When not well controlled, diabetes can affect many organs of the body. The skin being the largest organ in the body can also be affected by diabetes. In fact many people with diabetes will have a skin problem at some point in their life. For some people the skin problem may be the first sign that you have diabetes.
Diabetes does affect the skin in many ways. Some of these conditions do happen uniquely to people with diabetes while others may be found in everyone else. Even though some skin conditions may affect everyone else, people living with diabetes are more prone to being affected by these skin conditions. These include fungal infections, bacterial infections and itching.
Prolonged uncontrolled blood sugar levels lead to damage of the blood vessels and nerves. When this happens, there is decreased blood flow to your skin, commonly on hands and the feet. The skin texture, its appearance and its ability to heal when injured, gets affected.
The good news is that most of these skin conditions can be prevented or treated well if diagnosed on time. Good control of your blood sugar levels and good care of your skin are the two most important factors that all diabetics should always have in mind when it comes to their skin. If you are experiencing new changes in your skin, it is very important to see your doctor immediately to avoid complications.
Below are some conditions associated with diabetes and the skin.
Dry, itchy skin
A dry itch skin is one of the common skin problems in diabetes. It occurs as a result of high blood sugar levels. When your blood sugar levels are high, your kidneys work overtime in an effort to remove this sugar from your body. In the process, you lose a lot of fluids resulting in your body being dehydrated. This dehydration leaves your skin dry. Dryness of the skin often leads to problems such as itching, cracking and peeling.
Dry skin in diabetes can also be caused by damage to the nerves (diabetic neuropathy) that control the sweat glands. As a result, there is decreased or absent sweating. This may lead to a dry cracked skin.
An itchy dry skin can be caused by poor circulation. This is often due to atherosclerosis. When itching is caused by poor blood flow, the lower parts of the legs and feet are usually affected. Repeated fungal infections common in diabetes also contribute to an itchy skin.
Controlling the itching in diabetes is especially important as constant scratching may cause an inflamed skin or leave the skin broken. A broken skin becomes prone to infections and this is not a good thing in diabetes as there is often poor wound healing.
Stabilizing your blood sugar levels is the single most important factor in reducing dryness and itching. Avoiding conditions that can aggravate the dryness such as bathing in a hot tub is advised. Limit how often you bath and use a gentle soap. Always keep your skin well moisturized. Ensure that you apply the right lotion right after bathing as this will seal in the moisture that is in the skin.
Fungal infections are very common in diabetes especially when blood sugars are not well controlled. The infections cause an itchy, red, moist, swollen skin which is surrounded by blisters or dry scales. Fungal infections can also cause a cottage cheese-like discharge on folds of the skin.
Fungal infections can occur in any part of the body, but often occur around the nails, under the foreskin, under the breast, the groin, the armpits and in between the buttocks. Common fungal infections include vaginal infections, jock itch, athlete’s foot, and ringworm.
Athlete’s foot usually occurs in web spaces of the toes. It often appears as itchy, scaly or vesicle-like lesions. This infection is often caused by walking barefoot on contaminated surfaces. Making sure to wear shoes in public areas may prevent this infection. A jock itch is fungal infection covering the groin and sometimes extending to the upper thighs or pubic area.
Treatment of these infections includes keeping the affected are dry. Using anti fungal powders on skin folds reduce moisture and skin friction. Anti-fungal creams can clear the infection but if no response to these, oral anti fungal medication can be used.
People living with diabetes are prone to bacterial infections. This is because uncontrolled diabetes weakens your immune system and makes you prone to a number of infections. The bacterial infections also tend to be more serious in people with diabetes than in those without the disease.
Different kinds of bacteria may affect the skin but the commonest are the strep and staph infections. These infections may cause nail infections, sties (infection of glands in the eyelids), folliculitis (infections of the hair follicles), and boils. The area involved is often warm, red, swollen and painful.
Other serious infections like cellulitis and gangrene may occur that needs prompt attention by health care professional.
Bacterial infections mostly require treatment with antibiotics. Do consult your doctor if you think you have any form of skin infection.
Foot ulcers are a common yet serious complication of uncontrolled diabetes. They sometimes start as a minor trauma secondary to injury of the ill-fitting shoes that goes unnoticed. Some may result from the trauma that can occur when stepping on pins or a piece of glass. The ulcer may extend in to the deeper tissues of the skin and can become too stubborn to heal if blood sugar levels are not controlled.
Foot ulcers happen because of complications resulting in poor blood sugar control such as neuropathy and damage to the blood vessels. Almost all people who develop diabetic foot ulcers have a neuropathy of some sort.
Because of the poor blood supply, the ulcers tend to not heal well. Foot ulcers are serious as they can result in amputation if not treated on time. They therefore need to be attended to immediately. Consult your doctor immediately if you have a foot ulcer.
