Diabetes can affect every part of the body, including the skin. Many people with diabetes will have a skin disorder caused or affected by diabetes at some time in their lives. In some cases, skin problems can be the first sign that a person has diabetes.

In some cases, people with diabetes develop skin conditions that can affect anyone. Examples of these conditions include bacterial infections, fungal infections, and itching. However, people with diabetes also are more prone to getting certain conditions. These include diabetic dermopathy, necrobiosis lipoidica diabeticorum, and eruptive xanthomatosis. Some common skin conditions in people with diabetes:

Acanthosis nigricans

This is a condition that results in the darkening and thickening of the skin. Often, areas of tan or brown skin, sometimes slightly raised, appear on the sides of the neck, the armpits, and groin. Occasionally, these darkened areas might appear on the hands, elbows, and knees. Acanthosis nigricans can affect otherwise healthy people, or it can be associated with certain medical conditions. It is frequently found in people with diabetes.

Allergic reactions

Allergic reactions to foods, bug bites, and medicines can cause rashes, depressions or bumps on the skin. If you think you might be having an allergic reaction to a medicine, contact your health care provider. Severe allergic reactions might require emergency treatment. It is especially important for people with diabetes to check for rashes or bumps in the areas where they inject their insulin.

Atherosclerosis

Atherosclerosis is the narrowing of blood vessels thickening of the vessel walls. While atherosclerosis most often is associated with blood vessels in or near the heart, it can affect blood vessels throughout the body, including those that supply the skin. When the blood vessels supplying the skin become narrow, changes occur due to a lack of oxygen. Loss of hair, thinning and shiny skin, thickened and discolored toenails, and cold skin are symptoms of atherosclerosis. Because blood carries the white blood cells that help fight infection, legs and feet affected by atherosclerosis heal slowly when they are injured.

Bacterial infections

There are different kinds of bacterial infections affecting the skin. These include styes, which are infections of the glands of the eyelids; boils, which are infections of the hair follicles; and carbuncles, which are deep infections of the skin and the underlying tissue. There also are bacterial infections that affect the nails. With a bacterial infection, the areas involved generally are hot, swollen, red, and painful. Most bacterial infections require treatment with antibiotics in the form of pills and/or creams.

Bullosis diabeticorum (diabetic blisters)

In rare cases, people with diabetes develop blisters that resemble burn blisters. These blisters—called bullosis diabeticorum—can occur on the fingers, hands, toes, feet, legs, or forearms. Diabetic blisters usually are painless and heal on their own. They often occur in people who have diabetic neuropathy.

Diabetic dermopathy

Diabetes can affect the small blood vessels of the body that supply the skin with blood. Changes to the blood vessels because of diabetes can cause a skin condition called diabetic dermopathy. Dermopathy appears as scaly patches that are light brown or red, often on the front of the legs. The patches do not hurt, blister, or itch, and treatment generally is not necessary. The patches are sometimes called skin spots.

Digital sclerosis

The word "digital" refers to your fingers and toes, and "sclerosis" means hardening. Digital sclerosis, therefore, is a condition in which the skin on your toes, fingers, and hands become thick, waxy, and tight. Stiffness of the finger joints also might occur. Lotions and moisturizers might help soften the skin.

Disseminated granuloma annulare

This condition causes sharply defined, ring- or arc-shaped areas on the skin. These rashes most often occur on the fingers, hands, and feet, but they can occur on the trunk. The rash can be red, red-brown, or skin colored. Treatment usually is not required, but some cases might benefit from a topical steroid medicine, such as hydrocortisone.

Eruptive xanthomatosis

Eruptive xanthomatosis can occur in some individuals when blood glucose levels are not well controlled and when triglycerides in the blood rise to extremely high levels. This condition appears as firm, yellow, pea-like bumps on the skin. The bumps—which are surrounded by red halos and can be itchy—usually are found on the feet, arms, legs, buttocks, and backs of the hands. Lipid-lowering drugs might be needed.

Fungal infections

A yeast-like fungus called Candida albicans is responsible for many of the fungal infections affecting people with diabetes. This fungus creates itchy red rashes, often surrounded by tiny blisters and scales. These infections most often occur in warm, moist folds of the skin. Treatment of fungal infections involves keeping the area dry and using a combination of topical steroid and antifungal medicines.

Itching

Itching skin, also called pruritus, can have many causes, such as a yeast infection, dry skin, or poor blood flow. When itching is caused by poor blood flow, the lower legs and feet are most often affected. Use lotions or creams, avoid taking hot showers, and use gentle soaps to help keep your skin soft and moist. Moisturizers will also prevent itching due to dry skin.

Necrobiosis lipoidica diabeticorum

Necrobiosis lipoidica diabeticorum (NLD) is caused by changes in the blood vessels and generally affects the lower legs. With NLD, the affected skin becomes raised, yellow, and waxy in appearance, often with a bluish-purple border. Sometimes, NLD is itchy and painful. As long as the sores do not break open, treatment is not necessary. See your health care provider for treatment if the sores do break open or if the lesions are painful.

Scleroderma diabeticorum

Like digital sclerosis, this condition causes a thickening of the skin; but scleroderma diabeticorum affects the skin on the back of the neck and upper back. This condition, which is rare, most often affects people with diabetes who are overweight. Lotions and moisturizers might help soften the skin.

