Diabetes Related Foot Complications
What Are Diabetes-Related Skin Conditions?
Diabetes-related skin conditions are fairly common in people with type 1 and type 2 diabetes. Skin conditions can often be the first sign that someone may have diabetes. Many of the skin conditions associated with diabetes can affect all people, but people with diabetes usually develop the skin conditions much easier. Additionally, there are also skin conditions unique to diabetes.
It is important to pay attention and note any skin irritation or abnormality, as early detection helps with treatment, prevention, and further complications. Skin conditions that can affect all people are categorized as bacterial, fungal, and itching. Skin conditions considered unique to diabetes are diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic blisters, eruptive xanthomatosis, and others.
What Are the Symptoms of Diabetes-related Skin Conditions?
Skin conditions are common in people with diabetes and can affect children and adults, so it is important to pay attention to any changes or abnormalities in the skin. Early detection is key to treatment and prevention. The following symptoms are characteristic of diabetes-related skin conditions:
- Changes in skin, or any noticed abnormality of the skin
- Difficulty for wounds to heal, with or without infection
- Swelling or irritation around insulin injection sites
- Cracks or breaks in the skin
If you notice any changes or problems of the skin, please contact your Baptist Health medical provider, as early detection is important for treatment and prevention.
Types of Diabetes-Related Skin Conditions
Skin conditions affect all people, not just those with diabetes. However, people with diabetes seem to develop skin conditions more easily. It is important to identify any changes or abnormalities of the skin because early detection is crucial for treatment and prevention.
Some skin conditions associated with diabetes are:
Acanthosis nigricans can affect anyone, but typically develops more often in people with diabetes. Symptoms include a darkening and thickening of the skin, and can look like tan or brown (sometimes slightly raised) areas on the skin. They usually appear on the neck, armpits, or groin and occasionally on hands, knees, or elbows. People with diabetes are more at risk for developing this skin condition, specifically, if they are overweight. Treatments may include weight loss and blood sugar control.
Allergic reactions can develop from medications, insulin injections, bug bites, foods, etc. Contact your medical provider if you notice any rashes, bumps, depressions, or other skin abnormalities. It is especially important to consult your doctor if you notice an allergic reaction around insulin injection sites.
Bacterial infections of the skin can affect all people, however, people with diabetes can be more prone to infection, especially if sugar levels are not well controlled. There are several types of bacterial skin infections, including styes (infection of the eyelid glands), boils (infection of hair follicles), and carbuncles (deep infection of the skin and underlying tissue). Infected areas tend to be painful, feel hot to the touch, and appear red or swollen. Bacterial infections can be treated with antibiotics, or may need minor surgical intervention. It is important to contact a healthcare professional if you notice signs of infection.
Bullosis diabeticorum (diabetic blisters)
Although rare, people with diabetes sometimes breakout in blisters. The blisters are painless, but can look like burn blisters. They tend to appear on the hands, feet, fingers, toes, and sometimes on legs or forearms. The condition develops more often in people with diabetic neuropathy. The blisters often heal on their own in about 3 weeks. Appropriate management of blood sugar levels is helpful in recovery and prevention.
Diabetes-Related dermopathy is a skin condition that affects the small blood vessels in the legs. The changes in the blood vessels cause brown scaly patches to appear on the shins, or front part of the legs. The spots are often confused as age spots, and are painless and harmless. No treatment is necessary.
Digital sclerosis is a skin condition that affects the hands, fingers and toes. The skin becomes waxy and the joints can become stiff. On rare occasion, the knees, elbows, and ankles can be affected. This condition typically affects those with type 1 diabetes, and the treatment is to get blood sugar levels managed. There are also lotions and creams that can be help treat the areas.
Disseminated granuloma annulare
This skin condition creates defined rings or arc-looking raised rashes, typically on the hands, feet, or ears. Sometimes the bumps can be mildly itchy, but do not require treatment and will disappear on their own without leaving scars. If the rashes are itchy, there are topical medications that can help reduce the itchiness.
