Diabetes and Skin Conditions
Skin problems are common in people with diabetes, and sometimes a skin change is the first sign that someone has diabetes or prediabetes. Most diabetes-related skin conditions can be prevented or treated, especially when caught early. This guide explains why diabetes affects the skin, describes common skin conditions, and offers practical skin care tips. See a health care provider or dermatologist for any skin change that worries you.
Why diabetes affects the skin
High blood glucose can affect the skin in several ways. It can draw fluid from the body, leading to dry skin. It can reduce blood flow and damage nerves, which slows healing and reduces your ability to feel injuries. It can also weaken the body's ability to fight infections and create conditions in which bacteria and fungi grow more easily. Insulin resistance itself can cause characteristic skin changes. The American Diabetes Association notes that many skin conditions can affect anyone but are more common in people with diabetes.
Common skin conditions linked to diabetes
Acanthosis nigricans
Darkened, thickened, velvety patches of skin, usually in body folds such as the back of the neck, armpits, and groin. It is associated with insulin resistance and is common in people with type 2 diabetes, prediabetes, and obesity, and in people with polycystic ovary syndrome. The CDC lists dark patches of skin around the neck, armpits, or groin among symptoms more common in type 2 diabetes. It often improves when insulin resistance improves, such as with weight loss. If you notice these patches, ask your provider about checking your blood glucose. See prediabetes.
Bacterial infections
People with diabetes are more prone to bacterial skin infections, such as styes on the eyelid, boils, infections around the nails, and infected cuts. Signs include redness, warmth, swelling, pain, and pus. Most respond to prompt treatment, which may include antibiotics. Don't ignore a skin infection, especially on the feet.
Fungal infections
Fungal infections, often caused by Candida yeast, are common with diabetes. They usually develop in warm, moist skin folds, such as under the breasts, between fingers and toes, in the armpits, and in the groin. They often look like an itchy, red rash surrounded by small blisters or scales. Other common fungal infections include athlete's foot, jock itch, ringworm, and vaginal yeast infections. Keeping skin clean and dry and managing glucose help prevent them; antifungal treatments are effective. See diabetes symptoms in women.
Dry, itchy skin
Dry skin is common with diabetes, especially when glucose is high, and can lead to itching and cracking. Cracked skin on the feet can let in germs. Poor circulation can also cause itching, often on the lower legs.
Diabetic dermopathy
Sometimes called "shin spots," these are light brown, scaly, round or oval patches, usually on the front of the lower legs. They are harmless, do not hurt or itch, and don't need treatment. They are linked to changes in small blood vessels.
Necrobiosis lipoidica
A less common condition that starts as small raised bumps and develops into shiny, scar-like patches with a yellowish center and visible blood vessels, usually on the lower legs. The skin can be thin and may crack or form ulcers. It is more common in women. A dermatologist can recommend treatment.
Diabetic blisters
Rarely, people with diabetes develop blisters that look like burn blisters, often on the backs of fingers, hands, toes, feet, and sometimes legs or forearms. They usually are painless and heal on their own in a few weeks. Keeping glucose in range is the main treatment. See a provider to rule out other causes and to prevent infection.
Digital sclerosis and thickened skin
Some people with diabetes develop tight, thick, waxy skin on the backs of the hands, and fingers may become stiff. This can limit joint movement. Managing glucose and physical therapy can help.
Eruptive xanthomatosis
Firm, yellow, pea-sized bumps surrounded by a red ring that may itch. They usually appear on the backs of hands, feet, arms, legs, and buttocks. They are linked to very high triglycerides and high blood glucose. They need medical evaluation because high triglycerides can also cause pancreatitis.
Skin tags
Small, harmless growths of skin, often on the neck, eyelids, or armpits. Many skin tags have been associated with insulin resistance and higher blood glucose.
Vitiligo
Loss of skin pigment in patches. It is more common in people with type 1 diabetes, likely because both are autoimmune conditions.
Foot ulcers
Open sores, usually on the feet, caused by nerve damage, pressure, and poor circulation. They are serious and need prompt treatment. See diabetic foot care and diabetic neuropathy.
Skin changes from insulin injections
Repeatedly injecting into the same spot can cause lumps of fatty tissue (lipohypertrophy), which can make insulin absorption unpredictable. Rotating injection sites helps prevent this. See insulin basics. Some people also develop skin irritation from CGM or pump adhesives; barrier films and alternative adhesives can help.
Skin care tips for people with diabetes
- Keep blood glucose in range. This is the most important step for preventing many skin problems. See A1C and blood sugar targets.
- Keep skin clean and dry, especially in skin folds. Dry thoroughly after bathing, including between the toes.
- Avoid very hot baths and showers, which dry skin. Test the water temperature with your elbow if you have reduced feeling in your feet.
- Moisturize dry skin, but not between the toes.
- Use mild soaps and gentle skin products.
- Drink enough water to help keep skin hydrated.
- Treat cuts right away. Wash minor cuts with soap and water, apply a clean bandage, and watch for infection. See a provider promptly for anything that doesn't heal.
- Check your feet daily for cuts, blisters, redness, and cracks.
- Use a humidifier in dry weather.
- Protect your skin from the sun with sunscreen, hats, and protective clothing.
- Don't scratch. Use moisturizer for itchy skin; scratching can break the skin and lead to infection.
- Wear breathable fabrics such as cotton, and change out of damp clothes promptly.
- Don't smoke, which reduces blood flow to the skin.
When to see a provider
See your provider or a dermatologist if you have:
- A skin infection that isn't improving or is spreading
- A sore or wound that isn't healing, especially on the feet
- New dark patches in body folds
- Yellow bumps, waxy patches, or unexplained blisters
- Persistent itching or rash
- Any skin change that worries you
Seek urgent care for spreading redness, red streaks, fever, or a wound with pus or a bad smell.
Frequently asked questions
Can skin changes be the first sign of diabetes?
Yes. Dark velvety patches in body folds, frequent skin infections, slow-healing sores, and persistent itching can sometimes appear before diabetes is diagnosed. If you notice them, ask your provider whether you should be tested.
Are skin tags a sign of diabetes?
Skin tags are common and harmless, and many people without diabetes have them. Having many skin tags has been associated with insulin resistance, so it can be worth discussing with your provider, especially if you have other risk factors.
What lotion should I use?
Choose a fragrance-free moisturizer and apply it after bathing while skin is still slightly damp. Avoid applying lotion between the toes. For very dry, cracked heels, your provider may recommend a stronger moisturizer.
Key takeaways
- Diabetes can cause dry skin, infections, slow healing, and specific conditions such as acanthosis nigricans and diabetic dermopathy.
- Dark velvety patches in body folds can be a sign of insulin resistance and are worth discussing with your provider.
- Keeping glucose in range, keeping skin clean and moisturized, and checking your feet daily help prevent problems.
- Rotate insulin injection sites to prevent lumps.
- See a provider promptly for infections or wounds that don't heal.
Sources
Links to the sources cited above appear in the text. We rely on the Centers for Disease Control and Prevention (CDC), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the American Diabetes Association (ADA).