Diabetes and your skin
Dermatologist explains how diabetes affects the skin and the importance of proper skin care
Your skin is a window to your overall health, and what happens on your skin is often an indicator of what’s happening inside your body. Skin, hair, and nail conditions can be symptoms of a range of diseases, including diabetes. In recognition of National Healthy Skin Month and American Diabetes Month in November, a board-certified dermatologist is sharing the warning signs of diabetes that appear on the skin and skin care tips for people with diabetes.
Approximately 37.3 million Americans—about 1 in 10—have diabetes," said board-certified dermatologist Robert S. Kirsner MD, PhD, FAAD, Chair of Dermatology and Professor in Public Health Sciences at the University of Miami’s Miller School of Medicine. “About a third of patients who have diabetes don’t know they have the disease. While it can affect every part of your body, problems on the skin can be the first sign that a person has diabetes.”
When diabetes develops, it can show on your skin in many ways, including as:
- Yellow, reddish, or brown patches on your skin, which often begin as small raised solid bumps that look like pimples. These bumps eventually turn into patches of swollen and hard skin.
- A darker area of skin that feels like velvet on the back of your neck, armpit, groin, or elsewhere could mean that you have too much insulin in your blood. This is also often a sign of prediabetes.
- Shin spots are spots (and sometimes lines) that create barely noticeable depressions in the skin. They usually form on the shins. In rare cases, you’ll see them on the arms, thighs, trunk, or other areas of the body.
- Yellowish scaly patches on and around your eyelids can develop when you have high fat levels in your blood. It can also be a sign that your diabetes is poorly controlled.
One symptom of diabetes is hardness of the upper back and upper outer arms,” said Dr. Kirsner. “I can usually tell whether a patient has long-term effects of diabetes when I greet them by shaking their hand and lightly touching their back.”
When diabetes affects the skin, it can be a sign that your blood sugar (glucose) levels are too high. If you notice any of the warning signs of diabetes on your skin, Dr. Kirsner recommends speaking with a board-certified dermatologist who can tell you if the cause is a dermatologic condition, or if it’s a symptom of another disease, like diabetes. This is especially important if you have prediabetes or a family history of diabetes.
If you have diabetes, monitoring your glucose level, sticking to a meal plan, finding time to exercise, and managing stress can take priority, but Dr. Kirsner says that skin care also plays a key role in helping you manage the disease.
The right skin care routine can prevent a serious skin condition, such as an infection, open sores, or non-healing wound, from developing. Dr. Kirsner and the American Academy of Dermatology recommend the following skin care tips:
- Moisturize every day. Keeping your skin moisturized helps to make it flexible and prevent cracks that often lead to infection.
- Treat dry, cracked heels. This can prevent a serious infection, non-healing sores, and other problems.
- Use a gentle cleanser when bathing. Deodorant soaps and strong body washes can irritate your already sensitive skin. A gentle cleanser or one specially formulated for people who have diabetes helps to soothe your skin and prevent complications.
- Bathe and shower using warm (not hot) water. Hot water can strip your skin of moisture, leaving it feeling dry, tight, and uncomfortable.
- Dry the folds of your skin carefully. After bathing and swimming, gently dry the skin between your toes, armpits, and other places where skin touches skin. If water stays in these areas, it can increase the chance of skin infection.
- Get medical care for calluses on your feet. A corn or callus on your foot may seem like nothing to worry about. However, when you have diabetes, the thick skin can break down and open. Deep cracks can develop. If any of these occur, you can develop a serious infection, such as cellulitis.
- Seek immediate medical care for a skin or nail infection. People who have diabetes can develop an infection more easily than people who have a healthy endocrine system. An infection can quickly become serious.
- Treat all cuts, scratches, and wounds immediately. To treat wounds, wash the area with soap and water. Apply antibiotic ointment only if your doctor recommends this. Always cover the wound with an adhesive bandage. To help your skin heal, treat the wound every day.
- Check your feet every day for redness, scales, scratches, blisters, sores, and cuts. If you have a minor wound, treat it. Get immediate medical care for all other wounds.
Keep your toenails short. Long, rough toenails can irritate your skin. When toenails grow long, they can lift. This makes it easier for an infection to develop beneath a toenail. Keeping your toenails properly trimmed can prevent cuts and a possible foot infection.
Even minor skin conditions can become serious for people who have diabetes if they aren’t properly treated. Signs that you need to see a board-certified dermatologist include yellow, lifted, or thick nails; scaling between the toes or on the bottom of your feet; or moist skin buildup between your toes.
One of the most severe complications in patients who have diabetes is the development of a wound, typically on their feet, because they can have a lack of sensation in their limbs,” said Dr. Kirsner. “If these wounds are not treated appropriately, they can lead to amputation, bone infection, and even death. If you have diabetes and a wound, paying attention to the skin and treating wounds early is critical.”