Serious about skin
You are more likely to develop skin problems if you have diabetes especially during the colder winter months.
Up to a third of people with diabetes will have a skin disorder caused or affected by diabetes at some time in their lives. Sometimes skin issues are the first sign that a person has diabetes.
Anyone can develop a skin disorder but people with diabetes may be more prone to having skin issues, including bacterial infections, fungal infections, and itching.
Skin conditions are also more likely to become infected if you have diabetes (especially if your blood glucose levels are high).
Sharon, 30, from Wellington, who has type 1 diabetes, worries that her diabetes makes her more prone to having skin problems. She recently had to take a week off work after developing a boil on her leg that got infected despite taking antibiotics. "I went to the doctor and was taking antibiotics but it got worse and I ended up in hospital having an operation," she said.
Luckily, most skin conditions can be prevented or easily treated if caught early.
Dry skin. Rough, dry and scaly skin affects most people with diabetes over the age of 64. It can be found on particular parts of the body, for example, the legs, feet, hands and/or face. Or it can progress to all parts of the skin. In more serious cases the skin loses its suppleness, which can then crack and become red and inflamed.
Itching is the most obvious symptom. Aside from being irritating, dry skin can be made worse if you scratch and rub it. Scratching can also lead to infection, or even ulcers.
Dry skin often happens in winter because heating your house can lower the humidity (amount of moisture in the air) and dry cold winds during winter can also exacerbate the problem.
Fungal infections. Fungal infections in people with diabetes are often caused by a yeast-like fungus called Candida Albicans (thrush). It can create itchy rashes of moist, red areas surrounded by tiny blisters and scales. These infections often occur in warm, moist folds of the skin, including in the mouth and groin.
Other common fungal infections include athlete's foot, ringworm (a ring-shaped itchy patch), and vaginal infection that causes itching. If you think you have a yeast or fungal infection, call your doctor. You will need to have it diagnosed before you can treat it.
Bacterial infections. Several kinds of bacterial infections occur in people with diabetes, including:
styes, which are infections of the glands of the eyelid
boils, which are infections of the hair follicles
carbuncles, which are deep infections of the skin and the tissue underneath.
Infections can also occur around the nails.
Infected tissues are usually hot, swollen, red, and painful. The most common cause of skin infections are the Staphylococcus bacteria. If you think you have a bacterial infection, see your doctor quickly.
Itching. Localised itching is often caused by diabetes. It can be caused by a yeast infection, dry skin, or poor circulation. When poor circulation is the cause of itching, the itchiest areas may be the lower parts of the legs.
You may be able to reduce itching yourself. Take care not to rub the skin hard when bathing or showering. Use mild soap with moisturiser and apply a light moisturising skin cream after bathing.
10-point maintenance plan for good skincare
Health professionals believe people with diabetes can reduce their chances of skin problems by taking good care of their skin and managing their diabetes properly. Here are their top tips.
1 Keep your blood glucose levels in as healthy a range as you can. When your blood glucose levels are high you are more prone to have dry skin and you are less able to fend off harmful bacteria. This means high blood glucose levels increase your risk of infection.
2 Keep your skin clean and dry. Use talcum powder or anti-chaffing cream in areas where skin touches skin, such as armpits and groin.
3 Protect your skin. For example, wear gloves when using cleaners, solvents and other household detergents.
4 Avoid very hot baths and showers. If your skin is dry don't use bubble baths. Moisturising soaps may help. Afterward, use a light moisturising skin cream, but don't put lotions between your toes as extra moisture there can encourage fungus to grow.
5 Where possible prevent dry skin. If you scratch dry or itchy skin it can open up and infection can set in. Moisturise your skin to keep it supple and prevent chapping especially in cold or windy weather.
6 Treat cuts right away. Wash minor cuts with soap and water. Do not use alcohol or iodine to clean skin because they are too harsh. Only use an antibiotic cream or ointment if your doctor says it's okay. Cover minor cuts with sterile gauze.
7 During cold, dry months, keep your home more humid.
8 Use mild shampoos and unscented soaps. Do not use feminine hygiene sprays.
9 Take good care of your feet. Check them every day for sores and cuts. Wear broad, flat shoes that fit well. Check your shoes for foreign objects before putting them on.
10 See a doctor right away if you get a major cut, burn, or infection. If you have nerve damage or poor circulation in your feet you should immediately see a doctor if you get any sort of cut on your feet.
**See a dermatologist (skin doctor) about skin problems if you or your GP are concerned.
*This article first appeared in the Winter 2016 issue of Diabetes Wellness magazine. Subscribe to Diabetes NZ today to receive your copy.