If you live with type 2 diabetes, you’ve probably heard about symptoms and issues that can come up in your feet and your hands. However, diabetes can affect the rest of your body, including your skin.

If you’re noticing changes in your skin, they may or may not be related to diabetes. Understanding the possible connection can help you know what to watch for and when to seek care. If you think you might be experiencing any of these skin problems, talk to your doctor. They can help figure out what’s going on and create a treatment plan to help you feel your best and maintain a high quality of life.

How Blood Glucose Levels Affect the Skin

When your blood sugar levels are high and stay high for a long time, it can cause inflammation in your body. This is a normal immune system response, but when it doesn’t go away, it can damage various tissues in your body, including blood vessels. All of this can lead to drier skin, which can lead to a variety of skin problems. It can make you heal more slowly because your overall immune system response is weaker, which can lead to infections.

When it affects your skin, you may notice discoloration, rashes, other skin changes, or infections that heal slowly or not at all. If you notice any skin changes, it’s important to talk to a doctor right away.

If you have diabetic peripheral neuropathy, which is nerve damage caused by high blood sugar, you may lose feeling in your skin, especially in your feet. That can make it harder to notice small infections or areas of skin breakdown and treat them quickly.

Skin Problems Related to Diabetes

Many skin problems can be linked to diabetes. Most people don’t have all of them, but it helps to know what to watch for. These can show up on your legs, neck, trunk, and elsewhere on your body.

Skin Infections

Diabetes can put you at a higher risk for both bacterial and fungal infections. Bacterial infections usually involve skin inflammation, discoloration, swelling, and pain. They may take the form of styes in the eyelid, folliculitis (hair follicle infections), boils, or carbuncles (infections deep under the top layer of skin). Good skin care may help lower your risk, but getting these infections does not mean you have poor hygiene.

Fungal infections are usually caused by an overgrowth of a fungus called Candida albicans, which is similar to yeast. It tends to grow in moist, hot places on the body, like folds of skin. It can show up under the breasts, between any folds of skin, under your armpits, in the groin, and even under the foreskin of men who aren’t circumcised.

Jock itch, ringworm, athlete’s foot, and vaginal yeast infections are all examples of ways this can show up. You’ll see damp, discolored areas of skin that can itch a lot and may look like blisters or scales.

Dark, Velvety Skin Patches

You may see a dark patch of skin that feels almost like velvet. This is called acanthosis nigricans. It usually shows up in people who have a higher body weight, are diagnosed with obesity, or have developed insulin resistance. It may be a warning sign that blood sugar is high and that a person is living with diabetes or prediabetes. This skin condition is often found on the back of the neck and may be the first sign that someone needs to see a doctor about diabetes.

Red or Purple Shin Splotches

Sudden splotches on your shins can mean you’re experiencing necrobiosis lipoidica diabeticorum. Splotches usually look anywhere from red-brown to dark purple, depending on your skin tone. They grow slowly and may have waxy skin at the center of splotches that have grown together. Some may develop a purplish border, and you might be able to see blood vessels in the center of the splotches. If the splotches don’t break open, they may not need treatment.

Dark, Scaly Patches on the Shins

Dark, red, or brown spots on your shins can also be a sign of diabetic dermopathy, also known as shin spots. These may feel scaly at first and can leave dents if they last for a while. Many people think they look like age spots. They often fade once blood sugar levels are well managed, but this can take 18 to 24 months.

Hard, Tight, Thick Skin

If you have skin that becomes hardened and thickened, then seems to swell and get tight, it could be a sign of a condition called scleredema diabeticorum. It usually occurs somewhere on the upper back and can include the neck and shoulders, though it may show up anywhere except your hands and feet. This issue may occur even if your diabetes is under control.

Small, Yellow Bumps

Some people with diabetes develop eruptive xanthomatosis, where clusters of bumps appear, then seem to turn yellow or white in the center. They may be sore and can itch a lot. Each bump will end up roughly the size of a pea, feel firm, and may develop a red outline. They occur when you have very high triglyceride levels (a fat that’s in your blood).

Painless Blisters

If you have blisters that suddenly appear on your body, it may be bullosis diabeticorum, or diabetic blisters. It usually shows up in people who also live with neuropathy, or nerve damage, related to diabetes (diabetic neuropathy). These blisters can appear on your legs and arms, and will usually go away on their own, although it takes about three weeks.

Managing Your Skin and Diabetes

There are a few steps you can take to help prevent or manage diabetes-related skin problems:

• Check your skin every day — If you’re prone to certain diabetic skin conditions or need to check for infections, go over your skin every day in a mirror.
• Achieve and maintain blood sugar control — Your healthcare provider can help you do this in ways that are safe and manageable for you.
• Clean your skin and dry it anytime it gets wet — This helps avoid both dampness and dry skin.
• Balance your skin’s moisture level — You may need help from a healthcare professional to get the right moisturizer for your body and to understand your optimum moisture level.
• Get treatment for cuts and scrapes ASAP — You can do this at home if they’re minor, but you may want professional medical attention for anything more severe.

Your doctor can help you decide what is right for you and whether you need treatment.

If you notice a new skin change or a skin problem that won’t go away, talk to a doctor. They may refer you to a dermatologist, a doctor who specializes in skin conditions. Get medical help right away if you have a serious skin infection, especially one that is getting worse or not healing, because it can become life-threatening if left untreated.

Talk to Your Doctor

Your healthcare professional can help treat diabetes-related skin conditions and support you in managing your blood sugar to prevent further complications. If you have questions or notice new symptoms, contact your doctor. Ask your primary care provider to check the skin on your feet at each visit, including testing for any loss of sensation that could make you more prone to skin injury.

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