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Diabetes and Skin Care (Part 1)
March 3, 2008
By now, your skin is probably feeling the effects of a long winter: Dryness, itchiness, flakiness, and redness are all common conditions that can affect your skin. It’s especially important to pay attention to your skin when you have diabetes. Diabetes can affect your skin, just as it can your eyes, feet, kidneys, and heart, so make sure you check it daily.
In fact, the American Diabetes Association estimates that as many as one-third of people with diabetes will experience some type of skin condition at some point in their lives. Many of the typical skin conditions that go hand in hand with diabetes result from blood glucose levels that aren’t within target range. Here are a few:
Acanthosis nigricans: With this condition, skin becomes tan or brown in color, and may develop a velvety texture. This may appear on the back of the neck, under the arms, under the breasts, or in the groin region. It’s more common in people who are overweight, and may actually appear before Type 2 diabetes is diagnosed. Acanthosis nigricans can occur in overweight children with Type 2 diabetes as well as in adults, and there are plenty of stories of parents who frantically try to scrub off the “dirt” off the necks of their children! Acanthosis nigricans is thought to be due to insulin resistance. Treatment: Decreasing insulin resistance and improving blood glucose levels will help this condition fade eventually. Certain medicines may help to lighten the affected skin, and dermabrasion and laser therapy can help reduce thickened areas.
Scleroderma diabeticorum: While somewhat rare, this condition is seen in people with Type 2 diabetes and involves a thickening of the skin on the neck and back. Treatment: Improved blood glucose levels, along with a good moisturizer.
Diabetic dermopathy: This harmless condition appears due to changes in the blood vessels. The skin may develop brownish, circular patches (similar in look to age spots) that take on a scaly appearance. Diabetic dermopathy typically appears on the fronts of both legs and is more common in people who are over the age of 50, especially in those with high HbA1c levels and in those with other complications. They usually tend to go away after a while. Treatment: Improved blood glucose control.
Necrobiosis lipoidica diabeticorum (NLD): This condition is somewhat similar to diabetic dermopathy in that it’s caused by blood vessel changes. However, with NLD, the patches are fewer in number, but they tend to be larger and reddish in color. It is also more common in women than in men. NLD usually appears on the lower parts of the legs, and may actually ulcerate, or burst open. NLD can cause itchiness and pain. Treatment: Not usually necessary unless ulceration occurs, but cortisone creams and injections can help, along with blood thinners and more potent steroids.
Eruptive xanthomatosis: This skin disorder is more commonly seen in younger men with Type 1 diabetes, particularly in those with uncontrolled diabetes and high triglyceride levels. In this condition, round, yellow, pea-sized bumps appear on the face, arms, legs, and buttocks, often encircled by a red halo. These bumps are usually itchy. Treatment: Improved blood glucose levels, along with lipid-lowering medication.
Atherosclerosis: While not exactly a skin condition, atherosclerosis (a narrowing of blood vessels due to plaque buildup that can lead to heart disease) affects blood vessels that supply oxygen and nutrients to the skin. Without adequate nourishment, the skin, especially on the legs, becomes thin, shiny, and hairless. The skin may be cold to the touch. Cuts and infections in the feet and legs are slower to heal due to lack of adequate white blood cells in those areas. Treatment: Improved blood glucose levels, along with lifestyle changes and medication, if necessary, to prevent or treat heart disease.
There are many other skin conditions that can occur in people with diabetes, but the above are some of the most common. Also, bacterial staph infections, such as styes and boils, as well as fungal infections, such as yeast infections, athlete’s foot, jock itch, and ringworm, are quite common in people with diabetes.
Next week: Keeping your skin healthy!
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