Definition
Diabetes can affect every part of the body, including the skin. In fact, such problems are sometimes the first sign that a person has diabetes.
Some of these problems are skin conditions anyone can have, but people with diabetes get more easily. These include bacterial infections, fungal infections, and itching. Other skin problems happen mostly or only to people with diabetes. These include diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic blisters, and eruptive xanthomatosis.
Blacks have a high rate of diabetic complications, because of poor glycaemic control and racial disparities in health care in the USA.
Types of skin conditions
Acanthosis nigricans
Acanthosis nigricans is a condition in which tan or brown raised areas appear on the sides of the neck, armpits and groin. Sometimes they also occur on the hands, elbows and knees.
Acanthosis nigricans usually strikes in people who are overweight. The best treatment is to lose weight. Some creams can help the spots look better.
Diabetic dermopathy
Diabetes can cause changes in the small blood vessels. These changes can cause skin problems called diabetic dermopathy.
Dermopathy often looks like light brown, scaly patches. These patches may be oval or circular. People often mistake them for age spots. This disorder most often occurs on the front of both legs. But the legs may not be affected to the same degree. The patches do not hurt, open up, or itch.
Dermopathy is harmless and doesn’t need to be treated.
Necrobiosis lipoidica diabeticorum
Another disease that may be caused by changes in the blood vessels is necrobiosis lipoidica diabeticorum (NLD). NLD causes spots similar to diabetic dermopathy, but they are fewer, larger, and deeper.
NLD is a rare condition that often starts as a dull, red, raised area. After a while, it looks like a shiny scar with a violet border. The blood vessels under the skin may become easier to see. Sometimes NLD is itchy and painful. Sometimes the spots can crack open.
Adult women are the most likely to get NLD. As long as the sores do not break open, you do not need to have it treated. But if you get open sores, you should see your doctor for treatment.
Allergic reactions
Allergic skin reactions can occur in response to medicines, such as insulin or diabetes pills. You should see your doctor if you think you are having a reaction to a medicine. Watch out for rashes, depressions, or bumps that appear near the sites where you inject insulin.
Diabetic blisters (bullosis diabeticorum)
Rarely, do people with diabetes erupt in blisters. Diabetic blisters can occur on the backs of fingers, hands, toes, feet and sometimes on legs or forearms. These sores look like burn blisters and often occur in people who have diabetic neuropathy. They are sometimes large, but they are painless and have no redness around them. Diabetic blisters usually heal by themselves, without scars, in about three weeks. The only treatment is to bring blood sugar levels under control.
Eruptive xanthomatosis
Eruptive xanthomatosis is another condition caused by diabetes. It consists of firm, yellow, pea-like enlargements in the skin. Each bump has a red halo and may itch. This condition occurs most often on the backs of hands, feet, arms, legs and buttocks.
The disorder usually occurs in young men with type 1 diabetes. The person often has high levels of cholesterol and fat in the blood. Like diabetic blisters, these bumps disappear when diabetes control is restored.
Digital sclerosis
Sometimes, people with diabetes develop tight, thick, waxy skin on the backs of their hands. Sometimes skin on the toes and forehead also becomes thick. The finger joints become stiff and can no longer move the way they should. Rarely, knees, ankles, or elbows also get stiff.
This condition happens to about one-third of people who have type 1 diabetes. The only treatment is to bring blood sugar levels under control.
Disseminated granuloma annulare
In disseminated granuloma annulare, the person has sharply defined ring- or arc-shaped raised areas on the skin. These rashes occur most often on parts of the body far from the trunk (for example, the fingers or ears). But sometimes the raised areas occur on the trunk. They can be red, red-brown, or skin-colored.
If you get rashes like this, consult with your doctor. There are drugs they can prescribe you that will help clear up this condition.
Prevention
Luckily, most skin conditions can be prevented or easily treated if caught early. You can also prevent skin problems through the following:
- Keep your diabetes well managed. People with high glucose levels tend to have dry skin and less ability to fend off harmful bacteria. Both conditions increase the risk of infection.
- Keep skin clean and dry.
- Avoid very hot baths and showers. If your skin is dry, don’t use bubble baths. Moisturizing soaps may help. Afterward, use a standard skin lotion, but don’t put lotions between toes. The extra moisture there can encourage fungus to grow.
- Prevent dry skin. Scratching dry or itchy skin can open it up and allow infection to set in. Moisturize your skin to prevent chapping, especially in cold or windy weather.
- Treat cuts right away. Wash minor cuts with soap and water. Only use an antibiotic cream or ointment if your doctor says it’s okay. Cover minor cuts with sterile gauze. See a doctor right away if you get a major cut, burn, or infection.
- During cold, dry months, keep your home more humid. Bathe less during this weather, if possible.
- Use mild shampoos.
- Do not use feminine hygiene sprays.
- Take good care of your feet. Check them every day for sores and cuts. Wear broad, flat shoes that fit well. Check your shoes for foreign objects before putting them on.
- See a dermatologist (skin doctor) about skin problems if you are not able to solve them yourself.