Diabetes and Skin Health

Dr DEEPALI BHARDWAJ, MD

Some diseases, such as diabetes, can have a significant impact on our physical appearance, which in turn affects our confidence and self-esteem. Diabetes, in particular, is known to cause drastic skin changes, serving as a visible indicator of the disease's control.

Understanding these skin ailments associated with diabetes is crucial for effective management. When diabetes is inadequately managed, it can lead to various skin issues, further exacerbating the impact on one's appearance and confidence.

1. Bacterial Infections:

Individuals with diabetes face a heightened risk of bacterial infections, including styes, boils, folliculitis, carbuncles, and nail infections. These infections present with symptoms such as swelling, redness, heat, and pain in the affected area. Staphylococcus bacteria, commonly known as staph, are the primary culprits behind these infections. While bacterial infections were once life-threatening for people with diabetes, advancements in antibiotics and blood glucose management have significantly reduced the risk of fatalities. However, individuals with diabetes still have a greater susceptibility to such infections. Practicing good skincare can help prevent these infections, and prompt medical attention is crucial if symptoms arise.

2. Slow healing of cuts and wounds:

Diabetes can impede the healing process of cuts and wounds due to changes in blood vessels, making it harder for blood to reach the affected area. This delay in healing heightens the risk of infection, as the body's natural defense mechanisms are compromised. Therefore, individuals with diabetes must be vigilant in caring for wounds. Thoroughly cleaning the area with soap and water and applying antibacterial ointment are essential steps. It's crucial to monitor the wound closely for signs of infection, such as redness, swelling, or discharge. Prompt medical attention is necessary if any of these symptoms occur, or if the wound fails to heal within a reasonable timeframe. Early intervention is key to preventing complications and promoting proper healing in individuals with diabetes.

3. Acanthosis Nigricans:

Did you know that a dark, velvety patch on your skin, particularly in areas like your neck, armpits, or groin, could be an indication of prediabetes? This condition is known as acanthosis nigricans, and it's closely linked to elevated insulin levels in the blood. Typically manifesting as darker skin patches in body creases and folds, acanthosis nigricans can serve as an early warning sign of diabetes. If you observe such patches on your skin, it's essential to consult with your doctor promptly. Identifying and addressing acanthosis nigricans early on can be crucial in managing your blood sugar levels and preventing the onset of diabetes.

4. Dry, Itchy Skin:

Dry, itchy skin accompanied by off-color patches and changes in texture is a prevalent physical manifestation of diabetes. Elevated blood sugar levels in diabetes can inflict damage on the blood vessels and nerves essential for skin health, resulting in a range of skin issues. Additionally, the loss of moisture and hydration exacerbates dry skin, making it susceptible to cracking, peeling, and infections. Proper skincare is crucial for individuals with diabetes to mitigate these skin complications and maintain skin health.

5. Necrobiosis lipoidica:

Necrobiosis lipoidica is a rare skin condition often associated with diabetes. It typically manifests as shiny, red or brown patches on the skin, particularly on the lower legs. This condition is characterized by changes in collagen and fat beneath the skin's surface, leading to the development of lesions. While the exact cause of necrobiosis lipoidica remains unclear, it is believed to be linked to changes in blood vessel structure and function due to diabetes. Proper management of blood sugar levels and diligent skincare are essential for individuals with necrobiosis lipoidica to prevent complications and maintain skin health.

6. Fatigue:

Fatigue associated with diabetes can visibly impact an individual's appearance, often leading to the development of dark circles and bags under the eyes. These physical signs can convey a tired and rundown appearance, highlighting the profound effect that diabetes-related fatigue can have on overall well-being.

7. Blisters:

While uncommon, individuals with diabetes may experience the formation of blisters on their skin, known as bullosis diabeticorum or diabetic bullae. These blisters can emerge suddenly on the hands, feet, legs, or forearms and may resemble blisters caused by burns. Unlike burn blisters, however, diabetic bullae are typically painless. If you observe such blisters, it's crucial to consult your healthcare provider promptly to receive proper evaluation and treatment.

