Skin conditions are often an external sign of internal issues, including diabetes.

For those living with Type 1 or Type 2 diabetes, your body’s reaction to an overabundance of sugar can have a cascade effect on your skin. You may notice various conditions due to dermal cell fluid loss, nerve damage, decreased circulation, and inadequate immune response. Excess sugar in the blood results from the body’s inability to produce insulin or form insulin resistance. Excess sugar causes glycation where the sugar binds to proteins in our body damaging tissue. This can affect all organs in our body, including the skin.

The most common diabetic skin condition is dryness and itching, which you can address by keeping your body well-hydrated and your blood sugar in check. In some cases, more severe issues can occur, particularly in those who do not closely monitor and adjust their insulin levels to stay within the normal range. 

If you notice any of these diabetes-related skin conditions, it is absolutely crucial to speak with your dermatologist, endocrinologist, or primary care physician as soon as possible to prevent a medical emergency in the most extreme cases.

Diabetic Blisters

Diabetic blisters, or bullosis diabeticorum, are most common in diabetic patients suffering from neuropathy. Prolonged increased blood sugar can cause blisters to appear in clusters on the hands, fingers, feet, and toes as painless, fluid-filled “bubbles.” They are relatively rare, and you can prevent them by closely regulating your glucose levels. 

Digital Sclerosis

Poorly managed diabetes can cause the skin on the back of your hands to become thicker and tighter due to glycated proteins being deposited in the skin and then damage to blood vessels, making the area appear yellow and waxy. Digital sclerosis is more than skin deep, though. As the condition progresses, it causes the tendons to thicken as well, causing stiffness and immobility if left untreated.

While this condition isn’t particularly painful, it can severely affect the range of motion in your fingers and migrate from your hands to other joints in your body. 

Shin Spots

Doctors commonly refer to shin spots as diabetes-related dermopathy, which presents as small, scaly patches of brown, pink, or red spots on the front of your lower legs. They are caused by blood vessel damage, which allows fluids to leak into the skin of your shins. While they typically disappear without treatment, leg injuries can prolong the issue and cause more spots. 

Ulcers

Because diabetes can cause poor circulation, even a tiny scrape on the foot can turn into a deep, slow-healing wound called an ulcer. These painful sores worsen over time, as continued friction caused by shoes reopens and irritates the wound. It’s worst amongst those who have nerve damage, as they often don’t even notice the ulcer until it’s become infected. 

Acanthosis Nigricans

Acanthosis nigricans is one of the first signs of insulin resistance and pre-diabetes. They manifest as dark, velvet-textured patches of skin that form in creases or folds, particularly on the neck, elbows, knees, and armpits. 

While it’s unknown what exact body mechanisms cause AN, most research points to high insulin concentration causing excessive skin cell reproduction. Because your body is creating more skin cells than it is shedding, they stack on top of each other, causing hyperpigmentation and the distinctive velvety quality. 

NLD

Necrobiosis lipoidica diabeticorum is a severe diabetes-related skin condition in which patients develop a rash of patchy, reddish bumps with yellow centers on their shins. Eventually, these bumps can open into painful, slow-healing sores as the oxygen- and nutrient-deprived skin dies. The condition can go dormant, then flare up again when your blood sugar spikes. 

Cortisone creams, blood thinners, and UV light treatments have been shown to help keep NLD under control, so you must speak with your dermatologist at the first sign of the tell-tale rash. Not only can they help you keep your symptoms in check, but they can also monitor the condition’s progress to prevent worsening infections. 

Fungal Infections

All bodies have a natural skin microbiome populated by various microscopic organisms, including yeast. Those living with diabetes risk developing unchecked yeast populations as the body attempts to excrete excessive glucose via sweat. This abundant energy source can lead to yeast colonizing in warm, moist areas on the skin, causing an infection called cutaneous candidiasis. 

The condition can crop up on the feet, scalp, fingers, or between creases in your skin. If left untreated, the fungal infection will spread rapidly, causing itchiness, irritation, scaling, flakes, cracks, and blisters. Your compromised skin barrier can also allow bacterial infections to take hold, further complicating the issue. 

Work with Your Dermatologist to Control Diabetic Skin Conditions

Dermatologists are a fundamental piece of whole-body diabetes management, even for those who closely monitor and control their blood sugar levels. They can help you keep an eye out for conditions while they are still in their early stages and provide treatment plans that keep your skin healthy.

If you are living with diabetes, we encourage you to schedule an appointment to discuss any concerns you might have and set you on the right track for long-term skin health.