The phrase “feeling comfortable in your own skin” is usually used figuratively to describe a level of self-confidence or self-acceptance. But when your skin itches, hurts, flakes, breaks out, changes color, or just doesn’t look or feel the way you’d like it to, the phrase can take on a new, very literal meaning.
Diabetes can affect the skin in a number of ways that can make a person feel less than comfortable. In fact, as many as a third of people with diabetes will have a skin condition at some point in their lifetime. While some conditions may appear uniquely in people with diabetes, others are simply more common in people with diabetes. The good news is that a fair number of these conditions are treatable or can be prevented by maintaining blood glucose control and taking good daily care of your skin.
Dry, itchy skin
Dry skin can occur as a result of high blood glucose. When the blood glucose level is high, the body attempts to remove excess glucose from the blood by increasing urination. This loss of fluid from the body causes the skin to become dry. Dry skin can also be caused by neuropathy (damage to the nerves) by affecting the nerves that control the sweat glands. In these cases, neuropathy causes a decrease or absence of sweating that may lead to dry, cracked skin. Cold, dry air and bathing in hot water can aggravate dry skin.
Dryness commonly leads to other skin problems such as itching (and often scratching), cracking, and peeling. Any small breaks in the skin leave it more exposed to injury and infection. It is therefore important to keep skin well moisturized. The best way to moisturize is to apply lotion or cream right after showering and patting the skin dry. This will seal in droplets of water that are present on the skin from the shower. Skin that is severely dry may require application of heavy-duty emollients 2–3 times a day.
Itchy skin is usually related to dryness, but it can also be related to poor circulation, especially in the legs and feet. This is typically due to atherosclerosis, a disease in which fatty plaques are deposited in the arteries. Fungal infections, which can be more common when a person has high blood glucose, can also be very itchy.
When blood glucose levels are high, a person with diabetes is more susceptible to infection. This is believed to be why there’s a higher incidence of certain bacterial infections among people with diabetes and why these infections tend to be more serious than in the general population. The following are some of the more common bacterial infections in people who have diabetes.
Impetigo and ecthyma. Impetigo is a common, contagious, superficial skin infection that starts out as fluid- or pus-filled blisters or pimples that rupture to form erosions on the skin. These erosions are then covered by crusts. Minor breaks in the skin may lead to an impetigo infection, or it may arise as the result of an existing skin problem, such as atopic dermatitis, contact dermatitis, psoriasis, ulcers, traumatic wounds, burns, or insect bites. This infection most often arises on the face, arms, legs, buttocks, hands, and skin folds such as the underarms and groin.
Ecthyma has many features similar to those of impetigo and can in fact result from untreated impetigo. The main difference is that ecthyma goes into the deeper layers of the skin, forming ulcerations, which then become covered with thick crusts. This condition most commonly occurs on the legs and sometimes the buttocks. Poor hygiene increases the risk of ecthyma.