In the long list of organs in the human body – the heart, kidneys, eyes, lungs – the largest may be the organ we most often forget about: the skin. But according to the American Diabetes Association, up to one-third of people with diabetes may experience some sort of diabetes-related skin issue during their lifetime. In fact, skin problems may be one of the first warning signs that a person has diabetes. So how can people living with diabetes protect their skin?
Some diabetes-related skin problems may stem from having blood sugar that’s too high. High blood sugar levels can cause circulation problems, which can lead to dry and itchy skin. And high blood sugar levels also reduce the body’s ability to fight off many kinds of infections. This is why the first line of defense in diabetes skin care is blood sugar management: the closer a person can keep their blood sugar to target levels, the fewer skin problems they may experience. (Talk to your diabetes care team if you have concerns about skin complications or blood glucose management.)
In addition to paying attention to glucose levels, people with diabetes should take steps to keep their skin properly hydrated – not too dry, but also not too moist. Dry skin can lead to scratching or chapping, which in turn can cause damage that allows bacteria to get into the skin and cause infection. But on the flip side, skin that’s overly moist may be at greater risk for fungal infections like jock itch or athlete’s foot. In order to strike the right balance, try these tips:
People with diabetes should also be sure to treat cuts and wounds immediately – and if you notice any signs of a bacterial or fungal infection, see your doctor. Signs of a bacterial infection include skin that is hot, inflamed, swollen and painful. Fungal infections, on the other hand, usually show up as moist, red areas, sometimes with little blisters or scales.
In addition to these general skin problems, there are several less common issues that may be experienced by some people with diabetes that are related to blood sugar management. These include:
Chronic high blood sugar levels can cause light brown, scaly patches to develop on shins. These patches are harmless, but since they may occur alongside other issues caused by high blood sugar, be sure to mention them to your doctor.
Sometimes people living with diabetes – particularly those who have dark skin or are overweight – may develop dark patches in their skin folds, including their armpits, groins and the sides of their necks. Ask your diabetes care team about treatment options.
Rarely, people with uncontrolled diabetes may break out in blisters, usually on the backs of their hands, toes, fingers and feet. These blisters may accompany diabetes-related nerve damage. While the blisters are painless and usually heal without scars, the only long-term treatment and prevention is better blood glucose management.
Digital sclerosis affects about a third of people with type 1 diabetes. It’s a condition in which the skin on the back of hands (as well as sometimes your toes and forehead) becomes tight, waxy and thick, and the joints below the skin get stiff. The only treatment is better blood sugar management.
Over time, out-of-range blood sugar levels may cause nerve damage that makes it difficult to feel a cut or a blister, particularly on the feet. The result can be an open wound known as a diabetic ulcer. If left untreated, diabetic ulcers may become severely infected, and even lead to amputation – in fact, 85 percent of diabetes-related amputations are preceded by foot ulcers. This is why it’s important to regularly check the skin on feet – including the bottom – for any wound or sign of infection.
Disseminated granuloma annulare
Disseminated granuloma annulare shows up as ring- or arc-shaped raised areas on skin, usually in spots far away from the body’s trunk, such as fingers or ears. It usually resolves on its own, but can also sometimes be treated with topical steroids. Talk to your doctor about treatment options.
Catherine Price is a freelance journalist and type 1 diabetic who has written for The New York Times, Slate, Popular Science and O Magazine, among others. Her newest book, Vitamania: Our Obsessive Quest for Nutritional Perfection, is available from Penguin Press. She blogs about diabetes at ASweetLife.org and you can follow her on Twitter @Catherine_Price. Price is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor and interviewee, and not of Sanofi US, its employees, agencies, or affiliates.
© 2015 The DX: The Diabetes Experience