Expert-reviewed by Ashwini S.Kanade, Registered Dietician and Certified Diabetes Educator with 17 years of experience
Skin diseases are a common, yet commonly ignored, a complication of diabetes. Approximately 30% of people with diabetes have a skin disease.  And for 1 in 5 people, a visit to a dermatologist because of a skin disease leads to the diagnosis of diabetes.  Skincare is important in diabetes, and medical help for any disease should be sought sooner rather than later, lest the condition becomes difficult to treat. As with most complications of diabetes, strict management of blood sugar goes a long way in both preventing the skin complications and reducing their severity/duration.
How does diabetes cause skin disease?
High levels of blood glucose (hyperglycemia), which leads to high insulin levels in the bloodstream, as well as relatively lower immunity, both contribute to skin disorders in people with diabetes.
What types of skin diseases can occur?
People with diabetes are more prone to infections in general, and skin is no exception. The most common (about 40%) skin condition associated with diabetes is an infection, including (bacterial and fungal) infections of the genitals. 
2. Skin tags:
Skin tags are small, soft skin growths, usually found on the neck, back, and trunk.  They often occur in people with high blood sugar and in those with a higher body mass index (BMI). They can be found in individuals with prediabetes (fasting blood glucose 110 to 125 mg/dL) as well.
3. Acanthosis nigricans:
It is a condition in which a part of the skin in/around the folds—such as the neck and armpits—becomes hyperpigmented and develops a velvety texture. Although this is often found in overweight individuals, it is related to increased insulin levels (for example, due to hyperglycemia). Acanthosis nigricans too can be found in individuals with prediabetes. It is slightly more common in females. Weight loss and physical activity, along with blood sugar management, may somewhat reverse the condition.
4. Dry skin (xerosis):
Another commonly ignored complication of diabetes is dry skin. Depending on the climatic condition (e.g. dry, cold climates), it can occur in as many as 44% of people with diabetes.
5. Shin spots (diabetic dermopathy):
Shin spots are among the most common skin diseases found in diabetes. These are small, roundish, dull-red patches on the skin below the knee. They are strongly indicative of diabetes, and as many as 55% of people with diabetes, particularly men, have them. In some cases, they may be caused due to some medications (such as antimalarials).
Almost half of the diabetic population has generalised itching, particularly on the trunk and around the genitals. People with diabetes who smoke may have an even higher tendency to itch than those who don’t smoke.  It may be related to high blood sugar levels.
7. Facial reddening (Rubeosis faciei):
Reddening of the face is another common, but often ignored, skin manifestation of diabetes mellitus, and is worsened by high blood pressure. This condition reflects poor management of sugar levels, although it is less noticeable in individuals with a darker complexion.
What should I do if I have one of the skin conditions?
If you have any of the skin conditions mentioned above, you should consult a doctor and get checked for diabetes. The risk is higher if you have higher than average body weight and/or someone in your family has diabetes. Some of these conditions, particularly skin tags and hyperpigmentation around skin folds, can be seen even in patients with prediabetes, which helps in diagnosing the disease, and starting its treatment, early.
High blood pressure and other diabetic complications may co-occur with skin diseases in people with diabetes. If you have a diabetes-related skin condition, you should get your blood pressure checked as well as ask your doctor for blood tests to assess the proper functioning of your organs.
How can I prevent diabetes-related skin diseases?
If you don’t have any of the skin diseases, but you have diabetes or someone in your family does, you should check your skin regularly—for example, while taking a bath—for any changes (rash, patches, growths, increased or decreased pigmentation, etc.) in your skin (even those not mentioned above). This will help in early diagnosis as well as better control of your blood sugar.
Strict sugar management, weight loss and low to moderate carbohydrate consumption will help keep your insulin levels in check, thereby preventing the skin conditions (as well as many other complications of diabetes). Eat a diabetes-friendly diet, and avoid smoking.
- Goyal A, Raina S, Kaushal SS, Mahajan V, Sharma NL. Pattern of cutaneous manifestations in diabetes mellitus. Indian J Dermatol. 2010;55(1):39.
- Vahora R, Thakkar S, Marfatia Y. Skin, a mirror reflecting diabetes mellitus: A longitudinal study in a tertiary care hospital in Gujarat. Indian J Endocrinol Metab. 2013;17(4):659.
- Bustan RS, Wasim D, Yderstræde KB, Bygum A. Specific skin signs as a cutaneous marker of diabetes mellitus and the prediabetic state–a systematic review. Dan Med J. 2017;64(1):5316.