5 Skin Diseases That May Leave Permanent Damage

Diabetes relates directly to multiple skin diseases. If left untreated, these can lead to permanent scarring of the skin surface.

Woman scratching her left elbow

Skin diseases can affect healthy people but are more prevalent in people with diabetes. These include rashes and bacterial and fungal infections, which affect up to 30% of people with diabetes. Type 2 diabetes, in particular, also doubles a person’s risk of developing psoriasis – a skin disease with symptoms like rashes and scaly patches on the trunk, scalp, knees, and elbows.

In Traditional Chinese Medicine (TCM), diabetes-related skin diseases stem from Lung Dryness, Stomach Heat, or Kidney Deficiency. These imbalances stop the skin from obtaining proper nourishment.

“Dehydration due to Lung dryness and Stomach Heat can chap skin and make you prone to skin allergies. Insufficient water intake can lead to Kidney Deficiency, provoking skin swelling and inflammation,” explains Eu Yan Sang physician Lee Shin Wei.

Read on to learn about these skin diseases and the steps to prevent indefinite skin scarring.

Necrobiosis Lipoidica Diabeticorum

Unhealthy eating can lead to obesity, which makes a person vulnerable to acanthosis nigricans over time.  

This rare skin disease usually develops in young or middle-aged adults and is three times more common in women than in men. Type 1 diabetes also makes a person more vulnerable to necrobiosis lipoidica diabeticorum than people with type 2 diabetes. 

It starts as plaque or a raised area of dull, red skin that normally develops on the lower part of the legs. Over time, it’ll turn yellowish-brown and shiny and have a violet-coloured border. The blood vessels under the skin may also become visible. It occurs due to collagen degeneration and inflammation associated with the thickening of blood vessel walls and fat disposition. 

Digital Sclerosis 

One-third of people with type 1 diabetes have digital sclerosis. The disease turns the skin on the back of the hands, toes, and forehead thick and wax-like. It can also stiffen finger joints, restricting them from moving as freely as they should. In some cases, the knees, ankles, and elbows can also become stiff. 

Acanthosis Nigricans 

Acanthosis nigricans is linked to diabetes and insulin resistance but can also arise from other underlying factors, such as: 

  • Cancer 
  • Obesity 
  • Genetics 
  • Medication use 
  • Supplement use (high dose niacin) 
  • Autoimmune disorders 
  • Endocrine disorders 

It generally presents as hyperpigmentation of the skin folds. The affected skin might be itchy, have an odour and develop skin tags. Examples are the groin, underarms, or back of the neck. Sometimes, it can also appear on the hands, elbows, and knees. Skin thickening in these areas may also happen. 

Diabetic Blisters 

It’s uncommon for people with diabetes to develop bullosis diabeticorum or diabetic bullae (better known as diabetic blisters). However, it can present in people during early-stage diabetes or as an effect of long-term diabetes in those who do not control blood sugar well.

The risk of diabetic blisters is higher among men with type 1 diabetes who are between 50 to 70 years of age. The sores can appear on the backs of a person’s fingers, hands, toes, feet, legs, or forearms. These can grow up to five centimetres but are painless.

Eruptive Xanthomatosis 

High fat, triglycerides and cholesterol levels increase a person’s risk of developing eruptive xanthomatosis. More often than not, it’s seen in people with uncontrolled type 1 diabetes. 

Eruptive xanthomatosis refers to yellow and firm pea-sized lumps that may itch and have redness around the affected area. Symptoms of this disease can occur on the back of the hands or the feet, arms, legs, and buttocks. 

Ways to Address Diabetes-Related Skin Diseases Before They Cause Scarring

Preventive measures can help a person avoid permanent skin damage. Apart from keeping blood sugar levels under control, start by reviewing your daily skincare routine and making the necessary changes. 

Maintain personal hygiene without abrasive skincare products 

Refrain from taking hot baths and showers. If your skin is dry, bubble baths too, are discouraged. Instead, use a moisturising soap and lotion. Take note not to rub it between the toes, as added moisture in the area encourages fungus growth.

A nurse applying sterile gauze to an elderly person’s hand
Minor wounds should be cleaned and dressed immediately for people with diabetes.

Treat injuries that don’t require extensive medical attention 

If you sustain a minor cut, wash it immediately with soap and water and cover it with sterile gauze. Deeper cuts, burns, or infections should only be treated by a clinical physician. 

Consume herbs that tackle the underlying causes of skin disease symptoms 

To alleviate skin-related symptoms, a person must first determine, together with a TCM physician, their stage of diabetes. Certain herbal formulations can help with easing symptoms so do consult your physician before taking any of these.

Early stage

During the early stage, diabetes will provoke Blood and Qi Stagnation, inducing Heat accumulation and making the skin itch. Hence, it’s advisable to use catnip (mao bo he, 猫薄荷), as it cleanses the body’s blood and qi, promotes a better flow of the latter and relieves itching.

Middle stage

As the disease progresses to the middle stage, Stagnation can bring about an abnormal metabolism and accumulation of bodily fluids, resulting in pus. As such, it’s recommended for people with diabetes to consume psyllium (yang che qian zi, 洋车前子), which can reduce blood sugar levels. Another herb that is effective in removing water is Plantago asiatica (che qian zi, 车前子), which is a diuretic.

Middle-stage diabetes also impairs sleep quality and sees a person potentially experience Heat Disturbing Mind and Heart syndrome and unbearable itching. Adding herbs like Poria (fu ling, 茯苓) and lotus seeds (lian zi, 莲子) to a person’s diet can have a calming effect on these specific disorders.

Late stage

Turbid pathogens can turn into Heat in the later stages of diabetes, causing your skin to become dry and itchy. These symptoms can worsen if you are exposed to heat or when night falls. It can be accompanied by dry stools, mouth dryness, or a bitter taste in the mouth. To correct symptoms of late-stage diabetes, nourish yin, and eliminate Heat, use Rehmannia (sheng di huang, 生地黄), dwarf lilyturf (mai dong, 麦冬), figwort root (xuan shen gen, 玄参根), and Kudzuvine root (ge gen, 葛根). 

An early diagnosis helps people identify the skin diseases related to diabetes and suitable interventions that’ll help ease their specific symptoms. Do bear in mind that the above herbal formulas are dependent on varying body constitutions. Speak to a TCM practitioner if you’re considering natural, alternative remedies and avoid self-medicating. In doing so, they’ll be able to advise you on the appropriate herbs to use and prevent contraindications.

References

  1. DermNet New Zealand. 2019. Skin problems associated with diabetes mellitus. [online] [Accessed 28 June 2022] 
  2. American Diabetes Association. Diabetes and Skin Complications. [online] [Accessed 28 June 2022] 
  3. DermNet New Zealand. 2021. Necrobiosis lipoidica. [online] [Accessed 28 June 2022] 
  4. US National Library of Medicine. 2022. Acanthosis Nigricans. [online] [Accessed 28 June 2022] 
  5. National Library of Medicine. 2022. Skin Manifestations of Diabetes Mellitus. [online] [Accessed 28 June 2022]

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