As if people with diabetes didn’t have enough to deal with, those managing this blood-glucose imbalance also face special skincare challenges. The small capillaries close to a diabetic’s skin often become narrowed, which slows circulation and makes skin more prone to problems. For instance, cuts and wounds can take longer to heal, hair grows more slowly, and feet and legs can develop irritating itchiness.
These troubles happen because the body either doesn’t produce enough insulin (type 1 diabetes) or doesn’t respond to the insulin it does produce (type 2 diabetes). If the disease is not managed correctly, the resulting levels of high blood sugar can cause—along with skin woes—nerve damage and increased risk of infections.
Even though type 1 and type 2 diabetes are different and therefore require different treatments, when it comes to how the skin is affected, there isn’t much difference between the disease types, says Leonid Poretsky, MD, and director of the Friedman Diabetes Institute in New York City. Type 1 diabetics just need to be extra careful around the insulin-injection site to prevent infection, since a skin puncture can easily attract unwanted bacteria. (For holistic ways to prevent the disease, see “Lower Your Diabetes Risk” on page 37.)
Thankfully, a simple routine and specialized products can help control common concerns while making skin feel better and look more beautiful. A balanced diet and regular exercise—vital components to any skin-treatment plan—can also really help a diabetic’s skin look its best. “Walking is one of the best things you can do for yourself,” Poretsky says. “That movement gets blood flowing in all extremities of the body to keep circulation problems at a minimum.”
High and dry
As winter weather approaches, diabetics must be extra cautious of overly dry skin, which can crack and invite infections. Diabetics should use a mild soap daily to avoid stripping the skin’s natural oils, then apply a light moisturizer (that contains very few ingredients) on the face and body. “Just avoid creams or lotions that leave a visible film on the skin,” says Debra Jaliman, MD, a dermatologist in New York City. “[Products with mineral oil or petrolatum] can limit the amount of oxygen that reaches the skin.” Look for simple creams that include glycerin, a humectant that binds with moisture on the skin.
Diabetic skin also tends to be super-sensitive, so products with added fragrances and color often intensify irritation. Synthetic scents and colors can also contain hidden hormone-disrupters like phthalates, which have been linked to reproductive-system damage and even liver cancer.
Diabetics should skip scrubs and peels, as well, unless they have a doctor’s approval. “Products designed to exfoliate skin can cause injury or infection to a patient with diabetes,” says Jaliman. Especially avoid scrubs with uneven particles like crushed seeds or shells, which can cause microtears on the skin’s surface.
Neuropathy, or damage of the nerves, is another side effect of diabetes. For reasons unknown to doctors, this condition particularly affects the feet. “Skin on healthy people’s feet is very sensitive—they’ll be able to feel the tiniest pebble—but someone with diabetes may not even feel if she has glass in her shoe,” Poretsky says.
For this reason, diabetics need to closely inspect their feet each day for injuries or cuts they may not have felt in order to treat them fast. Although the process may seem time-consuming, diabetes sufferers should transform this task into a daily ritual by soaking feet in warm (but not too hot) water and washing with a mild soap while checking for redness or irritation. Dry thoroughly, especially between toes, and massage in a moisturizer.