Most people with diabetes keep their attention on blood sugar numbers and diet — but the skin is actually the body's largest organ, and often the first place it sends out warning signals. Skin problems affect up to 80% of people with diabetes, and in some cases, the skin shows signs even before a diagnosis is made.1

What does skin have to do with blood sugar?

Persistently high blood sugar affects small blood vessels and nerves throughout the entire body — and the skin is no exception.3 When circulation to the skin deteriorates, it receives less nourishment and moisture. Think of it like a patch of land that goes without water for too long: it gradually dries out, starts to crack, and struggles to heal. At the same time, high blood sugar weakens the body's defences, making it easier for bacteria and fungi to take hold.1

Common skin problems in diabetes

The following conditions are particularly common among people with diabetes:

  • Dry, itchy skin (xerosis): The most widespread problem, and the most easily dismissed. Dry skin itches, cracks, and cracked skin becomes vulnerable to infection — a vicious cycle.4
  • Dark, velvety skin on the neck and underarms (acanthosis nigricans): A deepening of the skin colour with a velvety texture, typically appearing on the neck, underarms, or groin. This is an outward sign of insulin resistance and is often seen in people who are overweight or have prediabetes.3
  • Brown spots on the shins (diabetic dermopathy): Small, reddish-brown round patches that appear on the lower legs. They are painless and harmless — colloquially called "shin spots" — but they reflect the impact of diabetes on small skin blood vessels and suggest blood sugar control deserves attention.3
  • Fungal infections (such as athlete's foot, jock itch, or candida): High blood sugar creates an ideal environment for fungi to thrive.2
  • Bacterial infections (such as folliculitis or boils): With the body's defences lowered, wounds are more prone to bacterial infection — and take far longer to heal than in people without diabetes.1

A few principles for taking care of your skin

Both the American Academy of Dermatology and the American Diabetes Association recommend that people with diabetes carry out regular skin checks and develop the following habits:1

  • Use a gentle body wash when bathing, keep water temperature moderate, and apply moisturiser immediately after drying — paying special attention to the feet.
  • Choose moisturising products that contain urea or lactic acid, which help the skin retain moisture.1
  • Check both feet every day — including between the toes — for any cuts, blisters, or unusual changes.
  • Keeping blood sugar well controlled is the most fundamental way to prevent skin problems.3