Diabetes & Skin Care

Your skin can be a window into your body, revealing insights into other medical conditions, says Dr. Kevin Belasco, a dermatologist based at Great Lakes Dermatology’s Brookfield office. “The role of the dermatologist can be very important in early recognition of conditions that affect more than the skin, and that can be significantly important to one’s health,” Dr. Belasco said.

One such condition is diabetes, a chronic disease marked by high levels of sugar in the blood.

According to the American Diabetes Association, diabetes afflicts 25.8 million children and adults in the United States, and as many as 7 million people have the disease and don't know it. “A lot of diabetes goes undiagnosed and we can help play a role with the practitioners with the early detection and management,” Dr. Belasco said. “Skin problems can be a prelude to recognizing that you have the disease.”

Certain skin problems – from infections and blisters to rashes and boils – are common in people with diabetes. And approximately one-third of people with diabetes will have a skin disorder caused or affected by diabetes.
Some skin conditions that may be related to diabetes include:

• Bacterial infections – everything from styes and boils to folliculitis (infection of hair follicles) and infections around the nails – and fungal infections are more common in patients with diabetes. Many of these infections can be painful and require medical treatment, Dr. Belasco said.
• Diabetic blisters, also known as Bullosis Diabeticorum. These resemble burn blisters and can develop anywhere, but often occur on fingers, hands, toes, feet or legs. They are generally painless and heal by themselves. Treatment involves getting blood glucose levels under control.
• Diabetic dermopathy. Changes in small blood vessels can cause this condition, which causes light brown, scaly patches often on the front of both legs. There is no perfect treatment except early recognition and control of diabetes.
• Eruptive Xanthomatosis. Patients with increased blood glucose levels can get these fatty deposits on the skin that can occur anywhere on the body. They have a red halo and sometimes itch.
• Atherosclerosis. This is a thickening of artery walls due to a build-up of fatty materials. It can cause skin, particularly on the legs, to become hairless, thin, cool and shiny. “Patients with diabetes have a remarkably increased risk of atherosclerosis,” Dr. Belasco said. This condition also can lead to heart attacks and strokes.
• Acanthosis Nigricans. This condition involves tan or brown spots or patches typically on the skin folds in the neck, underarms and groin. Obese patients with diabetes are particularly impacted by this condition.
• Granuloma Annulare. Ring- or arc-shaped rashes that are often red, red-brown or skin-colored.
• Necrobiosis Lipoidica Diabeticorum. This is a rare condition that involves the development of what looks like a shiny scar with a violet border. Blood vessels under the skin become easier to see and sometimes the spots crack open. There are some topical treatments and cortisone injection treatments, Dr. Belasco said.

A dermatologist can help diabetic patients with these and other skin conditions. But Dr. Belasco also cautions that it is also critical for patients with diabetes to get their blood sugar levels under control with proper diet, exercise and, possibly, insulin treatments. That's the best way to reduce future skin care issues, he said.

Overall, Dr. Belasco recommends that people seek out the advice of a skin care specialist if they experience changes in skin conditions. “Consulting with a dermatologist if you have any skin changes could provide a window to more potentially serious health risks,” Dr. Belasco said. “People don’t always make the connection between skin conditions and diabetes and other conditions, but they do exist and a trained specialist is needed.”