Diabetes Rashes and Infections: How Diabetes Can Change Your Skin

Diabetes affects many parts of the body. But, did you know that it can also affect your skin? Your skin can often indicate health issues, and not just those you see on the surface. People with diabetes can experience several skin problems. These include itching, infections, and other skin changes.

We’ll review some skin-related complications that can happen with diabetes and provide tips on how people with diabetes can care for their skin. 

Why do people with diabetes get rashes?

Diabetes affects almost 40 million people in the U.S. Both Type 1 and Type 2 diabetes lead to high levels of sugar (glucose) in the blood. High levels of sugar directly damage skin cells and prevent them from functioning properly. This leads to skin inflammation, dryness, and poor healing. 

Diabetes Center

Written by Sophie Vergnaud, MD

When we talk about “managing” diabetes, it means keeping blood sugar levels in a safe range. Many people manage their diabetes with medications and lifestyle changes like diet and exercise.

People with high blood sugars are at a higher risk for skin problems. One study showed that 94% of people with Type 1 diabetes who didn’t have their blood sugar managed had some kind of skin problem. 

Pictures of diabetic rashes and related skin conditions

Diabetes can be associated with several different skin changes. Here are pictures of some of the most common diabetes rashes. Keep in mind that these rashes aren’t always associated with diabetes. They can happen with other conditions and sometimes aren’t related to any other conditions at all. 

Dry skin (xerosis)

Dry skin happens when your skin doesn’t have enough water. This can lead to skin that’s itchy and feels rough. Dry skin is often flaky or scaly, which can look ashy in darker skin tones. Dry skin is common in people with diabetes — over 60% of people with diabetes have dry skin.

Dry skin is often scaly and flaky, and can look ashy in darker skin tones.

A person experiences dry skin on the leg.

Acanthosis nigricans

Acanthosis nigricans causes thickened and darkened skin patches. They are often described as having a “velvety” appearance. It’s more common in darker skin tones and it usually affects skin creases, like the neck, armpits, groin, and under the breasts. Some studies show that about a third of people with diabetes have acanthosis nigricans. 

Acanthosis nigricans usually affects skin creases, like the neck.

Acanthosis nigricans affects the skin in the armpit.

Diabetic dermopathy

Diabetic dermopathy causes spots on the shins that are reddish-brown and flat — eventually they become indented. This is very common, affecting up to 30% of people with diabetes.  

Diabetic dermopathy causes reddish-brown spots on the shins.

Diabetic dermopathy causes brown patches on the leg.

Skin tags (acrochordons) 

Skin tags are common, soft, noncancerous skin growths. They usually grow on a thin piece of skin called a stalk and are most common in skin folds (like the neck, armpits, and groin). People with multiple skin tags are almost twice as likely to develop diabetes than people without skin tags. 

A skin tag usually grows on a thin piece of skin.

Several skin tags cover a person’s neck.

Granuloma annulare

Granuloma annulare causes smooth, firm, and circular lesions that are widespread throughout the body. They’re red, pink, or brown in color and can be itchy. People with granuloma annulare are more likely to have diabetes.

Several spots of granuloma annulare cover a person’s back.

A person has granuloma annulare spots on the hand and knee.

Vitiligo 

Vitiligo causes white patches of skin (skin without pigment), especially in areas of friction or rubbing. Some studies show that 12% of people with diabetes will develop vitiligo. However, vitiligo can also occur with other autoimmune conditions.

Vitiligo on the hand shows up as white patches of skin.

A person has vitiligo around the eye.

Other diabetes rashes

Here are some other rashes that may be associated with diabetes: 

• Diabetic bullae: These are painless blisters on the toes and feet that come and go. There’s no redness.

• Necrobiosis lipoidica: These are thickening changes to the skin that are yellow, pink, or brown in color and usually appear on the shins. They aren’t painful or itchy. In rare cases, they progress to ulcers and skin cancer.

• Scleredema diabeticorum: This is a thickening of the skin on the neck, back, and back of the hands. It limits movement and usually occurs in people with a long history of diabetes. 

What other skin changes can a person with diabetes expect?

Diabetes can change the skin in other ways that may not show up in a rash. Here are some common ways.  

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Infections

Infections occur in at least 20% of people with diabetes. The most common are fungal infections of the skin, including candidiasis. Bacterial infections are also common, especially in areas of injury. It’s important to know how to prevent infections if you have diabetes. 

Poor healing

Diabetes affects the skin’s ability to heal. And any wound can become infected during the healing process. If you do get an infection, it’s important to treat it because infection can spread inside the body and cause sepsis. 

Diabetes also affects the nerves, especially those of the feet. People with diabetes often lose sensation in their feet, making it difficult to feel pain. Pain is one signal to protect your body. Without pain, many people with diabetes don’t know they have a wound, which can lead to chronic sores (like foot ulcers). This is why it’s important for people with diabetes to regularly examine their feet, both at home and in a healthcare professional’s office. Protective shoes can also help prevent foot wounds and infections. 

How can you prevent skin rashes if you have diabetes?

The main way to treat diabetes skin conditions is to keep your blood sugar levels within the normal range. You can do this through nutritious and balanced eating, physical activity, and oftentimes medications. 

The other main way to help diabetic skin is hydration. Urea is a natural ingredient made in the liver that’s a wonderful hydration tool. Experts often recommend products with urea to lock moisture in the skin. Urea also increases the fats, or lipids, in the skin. These lipids act like barriers to protect the skin’s moisture. If you have diabetes, experts recommend nightly use of creams with at least 10% urea on your legs, feet, and hands.

Since diabetes affects how wounds heal, it’s important to prevent and check for wounds. Daily self-exams of the feet can help catch early tears or wounds and prevent infection. Podiatrists are doctors who specialize in taking care of feet. Podiatrists can help build custom insoles and protective shoes for people with diabetes. These types of shoes can prevent wounds and infections. 

EXPERT PICKS: WHAT TO READ NEXT

• Tips for managing diabetes: From exercise to embracing humor, there are steps you can take to manage your diabetes.  

• Living with diabetes: Read how one woman let go of fear and took control of her health after being diagnosed with diabetes. 

• What is HbA1c? Learn about this important lab test and how to interpret your results.

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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