Diabetic Skin Conditions and Treatment

October 2024

Diabetes is best recognized for affecting the body’s insulin and blood sugar levels, but it can also cause several skin-related issues. Diabetic skin conditions can occur in individuals with Type 1 and Type 2 diabetes as a direct effect of the disease or a complication from medications.

In some cases, a skin issue can be an early sign of diabetes. According to the National Institute of Health, between 30% and 70% of individuals with diabetes will develop a skin condition.

Type 1 diabetes is diagnosed when the body’s immune system attacks and destroys cells that produce insulin, a hormone responsible for moving glucose from food into cells for energy. Those with Type 2 diabetes don’t produce enough insulin or their cells don’t react to insulin properly. Because diabetes affects the immune system and blood sugar levels, the skin is often impacted as well.

Why Does Diabetes Cause Skin Conditions?

There are a number of reasons individuals with Type 1 or Type 2 might develop a related skin condition.

One cause is hyperglycemia, which occurs when there is a high amount of sugar (glucose) in the blood. High glucose levels can set off a chain reaction where the body pulls fluid from other cells to produce enough urine to flush out the excess sugar. This removal of fluid can result in mild or severe dry skin that often manifests in different ways.

Diabetes can also cause changes in blood vessels, which can reduce the flow of blood to the skin. With less oxygen going to skin cells, individuals may develop areas of the skin that are discolored or different in texture.

Skin conditions can be an early sign of diabetes or develop after an individual has had diabetes for several years. While most of these skin conditions are best treated by managing your body’s blood sugar levels, there are other treatments to help alleviate the appearance of or discomfort from these skin issues.

It’s best to always see your dermatologist with any sudden changes to your skin, especially if the changes are severe and impact your daily life.

6 Types of Diabetic Skin Conditions

1. Diabetic Dermopathy

Diabetic dermopathy is one of the most common skin conditions related to diabetes. It often appears as light brown, scaly patches on the skin, and typically manifests on the shins. While this condition is considered harmless and doesn’t typically cause pain, its appearance can impact an individual’s self confidence.

How to Treat: There is no specific medical treatment for diabetic dermopathy; however, because this condition is caused by high glucose in the blood, your dermatologist may focus on managing your blood sugar levels to help prevent the development of future skin patches. Moisturizers can also manage irritation and discomfort by soothing dry, scaly skin.

2. Acanthosis Nigricans

Acanthosis nigricans is more common in individuals with Type 2 diabetes, and can be an early sign of insulin resistance. Acanthosis nigricans causes areas of the skin to become darker, thicker, and velvety in texture, and these dark patches often occur in skin folds, such as the neck, armpits, or groin.

How to Treat: This condition is best treated by addressing its root cause: insulin resistance. Individuals with acanthosis nigricans should make lifestyle changes to manage their diabetes and regulate their blood sugar to keep it within a recommended range. Additionally, your dermatologist may suggest topical retinoids or keratolytic agents to reduce the thickness of the skin and improve its appearance. In some cases, laser therapy may be employed to reduce pigmentation.

3. Necrobiosis Lipoidica

This rare condition causes raised, yellowish, or reddish patches or lesions on the skin, often on the lower legs. These areas can be itchy or painful and may even ulcerate in more severe cases. Necrobiosis lipoidica is more common in women with diabetes and often signals poor blood flow and inflammation.

How to Treat: A topical or injected corticosteroid can help reduce inflammation and prevent further skin damage. In more severe cases, your dermatologist may prescribe an oral medication like pentoxifylline (which helps improve blood flow) or an immune-suppressing agent.

4. Fungal Infections

Because diabetes can weaken the immune system, individuals become more susceptible to fungal infections, such as Candida. These infections typically occur in warm, moist areas where bacteria grows easily, like the armpits, groin, and between fingers and toes. Fungal infections can cause itchy, red rashes with small blisters or scales.

How to Treat: Prescription antifungal creams, powders, or oral medications will help clear the infection. To prevent new infections or flareups, you should maintain good hygiene and keep the affected areas dry.

5. Diabetic Blisters (Bullosis Diabeticorum)

While rare, some people with diabetes may develop blisters on their skin, which can manifest as a result of consistently high blood sugar levels, poor circulation, or damaged nerves. Diabetic blisters typically manifest on the hands, feet, legs, or forearms, can appear suddenly, and may resemble burns. Though they are usually painless, they can become infected if not properly cared for.

How to Treat: Like other diabetic skin conditions, controlling blood sugar levels is the best way to prevent and treat this skin issue. If you do develop diabetic blisters, they should be kept clean and covered to prevent infection. In most cases, they heal on their own within a few weeks. If the blisters become infected, your dermatologist may prescribe a topical antibiotic.

6. Bacterial Infections

Because diabetes can weaken the immune systems, diabetics are at an increased risk of bacterial skin infections, such as boils, styes, or carbuncles, caused by bacteria like Staphylococcus aureus. These infections can lead to painful, swollen red areas on the skin and may require medical intervention.

How to Treat: Your dermatologist may prescribe antibiotic ointments or oral antibiotics to clear the infection. In more severe cases where an abscess has formed, it may need to be drained or removed in a minor surgical procedure to clear the area of infected tissues.

Skin Conditions Caused by Diabetes Require Immediate Attention

Regardless of whether you have developed a skin issue as a result of diabetes, it’s best to visit with a board-certified dermatologist if you have diabetes to understand what to look for and any risk factors.

At Optima Dermatology, we’ll work with you to understand your diabetes, create a personalized care plan to treat any existing skin issues, and help prevent future complications.

For individuals with diabetes, early detection and treatment of a skin condition can prevent minor issues from becoming severe.

Request an appointment to discuss your diabetes, skin concerns, and develop a plan for any skin conditions caused by diabetes.