Diabetes and its effect on a patient’s skin

Diabetes can affect any part of the body, including the skin. In fact, skin problems are sometimes the first sign that a person has diabetes. As many as one out of three people with diabetes have skin complications. Luckily, most skin conditions can be prevented or successfully treated if caught early.

Itchy skin

Itchy skin in diabetes can have many causes. These include dry skin, poor blood flow, drug reactions or a yeast (fungal) infection. When itching is due to poor blood flow, you’ll likely feel it in your legs and feet.

Infections

These can either be bacterial or fungal. Fungal infections tend to occur in the moist areas under the breasts, around the nails, between fingers and toes, in the corners of the mouth (and inside), under the foreskin, in the armpits and groin. Common fungal infections include ringworms and vaginal thrush. Several kinds of bacterial infections occur in people with diabetes. These include boils, styes (infections of the glands of the eyelid) and nail infections. Bacterial infections can also develop if you have a cut or skin prick. Bacterial infections on the skin can become very serious in diabetics and have been known to lead to hospital admission and even loss of limbs.

Scaly spots on the legs

Diabetics may develop light brown, scaly patches on their shins (front part of the leg). These patches may be oval or circular. This is known as “diabetic dermopathy” and is due to changes in the small blood vessels in the skin. The patches are not painful and they do not itch.

Diabetic blisters

Although rare, people with diabetes can erupt in blisters (as though they have been burnt). These blisters can occur on the hands, feet, legs or forearms.

They are usually painless and are not red or inflamed. Although they can become very large, they often heal on their own without leaving any scars — usually in less than a month. Do not rupture these blisters as this can cause them to become infected.

Stiff waxy fingers

Sometimes, people with diabetes develop thick, waxy skin on their fingers, backs of their hands and toes. The skin feels ‘tight’ and finger joints can sometimes become stiff. This condition is known as “digital sclerosis” and is due to poor diabetes control.

Dark skin patches
Diabetics can develop dark brown skin patches on the sides of the neck, armpits, groin, elbows and knees. These patches are known as “acanthosis nigricans” and it usually affects people who are very overweight. The best treatment is to lose weight and get your diabetes under control.

Allergic reactions

Sometimes, diabetes medication (including insulin) can cause an allergic reaction. Tablets usually cause a generalised rash whilst insulin may cause redness or bumps or a rash at the site of injection. If you notice any of these, discuss it with your doctor.

Red patches on the legs

Diabetes can cause changes in the blood vessels leading to large red patches on the skin (usually the legs). The blood vessels also become more visible in fair skinned people. This condition is known as “necrobiosis lipoidica diabeticorum (NLD)” and it can be itchy and painful. Scratching should be avoided as it can lead to open sores which are difficult to treat in diabetics.

Yellow “bumps” on the skin

Diabetes makes it difficult for your body to get rid of fat. If you have very high cholesterol, you develop firm, yellow, pea-like spots in the skin on the face, hands, feet, arms, legs and buttocks. This condition is known as “eruptive xanthomatosis” and can be itchy. Often these bumps clear once the diabetes and cholesterol is well controlled.