As the weather turns cooler and fall turns into winter, most of us will start to feel the effects of the season on our skin. But for diabetics, dry, itchy skin can be more than just a seasonal nuisance. It can be a sign of danger. The nerve damage and other problems caused by the disease make diabetics more prone to developing skin conditions — some of which can signal serious underlying health issues that need quick attention.
"There are a number of skin conditions that occur more often in, or only in, people with diabetes," says Christopher Saudek, MD, Hugh P. McCormick Professor of Endocrinology and Metabolism at the Johns Hopkins University School of Medicine In fact, according to the American Diabetes Association, as many as one-third of diabetics will experience a skin disorder caused or affected by their disease. Read on for the most common skin conditions associated with diabetes.
Localized itching: Diabetics often experience itchy skin, particularly in the lower legs, which can be caused by dryness, poor circulation, or yeast infections. The nerve damage caused by diabetes may stop diabetics from sweating, which robs their skin of a natural moisturizer. Dryness and scratching can cause tiny cracks to form in the skin, which can admit bacteria and infection. Using a mild soap and moisturizing frequently may help reduce itching.
Diabetic dermopathy: Characterized by light brown scaly patches on the shins and legs, diabetic dermopathy (DD) is the most common skin condition associated with diabetes, according to an article in the Journal of the American Academy of Dermatology by Aaron Joseph Morgan, MD, and Robert A. Schwartz, MD, MPH. It occurs most often in patients over 50 and may affect twice as many males as females. While DD itself is harmless — in fact, there is no direct treatment — it may be indicative of other, dangerous diabetes-related complications, includingneuropathy, nephropathy,and retinopathy. Also, 55 percent of patients with DD have coronary artery disease.
Atherosclerosis: "High blood sugar can cause atherosclerosis, a narrowing of the blood vessels, which results in decreased blood supply to the skin and other areas of the body," says Amy Derick, MD, a private-practice dermatologist based in Barrington, Illinois, and a frequent guest expert on NBC News, The View, andCNN.com. The skin, particularly on the legs, can become thin and hairless, and prone to developing ulcers. The reduced blood flow can slow wound healing, allowing infections — and even gangrene — to develop. This is one reason that diabetics who don't frequently inspect their feet and legs for sores (they may not feel symptoms, because of nerve damage) are at great risk of requiring a toe, foot, or leg amputation.
Bacterial and fungal infections: Diabetics are often more prone to bacterial and fungal infections of the skin, including staphylococcus (staph) infections, yeast infections, and athlete's foot. "Infections may also occur in skin folds, such as under the arms or the breasts, or less commonly, in the mouth — the fungal infection known as thrush," says Dr. Saudek. It's important for diabetics to seek treatment for any skin infections because they are more prone to complications. "Increased serum glucose hinders the immune system's ability to fight off infections," says Dr. Derick. In the case of athlete's foot, for example, "tiny macerations form in the toe web spaces, increasing the possibility of another skin infection."
Necrobiosis: A skin condition seen almost exclusively in diabetics or people who are insulin resistant, necrobiosis appears as a rash of purple spots, most often on the lower legs and feet. The individual spots are usually round and may range in size from half an inch in diameter to three or four inches. Though rare, it largely affects adult women.
Acanthosis nigricans: This condition causes dark patches of thickened, "velvety" skin to develop in areas where there are skin folds, such as the neck, groin, and underarms. Researchers believe the patches are strongly linked to obesity and insulin resistance.
Digital sclerosis: This diabetic skin condition is marked by thickened, "waxy" skin, usually on the back of the hands and fingers. It can also affect the toes and the back of the neck.
Skin Care for Diabetics
Most skin conditions can be treated or prevented entirely by taking good care of your skin and managing your diabetes responsibly. Try these tips from the American Diabetes Association to keep your skin in good health:
  • Once a week, thoroughly inspect your skin (especially your lower legs and feet) for persistent or unusual sores, bruises, pain, or any other symptoms, and inform your doctor about them at once.
  • Keep your skin clean and avoid chafing by applying talcum powder — especially to such places as the armpits and groin.
  • Avoid very hot baths and showers and use a gentle moisturizer regularly.
  • Don't scratch! Scratching that itch can create tiny openings in the skin, making you more prone to infection.
  • Don't smoke. It can worsen several diabetic skin diseases.
  • Wear gardening gloves or work gloves to protect your hands during rough activities, and always wear shoes.
  • See a dermatologist about any skin conditions that you can't cure on your own.
Last reviewed: October 7, 2008 | Last updated: October 15, 2008 This section created and produced exclusively by the editorial staff of EverydayHealth.com. © 2008 EverydayHealth.com; all rights reserved.