Skin Care

People with diabetes need to pay special attention to their skin. Higher blood glucose causes reduced fluids in the body, and so your skin can become dry and even cracked. This can lead to itchiness, sores and infections. You are more susceptible to infections because of circulation problems. You may also notice a reduction in sweat caused by neuropathy. Sweat normally keeps your skin moist and soft.

Here are some tips for the care of your skin:

1. Wash with a mild soap and lukewarm water, and pat your skin dry with a soft cloth. Be sure to dry between skin folds. Avoid rubbing, and scratching or bruising your skin.
2. Use a moisturizing lotion after bathing to reduce dry skin.
3. Pay special attention to your legs, feet, and elbows where they skin may be drier and likely to crack. Examine your skin for any marks or sores particularly that are not healing.
4. Wash all sores and cuts with soap and water and cover with a bandage. Call your doctor if a cut is not healing, feels hot or looks red or swollen, or produces drainage.
5. Wear cotton underwear and socks.
6. Wear gloves when you are working, dress appropriately for warm and very cold weather.
7. Use a sunscreen of SPF of 15 or higher to protect your skin in the sun.
8. Drink adequate amounts of fluid, and continue to strive to keep your blood glucose as controlled as possible.

Skin Conditions

 

Acanthosis Nigricans

What Is Acanthosis Nigricans?

Acanthosis nigrican (AN), a skin condition, exists in two variations: a benign form and a malignant form. People with type 2 diabetes often develop the benign (non-cancerous) form of AN.

What Causes Acanthosis Nigricans?

The cause for Acanthosis Nigricans is still not clearly defined, but it appears to be related to insulin resistance. Frequently found in people with diabetes, Acanthosis Nigricans can occur as a result of obesity. Obesity associated Acanthosis is the most common type. Often, when the patient loses weight, the Acanthosis Nigricans disappears.

Another cause points to hyperinsulenemia, a consequence of insulin resistance, which can come from eating too many carbohydrates. Hyperinsulenemia causes an elevated fasting blood insulin level, which leads to turning on insulin receptors in the epidermis, or skin, and causes the skin cells to grow more quickly and a bit abnormally.

Some causes of Acanthosis Nigricans are not associated with diabetes include Cushing syndrome; a pituitary gland hormonal disorder called acromegaly; and gastric cancer. In some people, particular drugs or even family genetics can cause Acanthosis Nigricans.

What Are the Symptoms of Acanthosis Nigricans?

When Acanthosis Nigricans begins, you might notice a piece of skin that looks like a tan or brown warts with a very soft, velvety feel to them. Often, it can appear on the neck, under the breast, in the groin area, in an armpit, or even on top of the knuckles.

How Can You Treat Acanthosis Nigricans?

The primary goal in treating Acanthosis Nigricans is to treat the underlying disease which led to the skin lesions (obesity, insulin resistance, etc.) Although no cure exists for Acanthosis Nigricans, you might find that the condition disappears when you lose weight.

If the cosmetic aspects of the condition bother you, dermabrasion (sort of a surgical sanding of the skin to smooth it out) or laser therapy might help.

In some instances, your doctor might also recommend medication, called keratolytic agents, to put on the Acanthosis Nigricans spots to help shed some of the skin. You should not use this medication without a doctor recommendation.

How Can You Prevent Acanthosis Nigricans?

Maintaining a healthy weight might prevent Acanthosis Nigricans.

 

Dermopathy

What Is Diabetic Dermopathy?

Diabetic dermopathy, a harmless condition, is likely the most common skin problem in people who have had diabetes for a while, or whose blood sugar levels have remained high.

What Causes Diabetic Dermopathy?

One factor that influences the onset of diabetic dermopathy stems from the length of time you have had diabetes. Elevated blood sugar levels, and in some cases, trauma or injury might set off the condition.

What Are the Symptoms of Diabetic Dermopathy?

The first signs of diabetic dermopathy appear as a small, brownish-red, scaly area of skin with a round or oval shape and flat top level with the rest of the skin. Later, the area becomes depressed, causing the dermopathic patch to appear as a small dent. Most commonly, it appears on the shins, although it can also appear on the forearms, sides of the feet, and thighs.

How Can You Treat Diabetic Dermopathy?

Diabetic dermopathy heals itself eventually, although the redness might remain.

How Can You Prevent Diabetic Dermopathy?

