What is a diabetes rash?

Diabetes affects various parts of your body, including your skin. An estimated 1 in 3 people with diabetes (Type 1 or Type 2) will develop a skin rash or other skin problem at some point.

When you have diabetes, your chances of having dry, itchy skin are higher than someone who doesn’t have the disease. You’re also more likely to get other diabetes-related skin conditions.

What causes a diabetes rash?

For people who don’t have diabetes, a skin rash may be the first sign of high blood sugar (hyperglycemia) or prediabetes. Your healthcare provider can help you take steps to prevent diabetes.

If you take medications for diabetes, a skin rash may indicate that you need to adjust treatments to lower your blood sugar (glucose) levels. Some other rashes result from reduced blood flow to your extremities (hands and feet).

What does a diabetes rash look like?

Diabetes rashes look different depending on the type and cause.

Some diabetes rashes only affect people with diabetes. They usually go away when blood sugar is under control. These rashes include:

  • Blisters (bullosis diabeticorum): Painless blisters may form on the backs of hands and feet and on the legs and forearms. This rare condition most often affects people who have diabetic neuropathy.
  • Diabetes dermopathy: Light-brown, round-shaped scaly patches, like age spots, appear on the shins. These harmless spots don’t need treatment.
  • Digital sclerosis: Some people with Type 1 diabetes develop hardened, thick, waxy skin on the backs of their hands. The finger joints stiffen, making movement difficult. A related rash is scleredema adultorum of Bushke which is tightness, thickening, and hardening of the back, neck, shoulders and face. There are various treatments that dermatologists can provide for this.
  • Necrobiosis lipoidica diabeticorum (NLD): This lower leg rash is more common in women. NLD causes raised, red, shiny patches with a yellow center. Blood vessels may be more noticeable. The rash may be itchy and painful. You should see a dermatologist for treatment options.
  • Diabetes Foot Syndrome: These are ulcers that develop from trauma to the skin. The ulcers can take a long time to heal and there is an increased risk for infection.

Other conditions can affect anyone, but are particularly common among people with diabetes. These rash-causing conditions can also be a warning sign of pre-diabetes:

  • Acanthosis nigricans (AN): This condition causes dark, velvet-looking bands of discolored skin. It commonly affects people who have overweight/obesity. Acanthosis nigricans can be a warning sign of high blood sugar or prediabetes.
  • Disseminated granuloma annulare: Granuloma annulare often affects healthy children and young adults. In people with diabetes, disseminated granuloma annulare forms rings or arcs on the fingers, hands, feet and ears. The rash may be red, reddish-brown or skin tone. It doesn’t cause pain, but it may itch. Many times this will heal without therapy. For small areas of involvement, topical steroids can be useful in treatment.
  • Eruptive xanthomatosis: Firm, yellow, pea-sized skin bumps may itch and be encircled in red. This rash most often affects the backs of the hands, feet, arms, legs and buttocks. Among people with Type 1 diabetes, it’s most common in men who have high cholesterol.
  • Vitiligo: People with Type 1 diabetes are more prone to this skin condition. It causes skin to lose pigment, the substance that gives skin its color. Some people notice light or white patches of skin. Rarely, it itches or hurts. Treatments include corticosteroid creams, laser treatments and light therapy.
  • Skin tags: These are small brown bumps on your skin, often on your eyelids, neck, armpits or groin. These usually don't have any symptoms and no treatment is necessary.
  • Lichen planus: A lichen planus rash is characterized by itchy purple bumps on the skin, sometimes with a white lacy pattern. This is usually on the ankles and wrists, but can sometimes be seen in the mouth. There are many therapies, both topical and pills that can be used to treat this.
  • Acquired reactive perforating collagenosis (ARPC): This is usually seen in patients with kidney disease. The rash is usually red itchy bumps. Treatment can consist of topical steroids, steroid injections to the rash and other medications.

What other skin conditions affect people with diabetes?

