Diabetes-Related Skin Conditions

RECENTLY IN THE NEWS:

NBC News (3/5/2015) reports on its website that "family practioners, gynecologists and even dentists are getting into the cosmetic procedure business, and dermatologists say they're seeing the side effects."  Several dermatologists "from around the country told NBC News that they've had to the fix the mistakes of physicians who are dabbling in their specialty."  In a statement, the American Academy of Dermatology said, "A dermatologist is a licensed medical doctor and the only residency-trained physician fully educated in the science of cutaneous medicine, which includes medical and surgical conditions of the skin, hair, nails, and mucous membranes."

DRY SKIN CARE:

Keep your bathing to a minimum!  Wash with lukewarm water and keep your bathing to less than 10 minutes.  Wash with a soapless cleanser such as Dove and avoid harsh soaps such as Ivory or Irish Spring.  After bathing, moisturize within a few minutes of patting dry with a towel.  Moisturize with a sensitive-skin moisturizer without fragrance.  If you have a skin condition such as eczema, you will need to moisturize a few times per day.

WOUND CARE:

The day after your procedure, allow the cleanser and water to wash over the site.  That is adequate cleaning of the wound.  Thereafter, apply a generous layer of petroleum jelly (Vaseline) or another greasy substance such as Aquaphor healing ointment.  If the area is in contact with clothing, we advise you to cover it with a dressing.  Repeat the same procedure the next day and every day until the wound has healed.

HOW TO APPLY YOUR TOPICAL RETINOID (ACNE PATIENTS):

Topical retinoids include adapalene (Differin), tretinoin (Retin-A, Atralin, Ziana, Veltin, Tretin-X).  Apply a pea-sized amount to your entire face a few minutes after washing your face at bedtime (since most retinoids are inactivated by sunlight).  If your face is dry with the retinoid, apply a moisturizer prior to the application of the retinoid.  

CARE FOR SKIN IN THE SUN:

Use a daily moisturizer with a sunscreen of SPF 15 or higher on the areas that will be exposed.  If you're going to be directly out in the sun, wear an SPF of 30 or higher and make sure the sunscreen says that it is "broad spectrum."  Remember to reapply after two hours and after swimming or any exercising.  Physical sunscreens which contain titanium dioxide and/or zinc oxide are gentle and will not react with the skin.   Seek shade between the hours of 10 am-4 pm.

Check your skin for any new, changing, non-healing or itching lesions four times a year or every major holiday.  If you notice anything that is new or changing or not healing, please call and get it checked.

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As always, you can contact our office to answer any questions or concerns.

It is estimated that about one-third of people with diabetes will have a skin disorder at some time in their lives caused by the disease. Diabetics are more susceptible to bacterial and fungal infections; allergic reactions to medications, insect bites or foods; dry itchy skin as a result of poor blood circulation; and infections from foot injuries for people with neuropathy.

There are a number of diabetes-specific skin conditions:

Acanthosis Nigricans. A slowly progressing skin condition, which turns some areas of skin, usually in the folds or creases, into dark, thick and velvet-textured skin. Acanthosis nigricans often precedes the diagnosis of diabetes. It is sometimes inherited, but is usually triggered by high insulin levels. It can occur at any age and usually strikes people who are obese. There is no treatment for the condition except to reduce insulin levels. Prescription creams may help lighten the affected area.

Diabetic Blisters. Rare blisters that appear on the hands, toes, feet or forearms that are thought to be caused by diabetic neuropathy.

Diabetic Dermopathy. Round, brown or purple scaly patches that most frequently appear on the front of the legs (most often the shins) and look like age spots. They are caused by changes in small blood vessels. Diabetic dermopathy occurs more often in people who have suffered from diabetes for decades. They are harmless, requiring no medical intervention, but they are slow to heal.

Digital Sclerosis. This condition appears as thick, waxy and tight skin on toes, fingers and hands, which can cause stiffness in the digits. Getting blood glucose levels back to normal helps alleviate this skin condition.

Disseminated Granuloma Annulare. A red or reddish-brown rash that forms a bull's eye on the skin, usually on the fingers, toes or ears. While not serious, it is advised that you talk to your dermatologist about taking steroid medications to make the rash go away.

Eruptive Xanthomatosis. A pea-like enlargement in the skin with a red halo that itches. It most frequently appears on the hands, feet, arms, legs or buttocks. It is often a response to high triglycerides. Keeping blood glucose levels in the normal range helps this condition subside.

Necrobiosis Lipoidica Diabeticorum. This condition is similar to diabetic dermopathy, but the spots are larger, fewer, deeper in the skin and have a shiny porcelain-like appearance. It is often itchy or painful. It goes through cycles of being active and inactive. It is caused by changes in collagen and fat underneath the skin. Women are three times more likely to get this condition than are men. Typically, topical steroids are used to treat necrobiosis lipoidica diabeticorum. In more severe cases, cortisone injections may be required.

Vitiligo. Vitiligo refers to the development of white patches anywhere on the skin. It usually affects areas of skin that have been exposed to sun. It also appears in body folds, near moles or at the site of previous skin injury. The condition is permanent and there is no known cure or prevention. However, there are some treatments that can be used to improve the appearance of the skin, such as steroid creams and ultraviolet light therapy.