Keeping your blood sugar levels in check is one of the most important things when it comes to managing diabetes. However, it is just one part. What many don’t realize is that diabetes, specifically diabetes mellitus, can also lead to noticeable changes in the skin. There are certain skin lesions and conditions that can be early indicators of diabetes or prediabetes, helping to detect the condition before it progresses. Here’s a look at some of the most common skin signs associated with diabetes, why they appear and what they look like.
Why Does Diabetes Mellitus Affect the Skin?
Consistent high blood sugar levels can impact blood flow, immune function, and the skin’s ability to stay hydrated. Blood vessel and nerve damage, alongside higher glucose levels in skin cells, can cause the skin to be more susceptible to specific lesions and infections. Being aware of these skin signs can be crucial for diagnosing diabetes early and managing it effectively.
- Acanthosis Nigricans (AN)
Appearance: Dark, velvety patches with a slightly thickened texture. These patches usually appear on the neck, armpits, and groin and can also develop on the knuckles, elbows and knees.
Why It Happens: Acanthosis nigricans is linked to insulin resistance, where the body doesn’t respond properly to insulin, often causing insulin levels to increase. This excess insulin encourages skin cells to grow rapidly, leading to thicker and darker patches.
What to Watch: AN may be an early warning sign of insulin resistance or prediabetes. If you notice these patches, it’s worth speaking with a healthcare provider for further assessment of blood sugar levels and metabolic health.
- Diabetic Dermopathy (Shin Spots)
Appearance: Light brown, scaly patches that are round or oval, typically found on the front of the legs (shins). These spots might look like age spots or scars but are usually painless and don’t itch.
Why It Happens: Diabetic dermopathy results from changes in small blood vessels, which can weaken the skin’s structure. While harmless, these patches are more common in those with long-term diabetes and are often a sign of poorly managed blood sugar.
What to Watch: Shin spots themselves aren’t usually a concern, but they often indicate underlying blood vessel issues related to diabetes. Proper blood sugar management can help reduce the development of new spots.
- Necrobiosis Lipoidica Diabeticorum (NLD)
Appearance: Red, yellow, or brown patches that become shiny and may ulcerate, particularly on the lower legs. NLD is not common, but it sometimes causes pain or discomfort if left untreated.
Why It Happens: A change in the fat layers and collagen under the skin can cause NLD, often from chronic inflammation or blood vessel damage linked to diabetes.
What to Watch: NLD can sometimes lead to sores or ulcers, so if you have diabetes and notice these patches, consult a healthcare provider. This can assist in managing the condition and avoid further complications.
- Digital Sclerosis
Appearance: Thick, tight, waxy skin, often on the fingers, toes, and sometimes the back of the hands. In more severe cases, it can cause reduced mobility and a loss of sensation in the hands and feet.
Why It Happens: High blood sugar levels can lead to thickening of connective tissue, causing the skin and joints to feel stiff and waxy. This is more common in people with long-standing diabetes that is poorly controlled.
What to Watch: Digital sclerosis can limit joint movement, especially in the fingers, so early recognition and blood sugar management can help keep symptoms under control.
- Eruptive Xanthomatosis
Appearance: Small, yellowish bumps surrounded by a red halo, which may appear on the back of the hands, arms, legs, and buttocks. These bumps may also itch.
Why It Happens: Eruptive xanthomatosis is caused by very high levels of cholesterol and triglycerides, often associated with diabetes. High sugar levels can lead to fatty deposits beneath the skin due to the body finding it difficult to process fats.
What to Watch: Though the bumps themselves are harmless, they can indicate dangerously high blood lipids. This is a sign to see a healthcare provider, as you may need to adjust both your blood sugar and lipid management.
- Granuloma Annulare
Appearance: Reddish or skin-coloured, ring-shaped patches, usually on the fingers, hands, feet, elbows, or knees.
Why It Happens: While the exact cause of granuloma annulare isn’t fully understood, it has been associated with diabetes, especially in adults. It’s believed to be an inflammatory reaction that appears because of immune system changes.
What to Watch: This condition usually resolves on its own, but recurrent cases can signal underlying health issues like diabetes. In some cases, topical treatments can help, but managing blood sugar levels is the best approach to prevent it.
- Increased Susceptibility to Fungal and Bacterial Infections
Appearance: Fungal infections appear as red, itchy rashes in moist areas of the body, such as the folds of the skin, under the breasts, between the fingers and toes, or around the nail beds. Bacterial infections may look like red, swollen areas that are warm and tender.
Why It Happens: Diabetes can weaken the immune system, making your body and skin prone to infections. High blood sugar can also create a receptive environment for bacteria and fungi, which leads to more frequent infections.
What to Watch: Proper skin care and keeping the skin clean, especially in moisture-prone areas, can help reduce the risk of infections. Regular blood sugar control and good hygiene are essential to minimizing infection risks.
Tips for Managing Skin Health with Diabetes
Being aware of these skin signs is a powerful tool in managing diabetes. Here are a few simple tips for keeping your skin healthy if you have diabetes:
- Control Blood Sugar Levels: The most crucial factor in managing diabetic skin conditions is maintaining target blood sugar levels.
- Stay Hydrated: Diabetes can lead to dry skin, so drink plenty of water and use a gentle, fragrance-free moisturizer to keep your skin hydrated.
- Practice Good Hygiene: Washing gently and regularly can reduce the risk of infections, especially in moisture-prone areas.
- Choose Skin Care Products Carefully: Go for mild, fragrance-free skin care products to avoid potential irritation.
- Check Your Skin Regularly: Be vigilant about any new spots, patches, or bumps, particularly in areas where lesions are more likely to appear. Early intervention is essential to managing complications.
When should you Consult a Dermatologist or Doctor
If you notice skin changes that could be signs of diabetes, it’s essential to speak with a healthcare provider. Not every skin condition is linked to diabetes, but getting any unusual spots or lesions checked is always a good idea. A dermatologist can recommend treatments that may help, but ultimately, managing diabetes is the most effective way to maintain skin health and prevent complications.
Recognising and addressing skin lesions tied to diabetes is key to early detection and better diabetes management. By practicing good skin care and managing blood sugar, people with diabetes can reduce the impact of these lesions and maintain healthier skin.
Medically Reviewed by Dr Mathobele