By Tanya Caylor
Skin issues aren’t the first thing most people associate with diabetes. But it is a very real and potentially serious problem, affecting one-third of both type 1 and type 2 patients at some point in their lives, according to the American Diabetes Association.
The good news is, many skin issues are manageable and can even be prevented with proper self care.
How diabetes affects the skin and feet
When glucose levels are high, the body flushes out fluids, meaning less moisture makes its way to the skin. Over time, especially in those who have difficulty managing the disease, tiny blood vessels near the the skin’s surface may narrow and even become clogged, exacerbating the problem. Dry, itchy skin can crack, leading to complications such as infections and slow-healing sores. At this point, gangrene becomes a danger which can lead to amputation, according .
Diabetes patients are especially vulnerable to foot-related complications such as corns, calluses, ingrown toenails and foot ulcers. However, periodic foot screens by a doctor, in addition to daily personal monitoring of both the skin and toenails, can reduce the risk of amputation by more than 50 percent, according to the National Diabetes Education Program.
The most important component in keeping skin healthy is proper disease management. Eating right, exercise, monitoring blood sugar and taking medication as directed all help improve circulation in the body, which is the most important factor in keeping skin hydrated from within.
Good hygiene is critical to reduce the risk of infection, especially for those with type 1 diabetes, who are more likely to have a compromised immune system. Cleanse the skin daily with antibacterial but gentle soaps such as Dial, Safeguard or products with labels suggesting they they are intended for use on sensitive skin.
A relaxing soak in the tub has been shown to decrease blood sugar levels, according to a 2008 study by Dr. Philip Hooper of the McKee Medical Center in Loveland, Colo., but always check skin and feet first for cuts and abrasions that could allow bacteria to cause infection. Treat any openings in the skin with antibacterial ointment, and contact your doctor if they don’t seem to heal in a timely manner.
Overly hot water should be avoided, as it can dry out the skin. It can also cause burns in patients with neuropathy. Because numbness in the extremities may impair the ability to accurately register water temperature, use a thermometer to make sure bath water doesn’t exceed 104 degrees.
After cleansing, it’s important to dry the skin thoroughly, especially between the toes. Finally, apply a moisturizer daily to help keep skin from drying out.
Choosing a moisturizer
Experts say it is not necessarily important what kind of moisturizer is used, so long as it is applied regularly. Some doctors even recommend patients try rubbing petroleum jelly or olive oil into their feet, then covering with a pair of clean socks overnight. However, because moisturizing must be done frequently, it is important to select a product that does not irritate your skin. Though this can vary considerably from person to person, it is generally best to avoid products containing fragrance, menthol, camphor and high concentrations of alcohol. Never use a lotion or cream that contains phthalate, which may increase the risk of insulin resistance.
Moisturizers marketed for diabetic use tend to be hypoallergenic and fragrance-free. There are many such products on the market, most of which are available over the counter. However, whichever type of moisturizer you decide to use, never apply it between the toes. It is very important to keep this area dry to prevent the risk of fungal infections.
Avoiding fungal infections
Several over-the-counter remedies, such as Zeasorb powder and Sarna lotion, can be used under the breasts, in the groin area and under a flap of belly skin to prevent fungal infections that may develop in areas where skin comes in contact with other skin. Athlete’s foot antifungal creams such as Lotrimin and Lamisil can be used to treat fungus on the feet or between the toes. When getting a manicure or pedicure, be careful to avoid allowing the cuticles to be pushed back, as this can cause possible yeast or fungal infections.
Choose socks with care
People who have diabetes should avoid socks made of pure nylon, dacron and wool, as those materials can irritate the skin. These fabrics may also cause excessive sweating, which can lead to the development of cracks and fissures. It is best to use socks made of cotton or cotton blends. It also very important to change socks frequently, especially if they get damp or sweaty.
Don’t forget sunscreen
Finally, diabetes patients should take extra precautions whenever spending time outdoors. Wear a hat and sunscreen even on a cloudy day. A sun protective factor (SPF) of at least 15 is recommended for daily use. If your skin is particularly sensitive or prone to burning, opt for an SPF of 50.