People with diabetes can have any skin condition. But sometimes, people with diabetes have a rash or other skin irritation due to:

  • Allergic reactions: People with diabetes may have an allergic reaction to oral diabetes medications or injectable insulin. You may develop a rash or hives and swelling (urticaria) at the injection site or elsewhere on your body. Contact your healthcare provider if you think you’re having an allergic reaction.
  • Bacterial infections: Having diabetes increases the risk of bacterial skin infections. You may develop bacterial infections in eyelid glands (sty) or deep under the skin (boils and carbuncles). Infected skin may be swollen, hot, red and painful. You’ll need antibiotics to get rid of the infection.
  • Dry, itchy skin: High blood sugar and certain skin conditions can cause dry, itchy skin. If you have poor blood circulation, your lower legs may itch the most. Moisturizers can help.
  • Fungal infections: A yeast called Candida albicans causes most fungal infections in people with diabetes. You’ll have moist areas of tiny red blisters or scales that itch. Skin fungus tends to affect skin folds, including under the breast, between fingers and toes, around nailbeds, and in the armpits and groin. Common fungal infections include jock itch, athlete’s foot and ringworm. Antifungal medications can help.

The best thing you can do to prevent skin problems is to keep blood sugar levels within the range recommended by your healthcare provider. Proper skin care can lower your chances of getting a skin rash, infection or wound that’s difficult to heal.

Take these steps to prevent skin problems:

  • Check your skin daily for signs of rashes, redness, infections or sores.
  • Use warm (not hot) water and moisturizing soap in the shower. (Soaking in a tub dries out skin.)
  • Pat skin dry with a towel (don’t rub), making sure to dry in between fingers, toes and skin folds.
  • Apply fragrance-free moisturizers after showering while skin is still damp and soft. Look for creams and ointments (not lotions) with ceramide to help skin retain moisture.
  • Apply creams containing 10% to 25% urea (an emollient) to cracked, dry heels at bedtime.
  • Prevent dehydration and keep skin hydrated by drinking plenty of fluids.
  • Treat cuts and wounds immediately with soap and water. Use antibiotic ointments only if your healthcare provider gives the OK. Bandage the wound daily. Call your provider if you notice signs of redness, pain, drainage or infection.
  • Use a humidifier to add moisture to the air in your home.

A note from Cleveland Clinic

Having diabetes increases your risk for skin rashes and skin problems. It’s important to pay attention to your skin. Contact your healthcare provider as soon as you notice a rash or something that doesn’t look quite right. A rash may be a sign that you need to change medications or dosages to get blood sugar under control. A proper skin care routine can lower your risk of diabetes-related skin problems.

Last reviewed by a Cleveland Clinic medical professional on 08/21/2021.

References

  • American Academy of Dermatology Association. . Accessed 8/24/2021.Acanthosis Nigricans (https://www.aad.org/public/diseases/a-z/acanthosis-nigricans-treatment)
  • American Academy of Dermatology Association. . Accessed 8/24/2021.Acanthosis Nigricans: Diagnosis and Treatment (https://www.aad.org/public/diseases/a-z/acanthosis-nigricans-treatment)
  • American Academy of Dermatology Association. . Accessed 8/24/2021.Dermatologist-Recommended Skin Care for People with Diabetes (https://www.aad.org/public/diseases/a-z/diabetes-skin-care)
  • American Academy of Dermatology Association. . Accessed 8/24/2021.Diabetes: 12 Warning Signs that Appear on Your Skin (https://www.aad.org/public/diseases/a-z/diabetes-warning-signs)
  • American Academy of Dermatology Association. . Accessed 8/23/2021.Vitiligo (https://www.aad.org/public/diseases/a-z/vitiligo-overview)
  • American Diabetes Association. . Accessed 8/23/2021.Skin Complications (https://www.diabetes.org/diabetes/complications/skin-complications)
  • American Osteopathic College of Dermatology. . Accessed 8/23/2021.Necrobiosis Lipoidica Diabeticorum (https://www.aocd.org/page/NLD)
  • DermNet NZ (New Zealand). . Accessed 8/23/2021.Skin Problems Associated with Diabetes Mellitus (https://dermnetnz.org/topics/skin-problems-associated-with-diabetes-mellitus/)
  • National Health Service (UK). . Accessed 8/23/2021.Granuloma Annulare (https://www.nhs.uk/conditions/granuloma-annulare/)
  • Lima AL, Illing T, Schliemann S, Elsner P. . Am J Clin Dermatol. 2017. 18:541-553.Cutaneous Manifestations of Diabetes Mellitus: A Review (https://pubmed.ncbi.nlm.nih.gov/?term=Cutaneous+Manifestations+of+Diabetes+Mellitus%3A+A+Review&sort=pubdate)

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