If you suffer from diabetes, the risk of experiencing skin issues increases significantly. When blood sugar levels are excessively high, it can lead to problems with various functions and organs, including the skin. Many diabetics only realize that they have the condition once they start facing skin problems.

According to the CDC, 10.5% of Americans are living with diabetes mellitus. This number is expected to rise to 33% (or 1 in 3 people) by the year 2050. Blood sugar levels in people with diabetes are excessively high. This could be due to a lack of insulin or the production of ineffective insulin. An estimated one-third of people with diabetes suffer from skin problems that are a direct result of the disease. While using medication to address skin problems can help, controlling blood sugar is typically the most effective strategy to prevent and address diabetes-related skin problems.

Skin Health and Diabetes

When your body suffers from extremely high blood sugar levels for a long time, it experiences various changes that impair skin health. Due to a lack of insulin, their bodies fail to reabsorb excess glucose in the bloodstream. As a result, excess glucose is excreted, so the person urinates more often. This can cause dry skin and dehydration.

High blood sugar levels also cause inflammation, which has an impact on the skin. In addition, poor circulation in diabetes can harm nerves and cause blood vessel injury. It affects the skin’s structure, particularly its collagen. Consequently, skin can become rigid and, in certain situations, fragile, without strong collagen networks, which is essential for wound healing.

Most diabetes-related skin problems are minor issues. But in some cases, the symptoms are unpleasant and long-lasting, making medical intervention necessary. In the long term, proper blood sugar control is the most effective therapy option for many diabetes-related skin problems. However, a doctor may recommend oral steroids, medicated creams, or other therapies in severe situations that require immediate attention.

Man Checking Blood Glucose Levels

Here are some of the skin complications that can occur because of diabetes:

Acanthosis Nigricans

Acanthosis nigricans is a black ring of thickened, velvety skin that runs from the pelvis to the back of the neck and armpits. While diabetes is a major cause, it can also be the result of hormonal imbalance or the use of certain drugs, including niacin, corticosteroids, and birth control pills.

Acanthosis nigricans affects up to 74% of people who are overweight or diabetic. Although it is not dangerous or contagious, a doctor can provide treatment recommendations. Patients can benefit by managing their blood glucose levels and body mass index (BMI).

Necrobiosis lipoidica diabeticorum (NLD)

NLD is long-term but a rare condition that affects diabetics by causing a rash on their skin. According to studies, it impacts 0.3% of people with diabetes, more than half of whom use insulin.

Small and stiff, raised lumps frequently develop into bigger plaques of waxy, hard, depressed, and yellow to reddish-brown skin. Plaques are usually painless, and the skin around them appears pale.

Over time, lesions grow waxy and have a purple border. NLD, while generally mild, can result in problems such as scarring, and infection is more likely as well. Meanwhile, ulceration can develop in around 15% of cases.

Doctors can prescribe both topical and oral medicines to help in treating NLD. But if symptoms worsen, the patient’s treatment plan may need changing. Due to the risk of infection, the person should protect the skin from additional harm.

Skin Tags

Skin tags, also known as acrochordons, are little, flesh-colored growths that cling to the skin’s surface. They afflict around 25% of the general population. In diabetic patients, they occur as a result of excessive blood sugar levels.

Usually, skin tags appear on the eyelids, underarms, neck, beneath the breasts, and in the pelvic creases.

Skin Tags on a Mans Neck

Closed up the Skin Tags or Acrochordon on neck man on white background.

Xanthelasma

A person suffering from xanthelasma has yellow fat and scaly deposits near and on the eyelids. They can appear on the neck, trunk, shoulders, and underarms, among other places.

High blood sugar and fat levels in the body can cause xanthelasma, but it can also affect people who don’t have these conditions. In some circumstances, it could be due to a hereditary predisposition for developing xanthelasma and excessive cholesterol. Factors like diabetes, obesity, and pregnancy increase the risk of a patient developing the condition.

Xanthelasma is not a health hazard, but it can harm a person’s quality of life. Lipid-lowering medications may be effective, according to some small studies. Researchers are continuously exploring aesthetic treatments, such as laser therapy or a chemical peel. These treatments may help, but there is no specific treatment to get rid of xanthelasma permanently.

Diabetic Ulcers

A major complaint among diabetics is that little injuries turn into diabetic ulcers or open sores. There is a higher risk of developing diabetic ulcers in the feet than in any other part of the body.

Let’s say a person gets a cut on their foot due to uncomfortable shoes. Since diabetes causes problems in the circulatory and nervous systems, they won’t be able to feel it on their foot. As they’re unaware of the injury, the damage exacerbates. Furthermore, a lack of blood flow makes wound healing more difficult.

To summarize, ulcers form when you leave the wounds untreated. If the wound develops an infection, tissue death is possible, and in severe cases, amputation may be necessary. Because it only takes a minor cut for a diabetic ulcer to form, doctors urge diabetics to check their feet and other parts of their bodies for any sores.

Diabetic Ulcers

Isolated Rash, Wounds, and dry skin on human foot.

Psoriasis

Psoriasis patients frequently develop red, itchy, and scaly areas on their skin. Some people also suffer from changes in the texture of their nails or scalp. Some patients with skin psoriasis can even develop psoriatic arthritis, which causes significant joint pain.

In mild cases, some of the options to treat psoriasis include lifestyle adjustments, corticosteroid creams, and ointments, blood sugar, and body weight management. In moderate to severe instances, oral or injectable biologic drugs are suitable options as well.

