Diabetic Skin Issues and Tips on How to Help Manage Them

Up to 70% of people living with diabetes will experience skin issues at some point in their lives1. Understanding common diabetic skin issues and how to recognize them, as well as ways to help prevent or manage them, is an important part of living well with diabetes.

 

Table of Contents

Acanthosis Nigricans (Skin Darkening) Arrow icon
Xerosis (Dry Skin) Arrow icon
Digital Sclerosis (Tight, Waxy Skin) Arrow icon
Diabetic Dermopathy (Shin Spots) Arrow icon
Scleredema Diabeticorum (Thick, Hard Skin) Arrow icon
Fungal Infections Arrow icon
Diabetic Skin Care Tips Arrow icon

Acanthosis Nigricans (Skin Darkening)

Acanthosis nigricans may appear as dark, velvety, thick skin, as well as skin tags, usually in areas such as the back of the neck, elbows, hands, or groin1.

Because acanthosis nigricans is associated with obesity, weight loss may help improve issues, and topical treatments can help to manage it3.

 

Xerosis (Dry Skin)4

Xerosis, characterized by rough, dry skin, is a common issue for people with diabetes, often linked to poor skin protection and small blood vessel damage (microangiopathy).

Applying moisturizer can help improve skin hydration and reduce symptoms like scaling, cracking, and itching. Unmanaged, xerosis can lead to callus formation, increasing the risk of diabetic foot ulcers.

 

Digital Sclerosis (Tight, Waxy Skin)5

Digital sclerosis results in thick, tight, waxy skin around the joints of the fingers, toes, and hands in people with diabetes.

The cause of digital sclerosis is not known, but it is believed to be associated with high blood sugar levels and poor circulation. The affected areas are prone to cracking, which increases the risk of infection.

 

Diabetic Dermopathy (Shin Spots)1

Diabetic dermopathy, or “shin spots,” is the most common skin complication in people living with diabetes; it appears as light brown or red scaly patches on the skin, particularly the shin.

Even though diabetic dermopathy is harmless, and can go away on its own, people living with diabetes should still strive to prevent it from occurring by maintaining blood sugar control and practicing good skin hygiene.

 

Scleredema Diabeticorum (Thick, Hard Skin)

Scleredema leads to thickened, hardened skin, often affecting the back, shoulders, and back of the neck. It can also involve the face, chest, stomach, or thighs1.

Your healthcare provider may perform a biopsy to support diagnosis. Scleredema does not usually go away and may worsen over time, potentially leading to other problems4. Prevention is key, supported by good blood sugar control1.

 

Fungal Infections

Candidiasis is a common fungal infection in the general population but may appear more frequently in people living with diabetes6. It can appear in the mouth, the folds of the skin, and genital areas, as a creamy or red rash6. Candidiasis can be treated with topical or oral antifungal medications6.

Onychomycosis affects the toenails and can increase the risk of more serious foot issues like neuropathy. Your healthcare provider should perform an annual examination of your feet to assess for these issues specifically8. With onychomycosis, nails appear thick, brittle, and discolored7. Treatment options include topical and oral therapy; due to the slow-growing nature of toenails, it may take time to see improvement7. Checking your feet daily, including your nails, for any visible signs of infection is key7.

 

Diabetic Skin Care Tips

There are several ways to help prevent diabetic skin issues. These include2:

  • Drink plenty of fluids to keep your skin hydrated
  • Use mild soap and apply moisturizer after bathing, especially in winter months
  • Dry thoroughly after bathing, especially in areas such as underarms, and between your fingers and toes, where fungal infections can develop
  • Use a room humidifier to prevent dry air

In addition, maintaining healthy blood sugar levels is central to many diabetic skin issues. The CONTOUR®NEXT GEN meter supports effective skin treatment by ensuring blood glucose levels are controlled, which is crucial for healing and preventing further skin complications.

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References:

  1. Labib A, Rosen J, Yosipovitch G. Skin manifestations of diabetes mellitus. April 2022. In: Feingold KR, Anawalt B, Blackman MR, et al, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. PMID: 29465926.
  2. Diabetes Care Community. Diabetes and Skin Complications. DiabetesCareCommunity.ca. Published March 17, 2021. Accessed December 11, 2024. Available from https://www.diabetescarecommunity.ca/living-well-with-diabetes-articles/diabetes-management-articles/diabetes-and-skin-complications.
  3. Duff M, Demidova O, Blackburn S, Shubrook J. Cutaneous manifestations of diabetes mellitus. Clin Diabetes. 2015;33(1):40-8. doi: 10.2337/diaclin.33.1.40.
  4. Piérard GE, Seité S, Hermanns-Lê T, Delvenne P, Scheen A, Piérard-Franchimont C. The skin landscape in diabetes mellitus. Focus on dermocosmetic management. Clin Cosmet Investig Dermatol. 201315;6:127-35. doi: 10.2147/CCID.S43141.
  5. David P, Singh S, Ankar R. A comprehensive overview of skin complications in diabetes and their prevention. Cureus. 2023;15(5):e38961. doi: 10.7759/cureus.38961.
  6. Rodrigues CF, Rodrigues ME, Henriques M. Candida infections in patients with diabetes mellitus. J Clin Med. 2019;8(1):76. doi: 10.3390/jcm8010076.
  7. Winston JA, Miller JL. Treatment of onychomycosis in diabetic patients. Clin Diabetes. 2006;24(4):160-166.
  8. Embil JM, Albalawi Z, Bowering K, Trepman E: Diabetes Canada Clinical Practice Guidelines Expert Committee. Foot Care. Can J Diabetes. 2018;42 Suppl 1:S222-S227. doi: 10.1016/j.jcjd.2017.10.020.