Reviewed by: HU Medical Review Board | Last reviewed: March 2021. | Last updated: September 2023
Diabetes can affect every area of your body, including your skin. Because your skin is the largest organ in the body, it is important to recognize how diabetes can impact it. Skin changes in diabetes often reflect the inflammation that diabetes causes.1
Skin issues with type 2 diabetes
If you check your skin often and identify small problems in the early stages, you may help prevent serious complications and make sure that your most visible organ stays in great shape.1
Doctors think there are several reasons why diabetes may lead to infection. Diabetes can cause different things in your body to decrease or lose function. Reasons diabetes may lead to skin infections may include:2,3
- High blood sugar (hyperglycemia)
- Problems with the vessels (vascular insufficiency)
- Nerve damage (neuropathy)
Your immune system works to keep you healthy. Uncontrolled blood sugar in diabetes can change your immune system function. This makes your body less able to fight infection. Doctors think that high blood sugar is the biggest reason those with diabetes are at a higher risk for infection.2,3
Vessel damage leads to decreased blood supply, which is important for wound healing. Damage to the nerves decreases feeling to the affected area. If a wound or injury occurs where there is nerve damage, you may not feel the injury, which could lead to infection if it is not treated.2,3
Dry, itchy skin is common in diabetes. High blood sugar can lead to itchy skin and make you uncomfortable. Managing your blood sugar is the first step. Your doctor may recommend certain lotions or products the work best for your skin.4
Yellow patches around your eyelids
Yellow, scaly patches on or near your eyelids may occur with diabetes. These may also be called xanthelasma. These patches usually mean you have high levels of fat in your blood. Talk to your doctor about these and your current diabetes management program. Your doctor may suggest fat-lowering drugs, such as statins.4
Scleroderma is a chronic connective tissue autoimmune disease. Autoimmune means that your immune system cannot tell the difference between healthy cells and invaders like viruses, fungi, or bacteria. Because it cannot tell the difference, the body begins to attack and damage healthy cells. Chronic means that it lasts for a long time or never goes away completely.5
Another condition, scleredema, mimics scleroderma and may occur in diabetes. While scleroderma causes skin hardening and tightening, scleredema usually involves the joints of the shoulder or jaw. The exact cause of scleredema in diabetes is not known, but doctors think that it may be caused by:6-8
- Too much insulin produced in the body in response to high blood sugar (glucose)
- Small vessel damage
- Decreased oxygen delivery to tissue (hypoxia)
Diabetic dermopathy results from changes in the small blood vessels in the body. This condition appears as circular, light brown, scaly patches on the front of both legs. This is a harmless, painless condition that does not require treatment.1
Necrobiosis lipoidica diabeticorum (NLD)
Necrobiosis lipoidica diabeticorum (NLD) is a rare skin disease that affects fewer than 1 percent of those with diabetes. NLD most commonly affects the shins and appears as a dull, red, and raised area. NLD occurs in patches and results from changes in the blood vessels from diabetes. NLD may be itchy and painful when the spots crack open. This condition affects more women than men.1,9
This condition causes a darkening and thickening of the skin. This occurs in patches, usually in the folds of the skin. Acanthosis nigricans typically occurs in those who are obese or who have diabetes. Insulin resistance in diabetes may be the cause of acanthosis.10
What should I do to take care of my skin?
There are several practical things you can do to take better care of your skin when you have diabetes:11
- Inspect your feet each day. Alert your doctor if you develop blisters, calluses, breaks in your skin, areas where the skin is black, or if your feet feel abnormally cold.
- Avoid soaking your feet.
- Make sure the water in your shower or bath is not too hot.
- Use mild soap when bathing, and apply moisturizer cream after your bath, while your skin is still moist.
- Make sure to dry your skin carefully after bathing, making sure the folds of your skin are dry as well.
- If you have a serious cut, burn, or the signs of an infection (pain, swelling, redness), see your doctor immediately.
In general, talk to your doctor about your skin problems. What you think is minor may be a complication that should be addressed. Catching these early may make a difference in your overall health and diabetes management.