Diabetes Rash: What Does It Look Like?

Diabetes can cause skin conditions and rashes. In some cases, they can be a first sign of the metabolic disorder. In addition to causing new skin problems, type 2 diabetes can also worsen existing issues.

In this article, we’ll discuss what diabetes skin rashes can look like, causes, how to treat them, and the connection with bacterial and fungal infections. We’ll also discuss lifestyle changes and how to know when you should see a medical provider.

Why Does Diabetes Cause Skin Problems?

Type 2 diabetes is a chronic disorder that impacts how the body uses blood glucose and how it responds to insulin. Diabetes can lead to skin problems because it can lead to changes in small blood vessels that are near the surface of the skin.

When blood sugar levels are not controlled, diabetes can also cause skin-related symptoms as cells throughout the body may not be able to repair as quickly due to poor nutrient transfer. Diabetes can also worsen blood circulation, which can make wounds or skin injuries take longer to heal.

What Is a Diabetes Rash?

Diabetes rash can refer to several skin conditions that may be associated with diabetes, but the most common is acanthosis nigricans. This  is a common condition associated with diabetes. It leads to slightly darker, velvety patches of skin that form in the neck, armpits, groin, or other folds of skin. It can also appear in people who have prediabetes or who have not yet been diagnosed with diabetes.

Diabetes rash can also refer to shin spots known as diabetic dermopathy. This condition is often mistaken for age spots, but it occurs in people who have diabetes, primarily on the legs.

What it looks like

Diabetes rashes can look different depending on the person’s skin color, their overall skin health and appearance, and how severe the diabetes is. Diabetic dermopathy looks like light or dark brown round scaly patches on the shins. They may look unappealing, but they do not require treatment and are not contagious.

Acanthosis nigricans leads to slightly darker skin that appears to be discolored. It may feel soft or velvety to the touch. It is common in people who have obesity, and may appear before someone can be diagnosed with diabetes. It is not contagious, cannot spread, and does not require treatment.

Causes

In people who have not been diagnosed with diabetes, the appearance of a skin rash or changes to the skin can be a first sign of blood sugar problems. Rashes that are common in diabetes are usually caused by high blood glucose levels and may also be worsened by overweight or obesity.

How to treat it

Diabetes skin rashes do not require treatment on their own as they are not contagious. Weight loss and controlling blood sugar levels will often resolve acanthosis nigricans. Diabetic dermopathy spots will often fade on their own, although it may take months or years. You cannot clear existing spots, but controlling blood glucose levels and managing health can prevent new spots from forming.

Diabetes and Infections

Diabetes can cause skin rashes, but it can also lead to extremely dry, itchy skin, as well as poor wound healing when the skin does become damaged. Because blood glucose levels can affect many aspects of health, if blood sugar stays too high or diabetes is uncontrolled, it can suppress the immune system, which can lead to a decreased healing response from white blood cells. This can lead to more frequent infections or a longer healing time.

Diabetes also affects circulation, which can decrease how well red blood cells or white blood cells can be transported through the body. This can lead to a delayed healing response and increased susceptibility to bacterial or fungal infections.

Bacterial infections

The skin gets exposed to bacteria as a normal part of life, but the barrier function in healthy individuals is effective at preventing infections. When glucose levels are high and immune cells cannot rapidly respond to bacteria that enters the body through the skin, it can result in infections that can be hard to treat.

Common bacterial skin infections that can occur in diabetes include:

• Cellulitis
• Deep tissue infections
• Diabetic foot infections
• Styes
• Folliculitis
• Carbuncles

Because the immune system may be compromised in people who have diabetes, antibiotic treatments may be less effective at treating bacteria, or may lead to secondary fungal infections as a result of microbiome changes from antibiotic treatment.

Fungal infections

Athlete’s foot, yeast infections, ringworm, and other skin fungal infections may happen more frequently in people who have diabetes. Fungi can thrive under nails, on the scalp, and in folds of the skin. If the immune system is compromised from hyperglycemia, the body may have a harder time fighting fungal infections and medications may take longer to work. Fungal infections can also recur.

Treatment Options

Treating diabetes-related skin conditions and infections is important to prevent complications. Treatment depends on the specific type of infection and other aspects of a person’s medical history.

Over-the-counter remedies

While there are bacterial over-the-counter products like neosporin and bacitracin, bacterial skin infections typically require prescription antibiotic treatment. In people who have diabetes, it is especially important to promptly and thoroughly treat any bacterial infections to prevent complications. If you are prescribed antibiotics for a skin infection, always complete the full course, since stopping prematurely could lead to a resurgence in the infection and make the bacteria resistant to the next round of treatment. Antibiotic resistance is a serious global public health threat.

For fungal infections, OTC remedies may be effective for athlete’s foot, ringworm, yeast infections, and others. But if you have diabetes, you should still let your medical provider know. They may have you use over-the-counter treatments for a longer period of time, or may prescribe a treatment that is a higher dosage or potency. Fungal infections can be difficult to clear in people who have diabetes.

Prescription medications

If you have a bacterial or fungal skin infection, there are effective prescription treatment options.

Common medications include:

• Antibiotics like erythromycin, tetracycline, dicloxacillin, and others
• Antifungal drugs like itraconazole, fluconazole, and others

Lifestyle changes

Bacterial and fungal skin infections are more common in people who have uncontrolled diabetes. Lifestyle changes that keep blood sugar in balance can play a significant role in decreasing the risk of skin infections. These may include:

• Getting regular physical activity
• Eating a nutritious diet that is rich in fiber and low fat
• Staying properly hydrated
• Focusing on losing weight
• Practicing good hygiene to keep skin clean and clear
• Maintaining proper first aid and wound care practices to prevent skin infections from worsening
• Taking prescribed medications for diabetes or other health conditions as directed

When to See a Medical Provider

If you notice new changes to your skin’s appearance, consult a healthcare provider. They can assess the rash or change to your skin, and refer you to a dermatologist if needed. If your skin changes are consistent with a diabetes rash, a healthcare provider may run simple lab tests to check blood glucose levels and other basic metabolic functions.

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