Diabetes and Dry Skin: Understanding the Connection and Finding Relief

If you live with diabetes, you may already know how important it is to take special care of your skin. But do you know why, exactly? Diabetes and dry skin can lead to an array of complications, including infection, open sores and slow wound healing. That said, with proper care, many of these conditions are preventable.

Diabetes and Dry Skin: What's the Connection?

High blood sugar causes the blood to become more viscous, meaning it's thicker and does not flow as easily through the smallest blood vessels in the body. Decreased circulation keeps blood from flowing to the extremities and skin, complicating diabetes-related skin problems. People with diabetes also have impaired sweat gland function, which can make dry skin worse.

Nerve endings become less sensitive when they don't receive adequate circulation (this condition is known as neuropathy), so an individual with diabetic neuropathy may not feel a new, painful wound, such as a blister on their foot. And when blood does not flow readily to the skin, wounds that develop do not heal as quickly.

Why Skin Care Matters for People With Diabetes

A daily, proactive skin care routine is essential for anyone with diabetes. Even a seemingly small cut or blister can quickly worsen. People with diabetes should be particularly mindful of checking their elbows, legs and feet — the most common places diabetic wounds form.

High blood sugar promotes the growth of bacteria and fungi, so individuals with diabetes are also more likely to develop bacterial or yeast infections in the skin and open wounds. Diabetes can cause other complicated skin conditions that may need treatment from a medical professional.

Protecting Your Skin

Follow these simple steps to protect your skin if you have diabetes.

• Maintain blood sugar control. If you have diabetes, work closely with your healthcare provider to maintain target blood sugar numbers. Simply keeping your blood glucose and hemoglobin A1C in range goes a long way to prevent skin complications. Take your medications as prescribed, exercise regularly and limit added sugars.

• Consider getting personalized nutrition advice. You may find this helpful to better control your blood glucose. Ask your healthcare provider to refer you to a certified diabetes care and education specialist or a registered dietitian with expertise in diabetes management.

• Moisturize. Apply a moisturizer daily, especially after showering, swimming or washing your hands. According to the American Academy of Dermatology Association, it's best to use a moisturizing cream or an ointment rather than a lotion, as they're more effective in healing dry skin. Dry skin from diabetes can become red and itchy, but don't give in to the temptation to scratch. Your skin is more likely to crack and bleed, leading to open sores that may be difficult to heal. That said, you'll want to avoid moisturizing between your toes to prevent infection.

• Go fragrance-free. Search for fragrance-free products, seeing as fragrances can irritate fragile or sensitive skin. Keep in mind that some "unscented" products contain a neutral fragrance to mask the odor of chemicals in the formula. Some lotions, like Gold Bond Ultimate Diabetics' Dry Skin Relief, are formulated specifically for individuals with diabetes.

• Check feet daily: You'll want to inspect your feet every day for discolored skin, swelling, scratches, blisters, sores and cuts. If you have a minor wound, treat it. For all other wounds, seek medical care.

• Mind your heels. Heels, in particular, can crack and form wounds. Creams with urea or lactic acid help to soften dry, hardened heels. Look for a product like O'Keeffe's for Healthy Feet Foot Cream, which is safe and effective at healing dry heels in individuals with diabetes.

• Pick up diabetic socks. Diabetic socks keep feet dry and protect them from friction better than other socks, preventing fungal infections and blisters.

• Trim your toenails regularly. Untrimmed toenails can scratch the skin of your foot, catch on socks or break unexpectedly. If you cannot trim your own toenails, ask a caregiver to assist you. Overgrown toenails can become thick and difficult to cut. A podiatrist can safely trim your toenails back to a manageable length.

• Bathe gently. Take baths or showers with warm — not hot — water. Hot water strips moisture from the skin. Keep in mind that diabetic neuropathy dulls sensation, so if you can't feel how hot the water is, you may risk burning your skin. Consider using a water thermometer to accurately test the temperature. Also, opt for a mild soap.

• Dry skin thoroughly. Pay special attention to skin folds and between the toes, which can retain moisture and become a breeding ground for fungal infections.

• Treat minor wounds promptly. If you develop a small cut or scrape, wash the area with soap and water and then apply a bandage. Use an antibacterial ointment only if your physician recommends it.

When You Should Seek Medical Care

If you have diabetes, don't skip routine skin checks. Dermatologists can diagnose and treat diabetes-related skin conditions and podiatrists can treat foot wounds and remove corns or callouses before they become open wounds. You may need a referral to a wound care specialist for slow-healing or complex wounds.

See a healthcare provider if you notice any of the following signs you have a skin condition that needs additional medical treatment:

• Yellow, brown or red patches may indicate the condition necrobiosis lipoidica, which can lead to complications if left untreated. This skin condition is rare and typically occurs in women. If it does develop, it can be itchy and painful.

• A dark, velvety-feeling patch of skin might be acanthosis nigricans. It usually appears on the neck, but it can also appear on the skin folds of the armpits and groin. It is a warning sign of elevated blood sugars and is sometimes the first sign of diabetes.

• Thick, hardened skin on the fingers and toes may be digital sclerosis. In advanced cases, this condition can affect the joints.

• Small, red bumps resembling pimples that turn yellow as they resolve are a sign of eruptive xanthomatosis. This condition is most common on the buttocks, thighs, elbows and knees, but it can occur anywhere on the body. Fortunately, they heal quickly when blood sugar is well controlled.

• Raised bumps that are red or the same color as your skin, called granuloma annulare, can show up whether or not you have diabetes. However, it can be an early warning sign of diabetes. For those who already have diabetes, it sometimes covers large areas of the body.

• Yellow, scaly patches around the eyelids, known as xanthelasma, are caused by excess fat buildup in the blood and may be a sign of poorly controlled diabetes.

Managing dry skin is not only about your comfort; it's also about safeguarding your health and well-being, especially if you have diabetes. The best way to keep dry skin at bay is to understand how your blood sugar levels affect your circulation and how your circulation affects your skin. Once you make the connections, it's a lot easier to make the best skin care choices.

Clinically reviewed on January 16, 2024