Many people are surprised to learn that skin issues are among the potential complications related to diabetes. Yet one in three people with diabetes will experience a skin issue that is either caused by or affected by diabetes. In those over 75, the incidence of diabetes and skin complications is even higher. Diabetes Canada reports that rough, dry and scaly skin affects at least 75% of people with diabetes in that age bracket.
One of the primary causes of diabetes-related skin conditions is high blood glucose, which can lead to dehydration and result in dry skin. Nerve damage can also lead to reduced sweating, which again can lead to dry skin.
Dry skin can itch, leading to scratching. It can also crack. This can allow germs to enter, causing infection. The body’s resistance is lowered by high blood glucose levels, and healing can take more time. This increases the risk of skin infections and boils.
Shin spots (Diabetic dermopathy)
This condition is caused by changes in the small blood vessels. Small light brown lesions appear that are oval or circular in shape and are often raised at the edges. They may be mistaken for age spots, and do not hurt or open up.
NLD (Necrobiosis lipoidica diabeticorum)
This condition is also caused by changes in the blood vessels. It causes lesions that are similar to those in diabetic dermopathy but are larger, fewer and deeper. The lesions also change in appearance. They often start as a dull raised red area, but later become shiny like a scar, and often turn yellow-brown to purple with a violet or purple border. NLD may be itchy and painful, and can cause the skin to crack. It is most common in type 1 diabetes.
Diabetic blisters (Bullosis diabeticorum)
Diabetic blisters can erupt under the skin and may break. They may be quite large but are usually painless. They usually heal without treatment within three to four weeks.
Most commonly found in people who are overweight, this condition causes brown or black raised areas on places like the neck, under the arms or in the groin. It is most often caused by elevated insulin levels.
Tips to help avoid skin problems
- Stay within blood glucose level targets
- Drink lots of fluids to help keep skin healthy and avoid dryness
- Use a mild soap and apply a moisturizing body lotion after showering or bathing
- Rinse and dry well, especially in areas where moisture can hide – like under the arms and legs and between fingers and toes
- Check carefully for red, sore or dry spots that could lead to an infection
- Bathe less often during cold months when skin is particularly dry
- Talk to a member of the diabetes healthcare team if any skin problems arise
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