Skin complications can occur when blood sugar levels are too high. Diabetes rashes and patches of skin dryness or discoloration are often early signs of diabetes.

People with diabetes have blood sugar levels that are too high due to a lack of insulin or insulin not working properly. Skin conditions can often be the first sign that a person has diabetes.

People can use medication to resolve skin problems, but managing blood sugar levels is usually the best way to prevent and treat skin problems related to diabetes.

This article details the skin conditions that have links to diabetes.

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When blood sugar levels are too high for too long, several changes take place in the body that can affect skin health.

  • Dehydration: Blood sugar leaves the body through the urine. When there is too much blood sugar, a person will urinate more. This can result in dehydration and dry skin.
  • Inflammation: High blood sugar levels can also lead to inflammation. Over time, this can dull or overstimulate the immune response.
  • Circulation: Nerve and blood vessel damage can also reduce circulation. Poor blood flow can alter the skin’s structure, especially its collagen. Without healthy collagen networks, the skin can become stiff and, in some cases, brittle. Collagen is also necessary for proper wound healing.

Most diabetes-related skin complications are harmless, but some can result in painful and persistent symptoms and may require medical attention.

The most effective treatment option for many diabetes-related skin conditions is effective blood sugar management. However, in severe cases, a doctor may prescribe oral steroids, medicated creams, or another treatment.

The main symptom of acanthosis nigricans is patches of thickened, hyperpigmented skin. These patches may appear gray, black, brown, or generally darker than the surrounding skin.

This condition commonly affects the folds near the groin, back of the neck, and armpits.

Acanthosis nigricans can signify insulin resistance, which can occur in obesity, prediabetes, and diabetes. Conditions that affect a person’s hormone balance, such as polycystic ovary syndrome and thyroid disease, can cause acanthosis nigricans.

Acanthosis nigricans occurs in as many as 74% of people with obesity and diabetes.

It is not dangerous or contagious, but a doctor can advise about the treatment options. Managing blood glucose levels and body mass index (BMI) may help.

People with psoriasis often develop discolored patches on their skin, which may be itchy and scaly. Some people may also experience changes in their nails or scalp.

The appearance of psoriasis varies among individuals. In people with light skin, the affected patches tend to appear pink or red with silvery scales covering them. In those with medium skin tones, the patches can be salmon-colored with silvery-white scales. On darker skin, psoriasis can look violet with gray scales, or it can be dark brown and difficult to see.

Some people with psoriasis may also develop psoriatic arthritis, which can cause severe joint pain.

The treatment options for psoriasis include:

  • making lifestyle changes
  • applying cortisone creams and ointments to affected areas
  • managing blood sugar levels
  • reaching and maintaining a moderate body weight

In more severe cases, oral or injectable biologic medications may be necessary.

People with type 2 diabetes have a higher risk of developing psoriasis than those without diabetes.

Visit our dedicated psoriasis hub to learn more about this condition.

This is a connective tissue disorder in which symmetrical skin thickening affects the upper body — for example, the upper back and back of the neck.

Scleredema diabeticorum is a rare condition that affects 2.5% to 14% of all people with diabetes. It can also occur in people without diabetes following infection.

There are many forms of scleredema, and the treatment typically focuses on addressing the underlying cause. The proper management of blood sugar levels can improve the symptoms.

Other treatment options include oral medications, such as cyclosporine, corticosteroids, and methotrexate. However, research has not confirmed that any of these are effective. Some doctors may recommend light therapy.

People with diabetes may develop tight, thick, waxy-looking skin on their skin, hands, and digits. This is due to circulatory problems.

The symptoms often start on the hands but can spread to the arms and upper body. Less commonly, they can affect the knees, ankles, or elbows, and the skin may have an orange-peel appearance. Joint stiffness can occur.

The best way for people with diabetes to prevent this complication is by maintaining their blood sugar levels. A doctor may also recommend physical therapy.

Some people develop irregularly shaped blister-like sores that appear randomly across their feet and hands. The blisters are often large and painless, occurring either alone or in patches.

The only treatment option is good blood sugar management, although a doctor may aspirate large blisters under sterile conditions.

Those with bullae lesions should avoid breaking the blister, as doing so carries the risk of infection. These blisters usually heal without scarring, but if complications develop, amputation may be necessary.

This condition involves circular, reddish, or light-brown patches that usually appear on the shins or other bony parts of the body. The patches are also usually indented and scaly.

Population studies from Sweden have shown that about 33% of people with type 1 diabetes and 39% of those with type 2 diabetes develop diabetic dermopathy. Among those without diabetes, the rate is 2%.

The condition results from damage to the nerves and blood vessels — particularly small blood vessels. As the condition affects areas of the body with less protective muscle and fat, lesions may reflect an increased response to injury.

The lesions are harmless, and treatment is not usually necessary.

Sometimes, insignificant wounds can become open sores called diabetic ulcers. These can occur anywhere on the skin but are most common on the feet.

Diabetes can affect blood circulation and the nervous system. If a person has a wound on their foot due to a lack of sensation, it can mean that they do not notice the injury. In addition, the low blood supply can make it harder for wounds to heal.

Untreated ulcers are at risk of infection. Infections can cause tissue death, and the person may ultimately need an amputation.