8. Shin Spots:

Diabetic dermopathy, a prevalent skin condition among individuals with diabetes, presents as subtle depressions in the skin. Typically observed as brown spots or lines primarily on the shins, but can also appear on other body areas like the arms, thighs, or trunk. These spots are often confused with age spots due to their symptomless nature and may gradually fade within 18 to 24 months. However, they can persist indefinitely, underscoring the importance of proper monitoring and management for individuals with diabetes.

9. Acheocodons or Skin Tags:

Insulin resistance and prediabetes, often lacking noticeable symptoms, can provoke hormonal imbalances that stimulate the excessive production of skin cells, resulting in the formation of skin tags. These small, flesh-colored growths can emerge on various body parts, including the neck, armpits, and groin. Fortunately, a straightforward treatment option available at dermatology clinics involves Radio Frequency (RF) therapy, which effectively removes skin tags. It's advisable to address skin tags promptly as they arise to maintain skin health and prevent potential complications.

10. Alopecia Aereata:

Alopecia areata, a distinct subtype of alopecia, is frequently encountered as it stems from an autoimmune dysfunction. In individuals with diabetes, this condition can lead to patchy hair loss, affecting areas such as the scalp, eyebrows, and eyelashes. Hormonal imbalances linked to diabetes, exacerbated by elevated blood sugar levels, contribute to hair loss. Additionally, compromised blood circulation can hinder the hair follicles' capacity to regenerate new hair. Addressing these underlying factors is essential for managing alopecia areata effectively in individuals with diabetes, promoting optimal hair health and growth.

11. Changes in Body Type:

Diabetes often triggers alterations in body composition, including weight gain, obesity, and accumulation of abdominal fat. Type 2 diabetes, characterized by insulin resistance, prompts the body to store surplus fat, contributing to increased weight. Moreover, certain diabetes medications, such as insulin and sulfonylureas, can further exacerbate weight gain. Managing these changes in body type is crucial in diabetes management to mitigate associated health risks and promote overall well-being.

12. Fungal Infections:

Fungal infections pose a common challenge for individuals with diabetes, often stemming from the yeast-like fungus, Candida albicans. These infections manifest as itchy rashes, redness, and the development of tiny blisters or scales, primarily in warm and moist areas of the body's skin folds. These susceptible regions include under the breasts, around nails, between toes and fingers, corners of the mouth, under the foreskin in uncircumcised men, as well as the armpits and groin.

Typical fungal infections encountered by individuals with diabetes comprise athlete's foot, jock itch, ringworm, and vaginal infections, all characterized by persistent itching. It's imperative to promptly seek medical attention from a healthcare professional if you suspect a yeast or fungal infection. Early diagnosis and proper treatment are essential to effectively manage these infections and prevent potential complications, especially in individuals with diabetes.

How to manage it?

To effectively manage skin issues associated with diabetes, individuals should prioritize blood sugar control and adopt a holistic approach to skincare. This includes avoiding harsh chemicals, moisturizing regularly, opting for mild soap, and refraining from hot showers. A balanced diet, regular exercise, sufficient sleep, and adherence to prescribed medications are vital for overall health and skin wellness.

It's crucial to remain vigilant and promptly address any skin changes by consulting a dermatologist. Collaborating with healthcare professionals to develop a personalized care plan, including diabetes screening, ensures comprehensive management. By prioritizing proper blood sugar control and proactive skin care, individuals can prevent complications and maintain healthy, glowing skin, reflecting their commitment to overall well-being. Remember, caring for your skin is an integral part of caring for your overall health.

Dr. DEEPALI BHARDWAJ, MBBS, MD (USA, IM), DVDL, M.Phil (Cosmetology)

Allergy Fellowship Munich, Germany; Cosmetic surgeries, Iran

www.skincareindia.in