Untreated diabetes affects almost every part of the body including the skin. Diabetes-related skin complications are more common in people with untreated diabetes. Exposure to too much sugar circulating in the blood makes the skin vulnerable to infections and several other disorders. Almost a third of all diabetics suffer from some form of a diabetes-related skin problem.
Bringing your blood sugar level close to the normal range is considered the best option for treating your diabetic skin problems. Most of the diabetic skin complications can be cured with appropriate treatment. Skin disorders related to diabetes should not be ignored. If left untreated, even mild skin disorders can lead to severe problems.
How to Treat Diabetic Skin Complications
People with poorly controlled diabetes are susceptible to bacterial infections of the skin. Bacterial infections cause boils, styes and nail infections. These skin infections usually respond to oral antibiotic medications. Most of these skin infections are caused by the colonization of the bacteria Staphylococci (staph).
As most Staphylococci infections are becoming resistant to penicillin, doctors usually recommend penicillin-like antibiotics flucloxacillin and methicillin for treating the infections. Patients with a history of penicillin allergy are usually treated with erythromycin, vancomycin, rifampicin or clindamycin.
Too much sugar in the blood increases the risk of fungal infections of the skin. Diabetics have a higher risk of developing athlete’s foot, jock itch and ringworms. These fungal infections are usually treated with topical antifungal medications. Occasionally, oral drugs are prescribed for healing severe fungal infections. Antifungal medications commonly used for treatment include imidazoles, polyenes, allylamine, thiocarbamates, undecylenic alkanolamide, benzoic acid and ciclopirox olamine.
Itching of the skin in diabetics is a symptom of skin dryness, fungal infection or poor blood circulation. Using a mild soap while bathing and applying moisturizing lotion to the skin after bath help to moisten the dry skin and reduce itching.
When the cells that form the skin pigments are destroyed by diabetes, the skin loses its natural color. This condition known as vitiligo is characterized by discolored patches on the face, abdomen and chest. Vitiligo is more common in type 1 diabetes patients. It is treated with topical steroids, micropigmentation and light therapy. Corticosteroid creams are usually used as the first line treatment for vitiligo. It helps to restore the normal color of the skin.
When topical steroids cannot produce the desired result, your doctor may recommend psoralen photochemotherapy for treating the condition. Treatment includes applying topical psoralen on the vitiligo patches and exposing the skin to artificial ultraviolet A light for about 30 minutes. In case of severe vitiligo, oral psoralen is taken before the photochemotherapy.
For people with extensive vitiligo that covers more than half of the body, micropigmentation or depigmentation is recommended. This is not a treatment for vitiligo. It works by fading the color of the unaffected areas of the skin, so that the entire body has a uniform light color. This process involves applying monobenzene to the unaffected areas of the skin until these areas match the discolored patches.
This is a rare skin disorder related to diabetes that causes thickening of the skin on the upper back and back of the neck. Treatment for scleredema diabeticorum involves applying moisturizing lotion to soften the thickened areas of the skin.
Shiny circular or oval lesions that usually appear on the front of the legs are called diabetic dermopathy. Changes in the small blood vessels of the skin are responsible for this skin disorder. They are harmless and do not require treatment. Occasionally they itch. Applying calamine lotion or a moisturizer on these spots can reduce itching.
Necrobiosis Lipoidica Dibeticorum (NLD)
NLD is a rare diabetes-related skin disorder. The skin affected by this condition becomes thin and red. Lesions usually appear on the lower parts of the legs. They are large with well-defined borders. At times, this condition is painful. Treatment is needed for treating lesions that break open. At the early stage, NLD is treated with topical corticosteroids. However, these drugs are usually not effective for treating ulcerated NLD.
Treatment with tacrolimus ointment can heal the ulcerated lesions. This topical medication should be applied to the lesions twice a day, for a month. Applying bovine collagen to the affected areas can provide relief from this skin complication. Psoralen photochemotherapy can also be used for treating NLD.
Medications that studies suggest can be used for treating NLD include tretinoin and hydroxychloroquine. Ticlopidine, clofazimine, nicotinamide and perilesional heparin injections can reduce complications of NLD. Laser treatment is sometimes recommended for improving the condition of the skin affected by NLD. Skin grafting can also provide relief from this condition.
The skin on the hands, fingers and toes of people with digital sclerosis is thick and waxy. Applying moisturizer to the affected areas helps to soften the skin. However, reducing the blood sugar level is the best treatment for this diabetic skin complication.
Eruptive xanthomatosis occurs in diabetics with elevated triglyceride level in the blood. It is characterized by small pea-like yellow waxy bumps on the hands, legs and buttocks. This skin condition is treated with lipid lowering drugs and cholesterol and fat restricted diet.
Drugs commonly used for treating this skin condition include statins, bile acid binding resins, fibrates, nicotinic acid and probucol. When eruptive xanthomatosis does not respond to lipid lowering drugs, the bumps on the skin can be destroyed with laser therapy, excision, topical trichloroacetic acid or electrodesiccation.
This diabetes-related skin problem causes thickening and darkening of the skin folds. It usually affects overweight people with insulin-resistance. Losing weight and applying skin-lightening creams to the affected areas are currently the only treatment for this skin disorder.
Diabetic blisters may develop on the hands, back of fingers, toes and feet. They are more common in people with diabetic neuropathy. They are however harmless. Lowering the blood sugar level is the only option for healing the diabetic blisters. When your blood sugar level returns to the normal range, the blisters heal naturally within a few weeks.