According to some research, almost 6% of people with diabetes will develop some type of foot disease, whether it be infection, ulceration, or tissue death. Between 0.03% and 1.5% of these people will need an amputation.

It is essential for people with diabetes to manage their blood sugar levels and regularly check their feet and other parts of the body for wounds or lesions that may need attention.

Learn more about how diabetic ulcers can affect the feet.

A person with xanthelasma has scaly, yellow fat deposits on and near the eyelids. These deposits may also appear on the neck, trunk, and shoulders and around the underarms.

Xanthelasma can result from high levels of fat in the body, which can be due to genetic defects in fat metabolism or secondary causes, such as diabetes, pregnancy, or obesity.

Xanthelasma does not pose a health risk, but it can affect a person’s quality of life. Some small studies have suggested that lipid-reducing medications may be effective.

If a person with diabetes is unable to manage their glucose levels effectively, this can sometimes result in crops of bumps with a reddish-brown to yellowish-orange color. These lesions are fatty deposits under the skin.

Eruptive xanthomas can form anywhere on the body, but they most often appear on the thighs and buttocks and in the crooks of the elbows and knees.

Diabetes is one reason why this might occur. Other possible causes include genetic factors, hypothyroidism, and cirrhosis.

A severe case may signal an increased risk of pancreatitis. A person with severe symptoms should seek urgent medical attention.

The treatment for people with diabetes involves following a low fat diet, reaching a moderate weight, and managing blood sugar levels. A doctor may then recommend the use of statins or fibrates.

Skin tags are soft, skin-colored growths that hang from the skin. They affect about 25% of the general population, but they can also be a sign of high blood sugar levels in people with diabetes.

Studies have linked skin tags, also called acrochordons, with high or uncontrolled blood sugar levels.

Skin tags favor areas such as the eyelids, underarms, neck, breasts, and groin folds.

Necrobiosis lipoidica diabeticorum (NLD) is a rare and chronic condition that causes a rash to form. It is more common in people with diabetes than in those without the condition.

Lesions usually begin as small, firm, raised bumps and progress to larger plaques of waxy, hard, depressed skin. The plaques are usually painless, and the surrounding skin appears pale and shiny in comparison. Lesions often appear on both shins.

A worsening of symptoms may indicate the need to adjust the person’s diabetes treatment plan.

The treatment options for NLD include topical and oral medications. The person should also protect the skin from further damage through injury due to the risk of infection.

In rare cases, granuloma annulare may occur with diabetes.

Granuloma annulare features small, firm, raised, reddish, brown, or skin-colored bumps that spread outward in a ring. The lesions often occur on the hands, fingers, and forearms. They can be isolated or numerous on the body, where they usually appear symmetrically.

The lesions are harmless and usually disappear without treatment. However, in persistent cases, a doctor may prescribe a corticosteroid or isotretinoin (Accutane). Light therapy may also help.

People with type 2 diabetes tend to experience more frequent severe bacterial and fungal infections than those without diabetes. They may also have more frequent severe allergic reactions.

Bacterial infections

These usually appear as inflamed, pus-filled, painful sores, which are typically due to an infection with the Staphylococcus bacteria.

Antibiotics and effective blood sugar management can usually prevent bacterial infections from becoming life threatening.

After a few days, most bacterial sores will release pus and then begin to heal. A doctor may need to drain any sores that cannot drain on their own or are painful or persistent.

Common bacterial infections for people with type 2 diabetes include:

Fungal infections

These infections usually cause rashes that have a border of scaly skin and, sometimes, small blisters. Fungi require moisture to thrive, so infections tend to occur in warm, wet folds of skin, although they can occur anywhere on the body.

Common types include:

Treatment with antifungal medication can prevent prolonged or frequent infections.

The best way to reduce the risk, severity, and frequency of all diabetes-related skin conditions is to maintain healthy blood sugar levels.

Blood glucose tips

Lifestyle tips for achieving and maintaining healthy blood sugar levels include:

Attention to personal care and hygiene can also help prevent these complications.

Learn more about managing diabetes.

Skin care tips

People can take various steps to protect the health of their skin. These include:

  • avoiding long or hot baths and showers
  • avoiding saunas and hot tubs
  • choosing bath products that do not dry out or irritate the skin, such as fragrance-free soaps
  • using mild shampoos, conditioners, and body washes
  • keeping the skin as clean and dry as possible
  • using moisturizers to hydrate the skin
  • using a humidifier and bathing less frequently when the weather is dry
  • avoiding feminine hygiene sprays
  • refraining from scratching or rubbing infections, rashes, and sores
  • treating cuts immediately and monitoring their healing progress
  • consulting a dermatologist about persistent skin problems

It is crucial for people with diabetes to check their feet daily for skin alterations, sores, and other changes.

Well-fitting, comfortable shoes can help improve foot circulation and prevent or lessen the impact of other conditions.

Skin complications can often be the first sign of diabetes. High blood glucose levels can cause various types of rashes and lesions, and having diabetes can increase a person’s risk of infection.

However, many skin conditions associated with diabetes are cosmetic and ultimately harmless.

Adequately managing diabetes can resolve many skin complications. However, in other instances, topical ointments and prescription medications may be necessary.

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