Skin problems are a common complication of type 1 and type 2 diabetes. Up to 79% of people with diabetes will develop a disease-related skin disorder at some point. Many of them, such as certain rashes and blisters, can be direct manifestations of diabetes or allergic reactions to insulin or diabetes medications. Others, including fungal infections and dry, itchy skin, are not uncommon in otherwise healthy people, but tend to affect people with diabetes more frequently.Inasmuch asInasmuch as
Some skin problems are among the first signs of diabetes (along with other unrelated diseases and conditions, for that matter), so it’s important to see a dermatologist if you notice any unusual or unexplained changes in your skin. Early diagnosis and treatment are essential to treat skin conditions caused by diabetes to avoid serious consequences and complications.
How diabetes affects the skin
Diabetes can impact skin health in multiple ways. High blood sugar (hyperglycemia) is the cause of most skin problems caused by diabetes. Too much sugar in the blood causes the body to pull fluid from the cells in order to produce enough urine to eliminate the sugar, resulting in dry skin (xerosis).
Dry, red, itchy skin can also result from nerve damage (diabetic neuropathy), especially the nerves in the legs and feet. Damaged nerves may not carry the message of sweating, and sweating helps keep skin moist and soft.
In turn, when the skin is too dry, it can crack, peel and become itchy. Scratching it can create small openings in the skin. These openings allow infectious organisms easy access under the skin, where excess blood sugar provides a breeding ground for them to grow.
Beyond dryness and infections, there are an array of other skin problems associated with diabetes.
This condition is characterized by patches of skin around the neck that are darker than a person’s normal skin color. These areas can also appear in the armpits and groin, and sometimes on the knees, elbows and hands. The skin may also be thicker and take on a velvety texture.
Why it happens: Acanthosis nigricans is a sign of insulin resistance and is therefore sometimes the first sign of prediabetes or type 2 diabetes. It is especially common in obese people.
What to do: To make skin spots less noticeable, they can be covered with makeup, but in the long run weight loss is the most effective form of treatment.
Allergic reactions to drugs
Almost all diabetes medications, including insulin, can trigger an allergic reaction that causes symptoms affecting the skin, such as itching, swelling, rash, or redness.
Why it happens: Allergic reactions to drugs occur because a person has a pre-existing sensitivity either to the drug itself or to an inactive ingredient in the drug, such as a preservative. Some people who use injection medications have skin reactions limited to the area where the needle was inserted.
What to do: Call your health care provider if you have an allergic reaction to diabetes medicine. He or she may ask you to take an over-the-counter medication for short-term itch relief, and then discuss trying another medication to treat your diabetes.
If drug-induced skin changes are accompanied by difficulty breathing or other alarming symptoms, get emergency help right away.
Bullosis Diabeticorum (diabetic blisters)
They are painless, sometimes large blisters that appear spontaneously on the tops and sides of the lower legs and feet, and sometimes on the hands or forearms.
Why it happens: It is not known what causes the appearance of diabetic blisters. However, they are more common in people who develop diabetic neuropathy, a group of nerve disorders that affect people with type 1 and type 2 diabetes.
What to do: Most blisters heal in about three weeks without scarring, according to the American Diabetes Association (ADA). The only treatment is to control blood sugar.Inasmuch asInasmuch as
This presents as light brown or red scaly patches that often appear on the front of the legs. Usually oval or round in shape, they look like age spots and are sometimes called skin spots. They do not hurt or itch.
Why it happens: Changes in small blood vessels reduce the blood supply to the skin.
What to do: This harmless and painless condition requires no treatment.Inasmuch asInasmuch as
It starts with tight, waxy skin on the backs of the hands and stiffness in the fingers; some people may feel like they have pebbles at their fingertips. As the disease progresses, the skin may become hard, thick and swollen, spreading throughout the body starting with the upper back, shoulders, neck, chest and even the face. Rarely, the skin on the knees, ankles, or elbows thickens and takes on the texture of orange peel, making it difficult to move the affected joints.
Why it happens: Digital sclerosis is more common in people with type 1 diabetes who have other complications or whose disease is difficult to treat.
What to do: Better diabetes control can help. Meanwhile, physical therapy can bring more ease of movement to stiff joints.Inasmuch asInasmuch as
Disseminated granuloma annulare
It is a rash characterized by reddish or flesh-colored arcs or ring shapes on the fingers and ears, and sometimes on the front of the torso. The relationship between granuloma annulare and diabetes is somewhat controversial, but a small 2017 study found that subjects with the rash had high blood sugar levels.
Why it happens: There are no known causes of granuloma annulare, even when not associated with diabetes.
What to do: Most rashes caused by granuloma annulare disappear within a few months, although sometimes the bumps persist for up to two years. There’s no medical reason to treat it, but if it’s bothersome, options include prescription corticosteroid creams, ointments, or injections; apply liquid nitrogen to freeze lesions; laser therapy; certain oral medications.Inasmuch asInasmuch as
Itchy, waxy, yellow bumps on the skin surrounded by red halos. They are most commonly found on the face and buttocks, and can also appear on the extremities. Especially prevalent in young men with type 1 diabetes.
Why it happens: High blood cholesterol and fat levels occur when blood sugar levels are not well controlled.
What to do: Treatment consists of controlling blood lipids; lipid-lowering drugs may also be needed.Inasmuch asInasmuch as
Necrobiosis Lipoidica Diabeticorum (NLD)
Rash on the lower legs characterized by Slightly raised, shiny red-brown spots with yellowish centers that may develop into open, slow-healing sores. More common in women. Usually goes through phases of activity and inactivity. Sometimes requires a biopsy to diagnose.
Why it happens: Changes in fat and collagen below the surface of the skin.
What to do: Although difficult to treat, NLD sometimes responds to topical cortisone creams or cortisone injections. Ultraviolet light treatment has been shown to control this condition when it burns. A daily baby aspirin and other blood-thinning medications, such as Trental (pentoxifylline), may help.Inasmuch asInasmuch as
A rare condition that involves thickening of the skin on the upper back and neck.
Why it happens: The cause is unknown, but scleredema diabeticorum seems to occur more often in obese people.
What to do: Moisturizers can help, but the treatment is to control blood sugar.Inasmuch asInasmuch as
About 75% of people with skin tags have diabetes. These small, polyp-like lumps of flesh are most commonly found on the neck, eyelids, and armpits.
Why it happens: There seems to be a link between skin tags and insulin resistance as well as abnormal blood fats.
What to do: Although there is no reason to treat them, if they are bothersome or unsightly they can easily be removed.Inasmuch asInasmuch as
Painful, swollen, inflamed skin, often hot to the touch. Examples of bacterial infections are boils, eyelid styes, carbuncles, nail infections, and hair follicle infections.
Why it happens: Bacteria can grow in the presence of excess glucose. Staphylococcus is a common bacterium responsible for bacterial infections in people with diabetes.
What to do: These infections can usually be treated with antibiotics and improve with good blood sugar control.Inasmuch asInasmuch as
Itchy rashes in moist areas of the body, such as skin folds. These rashes may be red, surrounded by scales or blisters, and have a white film of yeast in the skin folds.
Why it happens: As with bacterial infections, excess glucose is beneficial for fungi.
What to do: Prescription medications and good diabetes control help with treatment. Examples of fungal infections are yeast infections, jock itch, ringworm, and athlete’s foot. Candida albicans is a common fungus responsible for fungal infections in people with diabetes.Inasmuch asInasmuch as