Psoriasis is more common in people with type 2 diabetes than people without diabetes.

Psoriasis

Psoriasis on a mid age mans elbow. Not isolated.

Diabetic Bullae or Blisters

Some people get oddly sized blister-like ulcers on their feet and hands. These can emerge all of a sudden, in patches or as a single blister. Despite being enormous in size, they are painless.

Although doctors can occasionally drain huge blisters using sterile equipment, the only long-term cure is adequate blood sugar management.

To avoid infection, those with bullae lesions should avoid touching or forcefully ‘popping’ it. It’s an uncommon condition and normally heals without leaving scars, but it may require amputation if problems arise.

Diabetic Dermopathy or Shin Spots

This condition causes circular, reddish, or light-brown spots on the shins or other bony areas. The patches are frequently scaly and indented.

Diabetic dermopathy affects around 39% of people with type 2 diabetes and 33% of patients with type 1 diabetes. This condition develops as a result of nerves damage and minor blood vessel abnormalities.

Sores may indicate an enhanced sensitivity to damage since the disorder affects parts of the body with less muscle and fat. Normally, the sores are painless, and the patient does not require treatment.

Waxy Skin and Stiff Joints

Diabetic patients may suffer from tight, thick, and waxy-looking skin, hands, and fingers because of blood circulation issues. It usually begins on the hands and spreads to the arms and upper torso. It may also affect the knees, ankles, and elbows, but these are less common. Besides this, the skin may develop an orange peel-like appearance, and the joints may become stiff.

Long-term treatment involves managing blood sugar levels, and doctors may recommend physical therapy as well.

Skin Infections and Diabetes

Infections caused by bacteria and fungi are more common and severe in patients with type 2 diabetes than non-diabetic people. They may also experience more severe allergy responses on a regular basis.

Granuloma Annulare

This condition comprises elevated, firm, small, reddish, or skin-colored pimples that extend outwards in a ring. Sores on the hands, fingers, and forearms are common. They exist in small groups or large numbers throughout the body. On the body, they generally seem symmetrical.

According to the National Organization for Rare Diseases (NORD), Granuloma annulare may be a consequence of diabetes or shingles, but the cause of the bumps is unknown.

The blisters are normally harmless and go away on their own. If they are unpleasant or persistent, a doctor may suggest corticosteroid or isotretinoin medicine.

Granuloma annulare

Granuloma annulare, a rare skin disease, on a leg of a female patient.

Eruptive Xanthomas

Clusters of reddish-brown to yellowish-orange pimples might occur due to poor glucose control in people with diabetes. These might also itch a lot.

Sores are most common on the thighs, buttocks, and crooks of the elbows and knees. One explanation for the condition is diabetes, and other factors include genetics, hypothyroidism, and cirrhosis.

A severe case could indicate a higher risk of pancreatitis, so patients with severe symptoms should seek medical help right away.

Diabetes treatment involves eating a low-fat diet, maintaining a healthy weight, and controlling blood sugar levels. After that, a doctor may prescribe statins or fibrates.

Sclerederma diabeticorum

Scleroderma diabeticorum is a connective tissue condition that affects the upper body, i.e., the back and neck.

In extreme cases, the condition might even make it difficult for a person to move. Scleroderma is an uncommon illness that mostly affects overweight persons. According to the authors of one study, it can affect people with diabetes who effectively manage their blood sugar levels, as well as those with, have poor glucose control.

It can also affect persons who don’t have diabetes after a streptococcal infection. Some doctors recommend medications like methotrexate, cyclosporine, and corticosteroids as a treatment.

Fungal Infections

The most common symptoms of fungal infections are red rashes with scaly skin and tiny blisters. Typically, fungi flourish in damp environments, causing infections to develop in warm, wet folds of skin., But even so, they can develop in just about any part of the body.

The following are examples of common types:

  • Infections caused by yeast, such as thrush
  • Scaly patches between toes, repeated blisters, or powdery scaling over the soles are symptoms of athlete’s foot.
  • Ringworm is a fungus that causes a ring-shaped rash.

Antifungal medicine can help prevent long-term or recurrent infections.

Fungal infection (ringworm)_

A close-up image of a human arm the a red circle of a ringworm infection, or a bacteria. The fungus is a painful and irritating skin condition of the immune system.

Bacterial Infections

Bacterial infections develop as inflamed, pus-filled, painful, red sores. These are often caused by a Staphylococcus bacterium infection, but proper blood sugar management and antibiotics can prevent the infection from becoming life-threatening.

Most bacterial sores produce pus after a few days and then heal. A doctor can also drain any sores that do not drain on their own or are painful. Bacterial infections that are common in persons with type 2 diabetes include:

  • Hair follicle infections
  • Styes, an inflammation of the glands of the eyelids
  • Boils are inflammatory nodules that start as uncomfortable patches and grow up to 1 inch around
  • Carbuncles are hard, sensitive lumps that form a ring around a group of linked boils
  • Infections of the nails
Bacterial Eye Infection

Bacterial Eye Infection

Recommendations for People with Diabetes

Maintaining appropriate blood sugar levels is the best method to prevent just about all diabetes-related skin problems.

Blood Glucose Recommendations

The following are some lifestyle recommendations for maintaining appropriate blood sugar levels:

  • regular physical activity
  • consuming a nutritious diet
  • keeping a healthy body weight
  • maintaining personal hygiene and self-care
  • regularly following the treatment plan, including taking any drugs prescribed by the doctor