Eruptive xanthomatosis can occur when blood sugar levels and triglyceride levels are out of control. The condition affects the backs of hands, feet, arms, legs, and buttocks and appears as hardened yellow pea-sized bumps with a red halo around them. The bumps can be itchy. The condition typically develops in men with type 1 diabetes and tends to clear up when the diabetes is managed better.
Fungal infections can impact all people with diabetes and affects the moist, warm environments of the skin, often where there are skin-folds. Candida albicans, the yeast-like fungus, is typically responsible for most fungal issues. Symptoms appear as itchy red rashes, sometimes with blisters or scales. This condition typically develops when blood sugar levels are not managed appropriately. There are various medications and topical creams that can help treat the rashes. Getting blood sugar levels under control can also help in reducing symptoms.
Itchy skin can have various causes. Often, dry skin, yeast infections, or poor circulation can be the reason for skin that itches. If poor circulation is the reason, the itching often occurs in the legs. Treatment to reduce itching is bathing less frequently, particularly when there is lower humidity, using mild soaps, and using lotions or creams to help moisturize the skin.
Necrobiosis lipoidica diabeticorum
NLD is a skin condition, similar to diabetic dermopathy, but less common and the affected areas will be fewer, larger, and deeper. The condition is caused by changes in the blood vessels and begins as dull red raised areas, usually impacting the lower legs. The areas can change to a yellow, waxy appearance with a violet border around the area. The spots might be itchy and painful and can, on occasion, break open or crack. This condition only requires treatment if the sores break open. NLD is a rare condition, and women are more likely to develop it.
Necrobiosis lipoidica diabeticorum
While not unique to diabetes, people with diabetes are at higher risk for yeast infections. Yeast naturally lives on the body, and problems arise when the yeast overgrows. There are many possible causes why yeast infections may occur more often in people with diabetes. Consult your health care provider as early as possible if you suspect a yeast infection. Typical areas for yeast overgrowth occur in the mouth/tongue, skin, genital areas, eye and feet. It is also important to follow special hygiene measures and manage blood glucoses to prevent re-infections. Ask your Baptist Health provider about prevention recommendations.
Diabetes-Related Skin Care and Treatment
There are various ways to treat and prevent diabetes associated skin conditions. The most important form of treatment is to manage diabetes appropriately. Lowering blood sugar levels can resolve many of the issues that lead to developing a skin condition. Other forms of treatment include, OTC (over the counter) medications, prescription medications, and lifestyle changes.
There are different OTC medications for treating diabetes associated skin conditions, specifically for people with type 2 diabetes. Non-prescription antifungals and topical steroid medications can help reduce some of the unpleasant symptoms of various skin conditions. it is best to consult your Baptist Health primary care physician before trying OTC medications.
Some diabetes associated skin conditions do require prescription medication. If symptoms are severe enough or don’t clear up, sometimes prescription medications are the best treatment option. Examples of prescription medications include:
- Certain antifungals
- Insulin therapy
Often, a person can resolve diabetes related skin conditions by making lifestyle changes. The most helpful lifestyle changes a person can make are implementing better management of their diabetes and making sure a healthy body weight is maintained.
Other lifestyle changes that can help resolve symptoms include:
- Monitoring blood sugar levels
- Following a meal plan that helps to manage diabetes, and maintain a healthy body weight
- Staying physically active
- Avoiding long hot showers or baths, specifically when the air is cold and dry
- Keep your environment (home or office) a little humid during cold and dry months
- Using moisturizers or skin care products (including lip balm) that keep the skin feeling hydrated
- Avoid scratching dry skin as this can lead to cuts, breaks, or lesions in the skin that could become infected
- Treat cuts immediately, seek medical assistance for deep injuries, and for slow healing or wounds that appear infected
- Stay hydrated
- Protect skin from the sun, wear sunscreen during sun exposure
- Check your feet for any changes or abnormalities, as diabetic neuropathy can cause loss of feeling or sensation in the feet
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