Because some researchers see a link between prolonged elevated blood sugars and diabetic dermopathy, you can help protect yourself by keeping your blood sugar levels within the range your doctor recommends.

 

Diabetic Blisters

What Are Diabetic Blisters?

Diabetic blisters are also called bullosis diabeticorum or diabetic bullae. They can sometimes develop in people with diabetes, although the condition is relatively rare. Only about one-half of one percent of those with diabetes is ever diagnosed with diabetic blisters.

The blisters often appear on the legs and arms and seem to appear for no reason. In most cases, when they disappear, they do not leave scars.

What Causes Diabetic Blisters?

There is no single known cause for diabetic blisters. Many of those who have diabetic blisters may also have neuropathy and nephropathy. Some researchers think that a decreased ability to sustain an injury may play a role. And in people with heart failure, the swelling that can result from that condition may be enough to cause the blisters.

Many people who develop the diabetic blisters have had diabetes for many years or have several complications from the disease.

What Are the Symptoms of Diabetic Blisters?

Most commonly, the blisters appear on the legs and feet. Rarely, you may also notice them on your fingers or the backs of your hands. You might go to bed one night with no blisters, wake up, and notice them.

The blisters tend to be large and irregularly shaped. Sometimes, they look like a burn. They are commonly clear and contain sterile liquid.

You might feel a burning sensation or a twinge of discomfort, but many people do not feel anything – other than a bit of surprise at seeing the blisters where there were none before.

How Are Diabetic Blisters Treated?

In many cases, the blisters heal by themselves, within two to four weeks, and no treatment is needed other than keeping them clean.

On occasion though, the blisters may burst. If this happens, your doctor may prescribe an antibiotic ointment or something to help dry the blister.

If the blister becomes infected or develops an ulcer, it will be treated more like a wound. Antibiotics may be used. In very severe cases, skin may need to be debrided (removed) to help the healing process.

Keeping your blood sugar levels within the range recommended by your doctor may help prevent many complications of diabetes, including diabetic blisters.

If you do get blisters, however, they may re-occur.

 

Dry Skin

What Is Dry Skin?

Dry skin is just as the name implies: skin that feels drier than normal. Many people have dry skin on occasion and it can be particularly severe in colder climates.

What Causes Dry Skin?

Living in a winter climate where the air is dry can cause dry skin. So too, can over-bathing. Basically, anything that draws moisture out of your body can cause dry skin.

People with diabetes are especially prone to dry skin because of changes in blood sugar levels. High blood sugar makes your body lose fluid and this can dehydrate your skin.

Perspiring can help keep your skin moist, but if you have neuropathy, you may sweat less and your skin can become dry.

What Are the Symptoms of Dry Skin?

If you have dry skin, you will be able to see it and feel it.

Particular symptoms often include:

• Itchiness
• Flaking of skin
• Fine lines or cracks in the skin

How Is Dry Skin Treated?

Dry skin is most often treated with creams to keep the skin moist. Some researchers suggest that oil-based creams are better at trapping moisture than those that are water-based.

In the event of very dry skin, your doctor may prescribe a special cream.

How Can Dry Skin Be Prevented?

There are several steps you can take to keep your skin from becoming too dry.

• Use a moisturizer regularly. Some research suggests that moisturizers containing a combination of urea and lactic acid (alpha hydroxy acid) can be beneficial.
• Keep your blood sugar levels within the range recommended by your doctor.
• Drink plenty of water each day.
• Use warm – not hot – water when you shower or bathe, and do not stay in too long.
• Dry yourself thoroughly after bathing
• Avoid deodorant or antibacterial soap that may dry your skin.
• Avoid smoking since this can dry your skin.
• Put a humidifier in your house during winter if you have radiators or forced air heat.

 

Eruptive Xanthomatosis

What Is Eruptive Xanthomatosis?

A harmless skin reaction that looks like small bumps, eruptive xanthomatosis might indicate that you have high cholesterol. You must treat high cholesterol, since it puts you at risk for atherosclerosis.

What Causes Eruptive Xanthomatosis?

Eruptive xanthomatosis results from poorly controlled blood sugar levels. It can also occur when your level of triglycerides (a form of fat) are elevated. Triglycerides exist normally in your body, but also come from food high in sugar, such as candy, honey and alcohol. Often, people with high triglycerides have high LDL, the “bad” cholesterol.

If you are insulin resistant, your body struggles to clear fat from your blood stream, and this can raise your triglycerides.

What Are the Symptoms of Eruptive Xanthomatosis?

