Skin Care: Identify Potential Problems and Avoid Complications

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Summer is here. This is a great time to think about taking better care of your skin and avoiding skin-related complications that are more common in people with diabetes. Dry and itchy skin is certainly not limited to people who have diabetes, but can be more severe if your glucose levels are high. One third of those with diabetes will have a skin condition at some point in their lifetime.

The good news is that with good skin care habits, and early recognition and treatment of underlying causes, you can prevent some of the more serious complications. When glucose is high your body tries to remove excess glucose through urination, and this leads to dehydration and dry skin. In addition, neuropathy can cause a decrease in or absence of sweating that results when the nerves that control the sweat glands. An absence of sweat contributes to dry, cracked skin.

Once skin becomes dry other problems can develop. It often leads to itchiness, cracking and peeling, which leaves skin more vulnerable to infections. Bacterial and fungal infections are common and they are contagious. They range from easy to treat with an antibiotic to quite dangerous. Here are short descriptions of some of the most common infections. Remember that your skin is your first barrier against infection.  Any break in the skin puts you at risk.  Report breaks in the skin, or signs of skin infection, to your healthcare professional.   

Bacterial Infections

Impetigo and ecthyma can result from minor breaks in the skin, with ecthyma sometimes a result of an untreated impetigo infection. They can result from scratches, burns, or insects bites and often start out as blisters or pimples. Ecthyma can form ulcerations and goes into to deeper layers of the skin.

Folliculitis, boils (furunculosis), and carbuncles are infections associated with the hair follicles. Sweating, shaving, or pressure on one spot, usually from lying down or sitting, for a long period of time can increase your risk for these infections.

Cellulitis and gangrene are two more serious bacterial skin infections. Symptoms to look out for are areas of the skin that are red, warm, painful and swollen. Cellulitis is often contracted from an open wound and typically affects the face, arms and legs. It is also associated with a bacterial infection of the blood. Gangrene is very serious and can be fatal. It results from a skin injury, laceration or surgical incision.   If you think that you have either of these conditions you should contact your healthcare professional immediately, as these conditions may need to be treated in the hospital.

Fungal Infections

Tinea and Candida are the cause of some of the most common fungal infections. Tinea is the culprit in athlete’s foot, jock itch, and ring worm.  Fungal infections on the feet commonly lead to toenail mycosis, which is a thickening and yellowing of the toenails.  Candidiasis tends to occur in the folds of the skin, such as the groin and underarms. Some candidiasis is called a yeast infection.  Infections in the feet should be treated by a doctor as soon as possible, and should be looked at by a podiatrist. 

Skin Conditions Related to Diabetes

The following is a list of skin conditions that are directly related to diabetes. These are the scientific names for the conditions and a short description. For more information, or if you think you have any of these conditions, please see the resources guide at the end of this article and consult your healthcare professional right away.

Acanthosis nigricans – dark brown or black markings or warts

Bullosis diabeticorum – blisters on the hands and feet, or sometimes the arms and legs

Diabetic dermopathy – light brown, round or oval scaly patches, usually found on the legs

Eruptive xanthomatosis – small yellow bumps, about the size of a pea, with a red ring around them

Necrobiosis lipoidica diabeticorum – red rash, sometimes with yellow in the center, usually on the lower legs

Care and Prevention

The best way to prevent the most common skin problems associated with diabetes is with tight glucose control. Frequent glucose testing or continuous glucose monitoring can help you recognize and treat high glucose levels and this will make you better able to keep your skin hydrated and fight off bacteria.

Here are some other important tips for daily skin care:

  • Make sure that your skin is clean and dry. In warmer months use powder where skin rubs against skin
  • Avoid hot showers and baths and use a moisturizing soap
  • Use a good hydrating lotion, several times a day if necessary, to keep skin moisturized
  • Use a sun screen, SPF 15 or higher, every day
  • Keep feet dry and clean. For more information see our May 2007 article about foot care
  • Treat cuts or injuries right away using soap and water as well as a good antibiotic ointment. Report any lesions or breaks in the skin to your healthcare provider
  • Use mild shampoos, cleansers and cosmetics
  • See a dermatologist about skin problems that you cannot solve yourself

 

Additional Resources 

To learn more about how tighter control can prevent complications, go to http://www.minimed.com/help/pumptips/goodcontrol.html.

American Diabetes Association – www.diabetes.org

•        Skin Complications - http://diabetes.org/for-parents-and-kids/what-is-diabetes/skin-complications.jsp

•        Skin Care - http://diabetes.org/type-1-diabetes/well-being/skin-care.jsp

dLife For Your Diabetes Life – www.dlife.com

National Diabetes Information Clearinghouse (National Institutes of Health) – http://diabetes.niddk.nih.gov/dm/pubs/complications_feet/