IF YOU are diabetic, you are more likely to develop skin problems, especially if your blood glucose level is high.
Fungal infections in persons with diabetes are often caused by the yeast called Candida Albicans (or thrush). These infections occur in warm, moist areas of the body, largely under skin folds. Problem areas are in the mouth, under the breasts, between the toes and under the nails. The corners of the mouth are also affected, especially in persons who have dentures. Under the foreskin is a commonly-affected site as are the armpits, groin and vagina.
The fungal infections present as itchy rashes that appear as moist, red areas surrounded by tiny blisters, scales and red spots. Other fungal infections including athlete's foot, ringworm of the body and Candidal infection of the vagina tend to occur more often in diabetics.
Bacterial infections, which are common in persons with diabetes, include styes, which are infections of the glands of the eyelids, and boils or carbuncles, which are infections of the hair follicles. Infected tissues are usually hot, swollen, red and painful.
Infections are also common around the fingernails where bacterial and combined fungal and bacterial infections are common. Localised itching may also occur in persons with diabetes. The causes may be due to bacterial infection, fungal infection, dry skin or poor circulation. Poor circulation, which is a consequence of poorly-controlled blood sugar, results in skin that is starved for oxygen and nutrients. This skin is likely to be dry, scaly and itchy. Often this affects the lower limbs.
Dry skin loses its suppleness and cracks easily. These cracks may be microscopic but result in the skin being easily irritated by external factors such as changes in the climate, synthetic fabrics in clothing and harsh substances such as detergents, some soaps and perfumed skin care products applied to the skin. Scratching the itchy skin triggers more itching and may result in infections and ulcers.
Thickening and narrowing of the arteries or atherosclerosis often affects diabetics at a younger age than is usual. The blood flow in these vessels is reduced again resulting in the skin being deprived of oxygen and nutrients. The skin becomes hairless, cool and shiny. In more severe cases it becomes thickened, scaly, itchy and dark in colour. Often this occurs on the legs and the formation of sores is a frequent outcome. Because the blood carries the infection-fighting white blood cells the affected legs heal very slowly and even minor scrapes may become sores. Diabetics also frequently have nerve damage in the lower limb or foot and consequently do not feel that part of the body. They may therefore be more prone to injury. There are many things that diabetics can do to reduce the likelihood of skin problems:
Keep your blood glucose levels under careful control.
Keep the skin clean and dry. Use absorbent powders in areas where the skin rubs together.
Avoid hot baths and showers. Use moisturising soaps. Apply a good moisturiser within a few minutes of bathing, especially on the legs.
Prevent dry skin.
Use moisturisers as often
as necessary to stop skin from
getting dry.
Avoid scratching the skin. Rub in a moisturiser instead.
Treat cuts promptly. Wash with mild soap and water, dry gently and apply an antibiotic cream or ointment. Cover with gauze. Seek medical care for large or deep wounds.
Take good care of feet. Check daily for sores and cuts. Ensure that footwear is well fitting and especially not too tight.
Treat any skin problem promptly.
Dr. Clive Anderson is a Dermatologist and Venereologist.
