisture and can lead to dryness, itchiness, and discomfort.
  • Implement seasonal skin-care changes. Prevent dry skin when the temperature drops by using a humidifier to replenish indoor moisture levels within heated, indoor air.
  • Treat cuts right away. Wash cuts and scrapes with mild soap and luke-warm water. Avoid products with antibacterial ingredients and alcohol, as they are too harsh. Contact our dermatologists right away for major cuts, infections, burns, or other skin issues.
  • Use sun protection daily. Use sunscreens with a sun protection factor (SPF) of 35 or higher on all areas of exposed skin. Choose sun-protective clothing and avoid unnecessary exposure to UV rays by staying in the shade while outdoors.
  • Wear 100% cotton underwear. Cotton allows air to circulate around the skin, helping to prevent the development of a bacterial or fungal infection in moisture-rich areas of skin.
  • Take good care of your feet. Check each foot each day for sores and cuts. Wear broad, flat, and well-made shoes that fit correctly and feel comfortable.
  • Contact our dermatologists. If you observe a skin issue or would like to schedule a dermatology appointment, contact our office for prompt service.

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