“People whose diabetes is out of control have high blood sugar and they’re predisposed to getting infections,” says William D. James, MD, a dermatologist at Penn Medicine in Philadelphia. Living with type 2 diabetes means you may be at a higher risk for various skin ailments, such as psoriasis, vitiligo, and numerous fungal infections, some of which can affect the nails, according to a review published in January 2015 in the journal Clinical Diabetes. Foot infections are the most common type of skin infections and, if left untreated, can lead to hospitalization, amputation, and even death, noted a past article. High blood sugar can also increase the risk of neuropathy, a type of nerve damage that can lead to loss of sensation or feeling. People with diabetes have an increased risk for neuropathy, according to the National Institute for Diabetes and Digestive and Kidney Disease. So people with diabetes and neuropathy may not feel cuts in their skin and may not be aware that they have a problem with infection, says Warren R. Heymann, MD, head of the division of dermatology at Cooper Medical School of Rowan University in Camden and Marlton, New Jersey. Fortunately, there’s an easy way to make sure you’re doing what you need for your skin: Talk to a dermatologist. These specialists can help diagnose and treat skin disorders more common in people with diabetes, and they can work with you to develop a skin-care routine to help combat skin woes such as dry skin. Still not persuaded? Here are four good reasons to add a derm to your diabetes healthcare team:
1. A Dermatologist Will Help You Figure Out if You’re At Risk for a Skin Infection
Not only that, but Dr. James says a derm can help you stay on top of signs of infection. Dr. Heymann says: “It’s really important that people with diabetes pay attention to their skin because of the risk of infections.” Infections are the most common skin concern for people with diabetes, and bacterial infections are more common and severe for people with diabetes, according to the aforementioned Clinical Diabetes study. According to Medline Plus, people with diabetes are at increased risk for staph infections, which are sometimes difficult to treat because of increasing resistance to antibiotics. Fungal infections can happen in the genital area, folds of the skin, nails, and other areas. The fungi thrive in sugary environments, so elevated blood glucose can increase the risk of fungal infections. “The most important thing is to be vigilant for changes to your skin to prevent complications of cellulitus [infection of the skin] and poor wound healing,” says Heymann. RELATED: 11 Ways to Care for Your Feet if You Have Type 2 Diabetes
2. He or She Will Teach You How to Inspect and Take Care of Your Feet
A dermatologist can teach you how to inspect your feet to prevent ulcers, which are open sores. Open sores can become infected if you don’t feel or treat them. So inspecting your feet, or having someone else inspect your feet (if you can’t see down there), is a cornerstone of preventing problems, says James. “Feet are of paramount importance in diabetes,” says Heymann. “Not everyone looks carefully at their feet.” Talk to your healthcare team immediately, including your primary care physician, dermatologist, or other specialist, if you suspect an ulcer. Most can be treated easily if caught in time. Inspecting your feet for calluses around ulcers is also important, says James. Thick calluses can form around ulcers if you continue to walk on them and don’t feel them due to nerve damage. These big, thick calluses prevent ulcers from healing and can lead to further infection. A dermatologist can also teach you how to prevent and take care of thickened calluses on your heel, says James. He adds that these calluses may be a sign that shoes or socks don’t fit or that something else is wrong, Thickened heels can crack and these opened barriers of the skin are prone to infection. RELATED: 6 Neuropathy Complications and How They’re Treated
3. Your Derm Can Help You Develop a Routine to Prevent Dry Skin
A dermatologist is your partner in making sure your skin is not excessively dry, says Heymann. In the wintertime, many people experience dry skin, but dry skin can be tricky for people with diabetes. Dry skin is often itchy, and scratching can break the skin and open it to infection, says James. “Dermatologists can educate people about how to keep their skin from drying out and how to moisturize well,” says James. He says that some of the more common skin conditions, like acne and warts, are not any more prevalent in people with diabetes than people without diabetes. And again, keep in mind that psoriasis and diabetes can exist together, Warren says. RELATED: 8 Ways to Maintain Healthy Skin With Type 2 Diabetes
4. A Skin Specialist Can Diagnose Edema and Other Skin Disorders for You
People with diabetes are also at increased risk for edema, per a study published in May 2017 in the journal Diabetes Research and Clinical Practice. Edema is a condition in which fluids build up in the body and cause swelling. James says that this swelling in legs and feet can squash toes together, causing sweat and excess moisture in between toes. Between toes is a breeding ground for bacteria and fungi that can cause infection, says James. He adds that a bacterial infection can travel up the legs, damaging blood and lymph vessels and making edema worse. He recommends that people with diabetes dry well between their toes. Dermatologists can also help diagnose and treat skin disorders that are more common in people with diabetes, such as: Acanthosis Nigricans This skin condition causes a velvety, darkened appearance to skin, is common in obese people with high blood sugar, and could be a sign of undiagnosed diabetes, says Heymann. Diabetic Dermopathy In this condition, discoloration happens on the lower legs. A review published in the July–September 2014 issue of The British Journal of Diabetes and Vascular Disease suggested about 55 percent of people with diabetes have diabetic dermopathy. Yet a previous study, published in the Indian Journal of Dermatology, found that it occurs in less than 1 percent of people with well-controlled type 2 diabetes. Necrobiosis Lipoidica With this condition, people may experience thinner skin on their shins that predisposes them to ulcers that are difficult to heal, although it is rare and occurs in less than 1 percent of people with diabetes each year, per a case report published in July 2012 in the Indian Journal of Endocrinology and Metabolism. Bullous Diabeticorum Another rare condition, this occurs in less than 1 percent of people with diabetes. It can cause blisters that could cause infection when broken, says James. RELATED: How to Take Care of Chronic Nonhealing Wounds From Type 2 Diabetes
Why Seeing a Dermatologist Can Improve Your Diabetes Management
When you decide to see a dermatologist depends on your age, history of diabetes, and history of skin problems, says James. Learning how to care for your skin is important for people with diabetes, and having a dermatologist or, at the very least, a primary care doctor that you see regularly about skin conditions is helpful, he adds.
