Skin Complications

Our skin is the largest and certainly the most visible organ in the body. That’s why it’s important to be proactive when it comes to skin health. If you check your skin often and identify small problems in the early stages, you can head off any serious complications and make sure that your most visible organ stays in great shape.

Even though it can be difficult to draw a direct connection between diabetes and skin conditions, there are some that tend to affect people with diabetes more than people without the disease. Most of these conditions are not serious. However, it’s always a good idea to check your skin regularly, so that a small problem doesn’t get out of hand.

In general, if you have diabetes, you may be more likely to have dry skin or areas of abnormal moisture. You may be more likely to develop blisters, breaks in the skin, or ulcers. Over time, people with diabetes may develop thickened, waxy skin, especially on the legs, feet, arms, and hands.1

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. If you build healthy skin care activities into your regular routine, you’ll be promoting the health of your skin. You should1:

  • Inspect your feet regularly and alert your doctor if you develop blisters, calluses, breaks in your skin, areas where skin is black, or if your feet feel abnormally cold
  • Do not soak your feet
  • Make sure the water in your shower or bath is not too hot
  • Use a mild soap when bathing and apply moisturizer cream after you bath, while your skin is still moist
  • Make sure to dry your skin carefully after bathing, applying talc or anti fungal powder to areas where skin is folded (underarms, groin, between toes, under breasts) and can remain wet or moist
  • If you have a cut, clean it, apply an antibiotic ointment, and dress it immediately. If you have a serious cut, burn, or the signs of an infection (pain, swelling, redness), see your doctor immediately.

Skin care recommendations

Recommendation

Description

Inspect feet daily
  • See your doctor if you develop a callus or blister
  • See your doctor if you develop abnormally cold feet, areas where skin appears black (this may occur on your toes), or breaks in your skin
Avoid soaking feet
  • Soaking can make your feet to moist and leave them vulnerable to fungal infection
Adjust temperature of bath or shower water
  • Make sure the water in your bath or shower is not too hot
  • Hot water can burn you if you have decreased sensation and it can dry your skin
Wash with mild soap and apply moisturizer
  • Use a mild soap and apply a moisturizer cream while your skin is moist
Dry your skin carefully
  • Make sure to dry your skin carefully after bathing, paying special attention to areas where skin is folded (underarms, groin, between toes, under breasts)
Use talc or antifungal powder in folds
  • Use talc or anti fungal powder (undecyclic acid) in areas where skin is folded (where skin touches skin)
Attend to minor cuts immediately
  • Clean cut immediately (with soap and water), apply an antibiotic cream or ointment
  • Cover it with a sterile gauze.
  • Do not use mercurochrome antiseptic, alcohol, or iodine
See your doctor if you have a serious cut, burn, or infection
  • Serious cuts, burns, or infection can get out of hand quickly and lead to life or limb threatening conditions

Based on Levin ME, Pfeifer MA, eds. The Uncomplicated Guide to Diabetes Complications. 3rd ed. Alexandria, VA:

American Diabetes Association; 2009.

In addition to daily skin care activities and taking preventative steps to identify and address problems in the early stages, there are some basic diabetes care tips—the ABCDEs of diabetes—that you should follow. The ABCDEs will benefit the health of your skin as well as other organs and help you prevent complications that often affect people with diabetes.

Learn more about healthy lifestyle changes you can make and ways you can make the ABCs of diabetes part of your life.

Skin conditions that are common in people with diabetes

There are several skin conditions that are common in people with diabetes. These include disorders characterized by skin dryness, itchiness, blisters, and discoloration. Other skin disorders include infections and skin reactions to drugs.

Common skin problems associated with diabetes

Problem

Description

Treatment

Dryness
  • Cracking (fissure), scaling
  • Hydration
  • Proper soap, moisturizer
Itching
  • Generalized itching
  • Moisturizer
  • Oral antihistamines
Yellow discoloration
  • Skin develops yellowish hue
  • None available
Scleredema
  • Thickened skin on neck, back, and shoulders
  • Control of blood sugar
  • No direct treatment available
Diabetic dermopathy
  • Dark spots (mostly on shins)
  • Moist interactive dressings for open areas
  • Avoid trauma to affected area
Necrobiosis lipoidica diabeticorum (NLD)
  • Spots (red-yellow) mostly on shins
  • Spots may break down and scar
  • Avoid trauma to affected area
  • Steroids (topical or intralesional)
  • Oral medications
Generalized granuloma annulare
  • Ring-shaped rows of smalled, raised, bead-like bumps
  • Avoid trauma to affected area
  • Steroids (topical or intralesional)
Dupuytren’s contracture
  • Loss of skin flexibility
  • Contraction of tendons
  • Control of blood sugar
  • Surgery
Acanthosis nigricans
  • Velvety dark areas of thickened skin in folds in neck, underarm, groin
  • Control of blood sugar
  • Weight loss
  • Topical agent to improve appearance
Xanthoma
  • Yellowish spots (flat or elevated)
  • Caused by high blood fats (cholesterol and triglycerides)
  • Low fat diet and lipid lowering agents
  • Control of blood sugar
Diabetic blisters
  • Blister formation on forearms, fingers, feet, without apparent cause
  • May be associated with neuropathy
  • Avoid trauma to affected area
  • Prevent secondary infection with antibiotic ointment
Fungal infection
  • Redness and/or scaling on folded skin
  • Maceration of toe webs
  • Nail changes
  • Antifungal drugs (topical or systemic)
  • Control of moisture
  • Keep skin clean
Bacterial infection
  • Redness, swelling, pain
  • Antibiotics (topical or systemic)
Drug reaction
  • Caused by sulfonylurea oral diabetes medications and insulin
  • Potential reactions to other medications and ingredients in cosmetics
  • Rash, thinning of fat in area of insulin injection
  • Antihistamines
  • Change of diabetes medication (consult with doctor)
Written by: Jonathan Simmons | Last reviewed: May 2014.
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