It’s fairly common to suffer from rashes and other skin problems in older age, but if you have diabetes you may be more at risk for a range of skin conditions—in fact, research suggests that more than half of people with diabetes develop skin disorders. Often these conditions affect people without diabetes, too—however, people with diabetes get them more easily. Dry skin is an example, says Saakshi Khattri, MD, associate professor of dermatology at Mount Sinai. “People with diabetes often develop dry, inflamed skin that is prone to cracking, which can enable bacteria to enter,” she says. Other skin disorders are specifically associated with diabetes. Here’s how to recognize and manage the most common problems, and care for your skin.
Boils are examples of bacterial infections, and are common in people with diabetes. They cause red, painful swellings around hair follicles. Dr. Khattri says that Staphylococcus aureus is the most common type of bacterial infection underlying boils. “People with diabetes also are vulnerable to pseudomonal skin infections, particularly in the feet,” she adds. A major example is Pseudomonas aeruginosa, a bacterium that frequently causes diabetic foot infections. “Recurrent fungal infections, such as Candida, also are common in diabetics,” Dr. Khattri adds. “Depending on what is causing a skin infection, antibiotics or antifungals will be used to treat it.”
This condition causes areas of skin to darken and develop a thickened, velvety texture. It typically affects the skin on the neck (pictured right), armpits and groin. “The condition has been reported to be a useful screening marker for the insulin resistance that underpins type 2 diabetes,” Dr. Khattri says. As such, acanthosis nigricans may be a sign of undiagnosed diabetes.
If you develop acanthosis nigricans, your doctor may prescribe creams containing retinoic or salicylic acid to improve the appearance of the affected areas.
Also known as diabetic blisters, this condition causes blisters on the hands, fingers, feet, and toes. The lesions have abrupt onset (often overnight) and resemble blisters caused by burns. They can be quite large, but are not painful. They heal spontaneously across several weeks, and treatment is not necessary, although your doctor likely will monitor the blisters for signs of infection and prescribe antibiotics if necessary. Your doctor also may aspirate some of the fluid from larger blisters to help prevent accidental rupture, but you should resist the urge to pierce the blisters yourself. Covering the blisters may help prevent infection.
This is a very common problem for people with diabetes. It causes light brown, scaly, oval or circular patches of skin, typically on the front of the legs, although the forearms also may be affected. The patches do not itch, hurt, or drain. After about 18 months to two years, the patches fade, leaving concave areas behind. As old patches fade, new patches may develop.
Diabetic dermopathy does not need any specific treatment—if the lesions bother you, you may want to camouflage them with makeup.
This condition tends to affect people with uncontrolled diabetes who also have high cholesterol levels. It results in small, firm, yellow-red bumps surrounded by a red “halo.” These usually develop on the backs of the hands, and the feet, arms, legs, and buttocks. The affected areas may itch, although they usually are asymptomatic. Eruptive xanthamatosis can be managed by lowering your blood fats as well as your blood sugar.
Skin Care Tips if You Have Diabetes
Dr. Khattri says that if you have diabetes, controlling your blood sugar is key to helping to prevent and manage skinrelated side effects. You can best do this by following your doctor’s advice when it comes to your diet and medication regimen. Regularly monitor your blood sugar using a home blood sugar meter, and immediately alert your doctor if your levels are trending upward. “Gentle skin care also is vital,” Dr. Khattri adds. “You need to try to maintain the integrity of your skin’s barrier layer.” You can best do this by avoiding long baths and showers using hot water. “Ideally, there shouldn’t be any steam, and the bathroom mirror should not be fogged when you finish,” Dr. Khattri says. “Use gentle, fragrancefree cleansers, don’t scrub your skin with a loofah or brush, and apply plenty of mild fragrance-free moisturizer within two or three minutes of drying off, to trap moisture in your skin.”
Treat cuts right away, by washing them with soap and water and covering them with sterile gauze. Seek medical advice for larger cuts and burns, and if you think a wound may be infected (for example, if the skin surrounding it becomes hot, swollen, and red). It is especially important to take care of the skin on your feet. Diabetes damages nerves throughout the body, including those in the skin. This can affect your ability to feel pain from minor cuts and other injuries to your feet, and it is all-too-easy for these to become infected without your realizing. “Everyone with diabetes should regularly see a podiatrist,” Dr. Khattri advises.