Vitiligo

Vitiligo is a condition that affects skin coloration. With vitiligo, the cells that make pigment (the substance that controls skin color) are destroyed, resulting in patches of discolored skin. Vitiligo often affects the elbows, knees, and hands, but it might be found on the face (around the mouth, nostrils, and eyes). This condition can be seen in people with type 1 diabetes. You should use sunscreen with a SPF of 30 or higher to prevent sunburn on the discolored skin.

How can these skin conditions be prevented?

Keeping your diabetes under control is the most important factor in preventing the skin-related complications of diabetes. Maintaining control of blood glucose level within the range recommended by your healthcare provider is most important. Proper skin care also can help reduce your risk of skin-related problems.

If you have diabetes, there are some steps you can take to help prevent skin problems. Consider the following tips for good skin care:

  • Keep your diabetes under control. Follow your healthcare provider's advice about nutrition, exercise, and medication. Keep your blood glucose level within the range recommended by your health care provider.
  • Keep your skin clean and dry. When bathing or showering, use warm water and a mild, moisture-containing soap. After washing, make sure to rinse and dry yourself well (pat your skin dry; do not rub). Check places where water can collect, such as under the arms, under the breasts, between the legs, and between the toes.
  • Look at your body after you wash. Make sure you don't have any dry, red, or sore spots that could become infected.
  • Avoid bathing in hot water and taking long baths or showers. Also avoid bubble baths, which often contain detergents that can be drying. Avoid scratching dry skin. Apply moisturizer instead.
  • Keep your skin moist by using a lotion or cream after you wash. Ask your healthcare provider to suggest a good lotion. Keep a bottle of lotion near the sink so you can use it after washing your hands. You should use a fragrance-free and dye-free moisturizer.
  • Apply lip balm to prevent chapped lips.
  • Limit the products you use on your skin to decrease your chances of having a reaction.
  • Treat cuts right away. Wash them with soap and water. Avoid antiseptics, iodine, or alcohol to clean cuts, because they are too harsh. Ask your healthcare provider to recommend an antibiotic cream or ointment to use on minor cuts.
  • Drink lots of fluids, especially water, to keep your skin moist and healthy.
  • To prevent dry skin when the temperature drops, use a room humidifier to add moisture to heated, indoor air.
  • To protect your skin from the sun, use sunscreens with an SPF of 30 or higher on your nose, and wear a hat. In colder months, wear warm gloves and shoes or boots.
  • Wear all-cotton white underwear. Cotton allows air to move around your body.

When should I contact my healthcare provider?

Contact your health care provider if you experience any of the following problems:

  • A major cut, burn, or infection
  • A skin change or problem that doesn't go away
  • A rash that develops after taking medication
  • A rash that develops near your insulin injection site

How do I care for skin conditions caused by diabetes?

Prepare a first-aid kit

  • Keep a first-aid kit handy to take care of your hands and feet. It should contain:
  • Antibacterial ointment
  • Gauze pads
  • Hypoallergenic tape or paper tape
  • Prepackaged cleansing towelettes (in case soap and water are not available)

How to take care of blisters

  • Don't try to break or "pop" the blister. The skin that covers the blister helps protect it from infection.
  • Gently wash the area with a mild soap and warm water.
  • Apply antibacterial ointment to the blister.
  • Cover the blister with a hypoallergenic or cloth bandage, or a gauze pad secured in place with hypoallergenic or paper tape.
  • Change the bandage at least once a day.
  • Wear a different pair of shoes until the blister heals.

How to take care of small cuts

  • Gently wash the area with mild soap and warm water.
  • Apply antibacterial ointment.
  • Cover the cut with a hypoallergenic or cloth bandage, or gauze pad secured in place with hypoallergenic or paper tape.
  • Change the bandage at least once a day.

How to take care of minor skin irritations

  • Gently wash the area with a mild soap and warm water.
  • Cover the irritated skin with a hypoallergenic or cloth bandage, or gauze pad secured in place with hypoallergenic or paper tape.
  • Check the area to make sure the irritation doesn't get worse.
  • Change the bandage at least once a day.

How to take care of minor burns

  • Don't try to break or "pop" blisters that may have formed.
  • Gently wash the area with mild soap and warm water.
  • Cover the burn with a gauze pad and secure it in place with hypoallergenic or paper tape.
  • Change the bandage at least once a day.

When to call a podiatrist (foot doctor) or other healthcare provider

  • If you do not see an improvement the day after treating a minor problem, such as a cut.
  • If you have pain or discomfort that continues for more than two days.
  • If you have a foot ulcer and develop a fever.
  • If you notice any pus developing on or near the sore.
  • If you have trouble trimming your toenails on your own.

Last reviewed by a Cleveland Clinic medical professional on 03/17/2011.

References

  • American Diabetes Association. Skin complications. Accessed 6/8/2020,
  • American Academy of Dermatology. Diabetes: 12 Warning Signs that Appear on Your Skin. Accessed 6/8/2020.
  • Grandinetti LM, Tomecki KJ. Dermatologic signs of systemic disease. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine 2010. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2010:section 3.
  • Rosen J, Yosipovitch G. Skin Manifestations of Diabetes Mellitus. [Updated 2018 Jan 4]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.

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