Control of blood glucose helps avoid many diabetic skin problems, which may be one reason to urge control and maintenance of blood glucose levels.
Despite this, skin conditions associated with diabetes are common. Up to one-third of people with diabetes have an associated skin condition. Fortunately, most skin conditions can be successfully treated before they worsen. Early detection and treatment is key.
Common skin lesions associated with diabetes
Itchy skin
Itchy skin (also called pruritus) can have many causes, such as dry skin, poor blood flow, or a yeast infection. If the itch is caused by poor blood flow, it may occur in the lower legs and feet. Lotion helps keep the skin soft and moist and prevents itchiness caused by dry skin.
Bacterial infections. Staphylococcus skin infections are more common and more severe in people with poorly controlled diabetes. When hair follicles are irritated, these bacteria can cause boils (inflamed, red, swollen bumps). The following infections are also included.
- Pinocytosis, an infection of the eyelid glands.
- Nail infections.
Most bacterial infections need to be treated with antibiotics, consult your doctor for details.
Fungal infections. Warm, moist skin folds are the perfect environment for fungal infections to occur. Here are three common types of fungal infections.
- Tinea cruris (redness and itchiness in the genital and inner thigh areas).
- Tinea pedis (affects the skin between the toes).
- Tinea monnieri (ring-shaped, scaly plaques that may be accompanied by itching or blisters, seen on the feet, groin, chest, abdomen, scalp, or nails).
Many people with diabetes develop fungal infections from a yeast-like fungus called Candida albicans, which can occur in the vaginal area in women. The corners of the mouth are also susceptible to these infections. The infection looks like a small cut and is called “corns of the mouth”.
Nail fungus is a fungal infection of the nails and toenails that is more common in people with diabetes. Tinea capitis causes the nail or toenail to discolor, thicken, and separate from the nail bed.
Fungal infections usually require the application of medications that kill the fungus (i.e., antifungals) to treat the lesion. Ask your doctor what medication to choose.
Echinococcosis nigricans
This disease, most common in people with type 2 diabetes, causes the skin to darken and thicken, and the skin folds to become more visible. The lesion looks like a small wart. The skin turns tan or brown. Sometimes it protrudes slightly from the skin and may have a velvety appearance.
Acanthosis nigricans may appear on the sides of the neck or on the back, in the armpits, under the breasts, and in the groin. Sometimes the tops of the knuckles may also have a bizarre appearance. This condition is common in people who are overweight.
Acanthosis nigricans usually begins before diabetes and may be a sign of insulin resistance. Although there is no cure, weight loss may help.
Plaque Nigricans
This disease affects skin color. It is more common in people with type 1 diabetes. In vitiligo, the cells that make melanin, the substance that gives skin its color, are destroyed.
People with vitiligo have patches of discolored skin, commonly on the chest and abdomen, but also on the lips, nose, and face area around the eyes. Treatment includes steroid creams, ultraviolet therapy, and color tattooing (tattooing). Sunscreens with a sun protection factor of 30 or higher should be used to prevent sunburn on discolored skin.
Shin spots (diabetic skin lesions)
This condition is caused by changes in the blood vessels of the skin. The skin of the lower leg appears as a shiny, round or oval lesion. The lesions are painless and rarely cause itching or burning sensations. Treatment is usually not necessary.
Unusual diabetes-related skin lesions
Progressive lipid-like necrosis
This condition may occur in people who have had diabetes for a long time and have poor glycemic control. Inadequate blood supply to the skin leads to changes in subcutaneous collagen and fat. The skin surface becomes thin and red. Most lesions appear on the lower legs and may become ulcers if there is trauma. The lesions have very clear borders. Itching and pain are sometimes present. No treatment is needed as long as the lesions do not break down. If the lesion splits, seek medical attention.
Sclerosis of the fingers and toes
The skin on your toes, fingers, and hands becomes rough, waxy, and tight because of poor blood flow, and these symptoms may also lead to stiffness in your finger joints. Controlling blood sugar can help with this condition. Try using lotions and moisturizers to help soften the skin.
Heart or blood vessel problems
Atherosclerosis, which is the narrowing of blood vessels. As plaque builds up, the walls of the blood vessels gradually thicken and they become narrower, which can affect the blood supply to the skin. Narrowing of the blood vessels that carry oxygen to the skin can cause associated changes such as hair loss, thinning hair, glowing skin (especially in the shin area), thickened and discolored toenails, and cold skin. Injuries to the legs and feet heal more slowly because the blood carries the white blood cells that help fight infection.
Eruptive xanthomas. Severe insulin resistance can make it difficult for the body to remove fat from the blood. If cholesterol levels are high, these skin changes can occur. Hard, yellow, waxy pea-like bumps appear on the skin, surrounded by red circles with itching. They are common on the eyes, elbows, face and buttocks, and may also appear on the back of the arms and legs. Doctors will try to control blood lipid levels to treat this condition. The skin bumps usually go away after a few weeks, and medications (lipid-lowering drugs) may be needed to control the levels of different types of fat in the blood.
Rare diabetes-associated skin lesions
Diabetes-associated blisters (diabetic maculopathy)
Rarely, people with diabetes develop burn-like blisters. The lesions may appear on the fingers, hands, toes, feet, legs, or forearms, are usually painless, and heal on their own. It is common in patients with severe diabetes and diabetic neuropathy. Your doctor will help control blood sugar levels to treat this lesion.
Disseminated granuloma annulare
It is controversial whether this disease is associated with diabetes mellitus. Disseminated granuloma annulare causes distinct rings or curved areas on the skin. This rash is most commonly seen on the fingers and ears, but may also appear on the chest and abdomen. The rash may be red, reddish-brown, or skin-colored. Treatment is usually not needed, but sometimes the application of steroid medications such as hydrocortisone to the skin can be helpful.
Diabetic sclerosis
This disease causes thickening of the skin on the neck and upper back, and it is a rare condition but may occur in people with type 2 diabetes. Treatment is to control blood sugar levels. Lotions and moisturizers help soften the skin.