Also known as bullosis diabeticorum, diabetic blisters are not very common but do appear at times. They sometimes occur in the legs, feet, toes, forearms, hands and fingers. They appear like burn blisters, painless and often heal by themselves with no scarring. They sometimes appear in people with diabetic neuropathy. The only treatment for diabetic blisters is controlling your blood sugar levels.
This condition is usually found in people with diabetes who are also obese. It causes tan, brown or gray thickened patches commonly in the neck but may also appear on the armpits, the groin, the knees or elbows. Although it can affect otherwise healthy people, acanthosis nigricans is often frequently found in people with diabetes. It may be associated with some health conditions like acromegaly and PCOS.
This condition has no cure, but it improves markedly with weight loss. Some creams may help make the spots look better.
Also known as a “shin spots”, diabetic dermopathy is a skin condition that appears as scaly light brown or red patches often in front of the legs. The lesions may rarely be found on the scalp, the trunk or the thighs. The patches may be oval or circular and do not hurt or itch. It is one of the most common skin problems found in people with diabetes.
This condition is thought to be associated with nerve damage and damage to the small blood vessels that supply the skin. It tends to be found in people who have had diabetes for a long time and also closely linked to high HbA1c. Because of this link, it is believed to be caused by poorly controlled blood sugar levels.
Shin spots are harmless and do not require any form of treatment. They may improve when blood sugars are well controlled but often do not disappear completely.
Necrobiosis lipoidica diabeticorum (NLD)
Like diabetic dermopathy, this condition is also associated with changes in the blood vessels. It causes well demarcated red-brown plaques on the legs with itching and pain. The center of the plaque is often yellow and may ulcerate. The spots are larger than those found in diabetic dermopathy.
This condition is rare and mostly found in women with diabetes or family history of diabetes. It may be found in other medical conditions as well.
This condition is often difficult to cure completely but topical steroids may stop the progression of this skin condition.
This condition causes the skin on your toes and fingers to become thick, waxy and tight. It may also affect your forehead, the knees, elbows and ankles. The joints become stiff and have decreased range of movement.
This condition is caused by constantly high levels of sugar in the blood and the only treatment is to control these levels. Moisturizers may also help with making the skin softer.
Vitiligo happens when the cells that make melanin (natural skin pigment) are destroyed. When this happens, patches on discolored skin occur in different parts of the body. Vitiligo can develop in any part of the body.
It is more common it type-1 diabetes than in type-2 diabetes. Treatment is only recommended in severe cases. However, use of sun screen is advised to prevent damage to the discolored skin.
This condition appears as firm, yellow, pea-like bumps on the skin. It happens when your blood sugar is out of control. The bumps are often itchy and occur on the back of the hands, feet, arms, legs and buttocks. The condition is common in young men with type-1 diabetes and is associated with high levels of cholesterol.
Treatment involves controlling your blood sugar levels and lipid lowering drugs to control the cholesterol levels.
Protecting your skin
Your quality of life can be so compromised when your skin is constantly itchy, painful or doesn’t look good. That is why it is important for you to take good care of it on a daily basis.
Keeping your blood sugar levels under control is the single most important step to take to protect not only your skin, but all the other important organs of your body. This will strengthen your immune system and keep infections away. To keep you blood sugar levels under control you should follow your doctor’s advice, make the right food choices, exercise and take your medication as advised.
Examine your skin every day. Look for any skin changes or cuts that may warrant you to see your doctor promptly.
Avoid a dry skin. Keep your skin moisturized at all times by using a lotion or cream after you take a bath. Taking a long bath in hot water should be avoided as it may worsen a dry skin. Moisturize your hands all the time after you wash them. Avoid scratching an itchy skin as it may precipitate cuts which may take time to heal or get infected.
Keep your body well hydrated all the time by taking in lots of fluids. This will keep your skin healthy and prevent it from drying quickly.
Take great care of your feet. Examine them every day for cuts and sores. Wear well-fitting shoes. Cut nails properly to avoid injury. Avoid lotion between the toes as extra moisture can encourage growth of fungus in between the toes. Avoid walking barefoot even when you are indoors. Your doctor should examine your feet at least once every year.
When buying soaps or lotions, look for the mild hypo-allergic products. They do not irritate the skin.
The skin is the biggest organ and one of the most important organs in the body. It should be well taken care of. We all want to fell and look confident in our own skin. That is why taking care of your skin if very vital. Problems with the skin may be quite irritating and debilitating.
A fair number of skin conditions related to diabetes are manageable when you blood glucose levels are well controlled
As a person living with diabetes, making your skin happy is an important aspect of your day to day life. You can still live a happy healthy life by adopting the right habits. These include ticking to a healthy well balance meal, exercising, maintaining a good weight and avoiding stress.
Make the right choices today and enjoy a happy healthy skin forever.
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