Diabetes and itchy skin

Many of us experience dry, itchy skin in the winter. This can be caused by a combination of low humidity with cold winter air, taking hot showers, failing to use an appropriate moisturizer, etc. People with diabetes mellitus have additional challenges. Many people are familiar with the term diabetic peripheral neuropathy - burning, numbness, pain and pins and needles that can occur in the lower extremities. This type of neuropathy involves the sensory nerves, producing the aforementioned symptoms. Neuropathy can also involve the autonomic nervous system, causing a decrease in the body’s of ability to perspire. This can lead to excessive dryness of the skin.

While dry, itchy skin is a nuisance for many of us it can take on additional importance in the diabetic. Dry skin does not have the same type of elasticity or resiliency that normally hydrated skin has. This can lead to cracks in the skin. In an individual with diabetes who already has compromised sensation and immune function this can lead to infections which could be potentially limb or life-threatening.

People with diabetes can help reduce these risks with simple steps. First and foremost is adequate glycemic control. Working with your primary care physician or endocrinologist to understand and control the disease can help prevent dry skin as well as bigger problems in the future such as ulceration, infection, amputation, reduced kidney function and loss of vision due to diabetic retinopathy. Additionally, the individual with diabetes can manage dry skin by avoiding long, excessively hot showers which have the effect of drying the skin. Applying a moisturizer after bathing can be very useful. A simple moisturizer without fragrance or alcohol (which can irritate the skin) is best. Consider using a humidifier in your home. Lastly, inspecting the skin each day and contacting your health care provider if any open or sore areas are noticed is of vital importance.

James R Hanna, DPM, FACFAS