Eruptive xanthomatosis usually appears on the shoulders, the buttocks or along the surfaces above the muscles that help you move your joints. On rare occasions, it can occur in your mouth.

Often the itchy, tender, pea-size bumps appear reddish-yellow.

How Can You Treat Eruptive Xanthomatosis?

Eruptive xanthomatosis often disappears by itself within a few weeks. However, you should still seek treatment because of the condition’s strong association with high levels of triglycerides.

Treatment involves getting your triglyceride, cholesterol and blood glucose levels under control. Doing so might require the use of lipid-lowering drugs (such as statins like Lipitor® or Zocor®) or fibrates (such as TriCor® or Lopid®).

How Can You Prevent Eruptive Xanthomatosis?

Keep your blood sugar levels in the range recommended by your doctor. Limit your intake of sugar and alcohol – both of which can raise your triglycerides level.

 

Necrobiosis Lipoidica Diabeticorum

What Is Necrobiosis Lipoidica Diabeticorum?

A skin condition called Necrobiosis Lipoidica Diabeticorum (NLD) occurs when collagen breaks down, deposits of fat build up and the blood vessel walls thicken.

As a chronic condition, NLD might progress slowly and might sometimes scar the skin. The condition might not bother you for a while, and other times it might flare up.

What Causes Necrobiosis Lipoidica Diabeticorum?

Researchers do not know the exact cause of Necrobiosis Lipoidica diabeticorum. However, some studies indicate a possible connection between NLD and damage to small blood vessels that might result from diabetes.

Other theories point to possible causes such as inflamed blood vessels, antibodies or metabolic changes.

What Are the Symptoms of Necrobiosis Lipoidica Diabeticorum?

NLD appears as a rash most often on the lower legs, but some people might notice it on their face, torso, scalp or arms.

In the beginning, the rash might appear reddish-brown with fairly well-defined borders. Over time, the lesions might grow larger and turn shiny and red, sometimes developing a yellow center. Eventually, the lesion develops into a purplish depression in the skin.

Sometimes, NLD itches and hurts; but many people report no symptoms other than the rash.

How Can You Treat Necrobiosis Lipoidica Diabeticorum?

As long as the lesions of the rash do not break open, NLD does not usually require treatment. Your doctor might ask you to rest your legs occasionally and protect them with elastic support stockings. He or she might also recommend that you take a baby aspirin each day.

Treating NLD can be tricky. During a flare up, some people find relief using a topical cream that contains cortisone and covering the area with a sterile dressing. Others find that cortisone injections can help.

Some researchers have found that treating the area with ultraviolet light can control NLD during flare-ups. In some cases, doctors might prescribe steroids such as prednisone.

Trauma to the affected area might cause ulcers to form, and these do need treatment. If this occurs, see your doctor.

How Can You Prevent Necrobiosis Lipoidica Diabeticorum?

Since people with diabetes face a greater chance of developing NLD than those without diabetes, it makes sense to control your disease. To do this, keep your blood sugar levels within the range recommended by your doctor.

 

Thick Skin

What Is Thick Skin?

If you develop skin that has thickened over time, you might have either scleroderma diabeticorum or digital sclerosis.

In each condition, the skin might feel thicker and, in some instances, look rough or pebbled.

What Causes Thick Skin?

Some research suggests that people with diabetes might generally have thicker skin in some areas than people without diabetes. However, this does not mean they have either scleroderma diabeticorum or digital sclerosis.

Elevated blood sugar levels seem to be the major cause of skin that thickens over time.

 

About Scleroderma Diabeticorum

Scleroderma literally means hard skin. If you develop this condition, the skin on your upper back and the back of your neck gets thicker. This relatively rare condition can involve inflammation, blood vessel damage, and changes in your immune system.

Another condition, called sclerederma, includes tightness that might also extend to your upper arms.

 

About Digital Sclerosis

Digital sclerosis makes the skin on your digits (fingers and toes) and your hands and feet become thicker.
The skin might also feel tight and rather wax-like. You might also experience stiffness in your finger joints.

How Can You Treat Thick Skin?

For either condition, moisturizing lotion might help the skin feel softer and less tight. Staying well hydrated by drinking plenty of water might also help.

If you feel stiffness from digital sclerosis, finger-stretching exercises might help limber things up.

How Can You Prevent Thick Skin?

To give yourself the best protection against either of these conditions, keep your blood sugar levels within the range that your doctor recommends.