Diabetes may increase the risk of skin changes and infections in many individuals due to the raised blood glucose levels.
Skin problems caused by Diabetes are:
- Acanthosis Nigricans– The skin folds at armpit, groin, sides and back of neck, etc. become thick, hard, dark and velvety to touch in individuals with Diabetes. This condition usually predisposes Diabetes and may indicate high insulin levels and that blood glucose levels are more than normal. These skin changes are usually more prominent in overweight and obese individuals. The treatment is usually directed towards weight loss, lowering blood sugar levels to normal with medications, healthy diet and physical activity, regular moisturization of skin, etc.
- Fungal infections- These are quite common in Diabetic individuals because the factors and environment are usually favorable for the growth of fungus when blood sugar levels are high.
- Yeast infections in vagina caused by a fungus called candida albicans in many women.
- Angular cheilitis presents as small cuts, cracks at the corners of mouth.
- Onychomycosis is fungal infection of nails of fingers and toes usually presenting as thick, brittle, weak, yellow/white nails.
- Ringworm infection causes itchy, ring shaped, dry and scaly patches of skin with raised and red edges with pale center, seen most commonly over groin, buttock region (called jock itch), chest and abdomen, scalp, toes and feet (athlete’s feet) etc. It commonly occurs in moist areas of skin with excessive sweating, tight clothing and shoes, etc.
Fungal infections can be treated primarily with good personal hygiene with fresh, clean and moisturized skin and anti-fungal creams or medications.
- Bacterial infections- Individuals with Diabetes are prone to develop bacterial infections by Staphylococcus (bacteria) such as
–Boils (infected hair follicle at the base inside skin).
–Stye (infection of glands at the eyelid lining causing swelling, redness, pain, etc.) and
Treatment include primary care at the site with personal hygiene, antibiotic medications/creams.
- Diabetic ulcers- Poor circulation and nerve damage due to high blood glucose levels for a very long time decreases the ability of the body to heal wounds fast and lead to formation of ulcers easily. Treatment is directed towards wound care and diabetic medications.
- Dry and itchy skin is common due to high blood glucose levels causing poor blood circulation. Regular and proper moisturization of skin and drinking plenty of water in a day are important.
- Digital sclerosis- The condition causes thick, tight and waxy skin over fingers, toes, that may or may not be associated with stiffness of joints. The treatment includes lowering blood sugar levels to normal, physiotherapy and skin nourishment with the use of moisturizers.
- Necrobiosis lipoidica – This starts with cluster of multiple, small, solid, red bumps like pimples, that become yellow/red/brown raised patches of skin. The skin may look shiny and may be painful, itchy, hard and swollen.
- Diabetic dermopathy- This presents as shiny circular or oval patches of skin on the front parts of legs usually called shin spots, that may or may not be associated with itch, burning sensation.
- Eruptive xanthomatosis – This condition usually occurs when insulin resistance is severe in Diabetes as it may lead to stagnant and increased fat and triglyceride levels in the body. This leads to the formation of hard, yellow bumps on the skin surrounded by red halos (rings) over face, buttocks, arms and legs, skin folds, etc. Treatment primarily includes lowering fat levels in the blood.
- Blisters- Rash, blisters may develop over arms, hands, legs, fingers, toes, etc. and at the site of insulin shots but may heal on their own usually. Treatment to control blood glucose levels and personal care with monitoring by avoiding scratching, picking, applying calamine lotion, aloe vera gel, etc. over the rash, bumps are important to avoid secondary infections.
Prevention and management of the skin infections primarily includes regular intake of prescribed medications for Diabetes, healthy diet with small and frequent meals at regular intervals, avoiding fatty, high carbohydrate rich, oily and spicy foods, regular exercises or walking at least for 30-45 minutes every day for all the skin conditions associated with Diabetes.
Other important measures are good hydration by drinking plenty of water, at least 2-3 liters a day, moisturization of skin by applying simple lotions without harsh chemicals, etc.
The skin problems can be prevented by maintaining normal blood glucose levels and regular monitoring of the the same.
– Dr. Divya Teja Pasupuleti