Skin Care for Diabetes: Infections, Dry Skin and Foot Care

Diabetes affects the skin in several ways: it makes bacterial and fungal infections more likely, causes dry and itchy skin, can produce dark velvety patches on the neck and armpits, and, through nerve damage and poor circulation, puts the feet at risk of wounds and ulcers. Keeping blood sugar under control, caring for the skin gently every day and checking your feet daily are the most effective ways to prevent problems.

India has one of the largest numbers of people living with diabetes in the world, and many people first learn they have diabetes because of a skin problem such as repeated fungal infections or boils. This guide covers what to watch for and what you can do at home.

How does diabetes affect the skin?

The American Diabetes Association (ADA) explains that people with high glucose levels tend to have dry skin and a reduced ability to fend off harmful bacteria, and both increase the risk of infection. Over time, diabetes can also damage nerves and small blood vessels, which affects how the skin feels, heals and is supplied with blood.

Some skin problems can happen to anyone but are more common or more severe with diabetes, while others are seen mainly in people with diabetes.

Which skin problems are common in diabetes?

Problem	What it looks like	Where
Fungal infections	Itchy, red, moist rash, sometimes with tiny blisters and scales at the edge	Groin, under the breasts, between toes and fingers, around nails, corners of the mouth
Bacterial infections	Boils, styes, infected hair follicles, infections around the nails	Anywhere
Dry, itchy skin	Rough, scaly skin, often worst on the lower legs	Legs, feet, arms
Acanthosis nigricans	Dark, thick, velvety skin	Back of the neck, armpits, groin
Skin tags	Small, soft, skin coloured growths	Neck, eyelids, armpits, groin
Diabetic dermopathy (shin spots)	Round or oval light brown, scaly spots	Shins
Foot ulcers	Open sores that heal slowly	Soles, toes, pressure points

The American Academy of Dermatology (AAD) also lists less common signs such as necrobiosis lipoidica (reddish brown or purplish patches on the shins), scleredema (hard, thickened skin on the upper back and neck), eruptive xanthomas (sudden crops of yellowish bumps) and xanthelasma (yellowish patches on the eyelids).

Fungal and yeast infections

The ADA notes that yeast infections in diabetes often occur in warm, moist folds of skin, such as under the breasts, between the fingers and toes, in the armpits and groin, and at the corners of the mouth. In India’s heat and humidity these can be stubborn. See our guides on fungal infections and ringworm, skin fold rashes and nail fungus.

Bacterial infections

The ADA lists styes, boils, infections of hair follicles, carbuncles and infections around the nails. Our article on boils and recurrent boils explains how to care for them and when they need a doctor.

Dark velvety patches

The AAD notes that acanthosis nigricans can be a sign of prediabetes, often linked to insulin resistance. It does not go away with scrubbing or bleaching creams. Read our guide on dark underarms and acanthosis nigricans.

Can a skin sign be the first clue to diabetes?

Yes. According to the AAD, several skin signs can appear before diabetes is diagnosed or when it is poorly controlled, including dark velvety patches, many skin tags, frequent infections such as oral thrush or vaginal yeast infections, and sudden crops of yellowish bumps. If you notice these, ask your doctor about a blood sugar test, especially if you have a family history of diabetes, are overweight or have PCOS.

How should I care for my skin every day with diabetes?

Practical steps based on ADA advice:

• Keep your blood sugar within the targets your doctor sets. This is the single most important step for skin health
• Bathe with lukewarm water, not very hot water, and use a mild soap or soap free cleanser
• Dry carefully, especially in skin folds, between the toes and under the breasts
• Moisturise daily after bathing, but not between the toes
• Treat cuts promptly. Wash minor cuts with soap and water and cover with a clean dressing. Avoid harsh antiseptics on broken skin unless advised
• Wear loose, breathable cotton clothes and change out of sweaty clothes
• Avoid scratching. Itching from dry skin, yeast or poor circulation can break the skin and invite infection. Our guide on itching all over the body explains other causes
• Do not self treat with steroid or combination creams for rashes, which can worsen fungal infections

How do I look after my feet?

DermNet explains that peripheral neuropathy (nerve damage) develops in about half of adults with diabetes, so cuts, blisters and pressure on the feet may not be felt. Poor circulation then slows healing, which is why small foot injuries can turn into ulcers.

A simple daily foot routine:

1. Check your feet every day, including the soles and between the toes. Use a mirror or ask a family member if you cannot see well
2. Wash feet daily in lukewarm water. Test the water with your elbow, not your foot
3. Dry well between the toes
4. Moisturise the tops and soles, not between the toes, to prevent cracked heels. See our guide on dry skin and cracked heels
5. Cut toenails straight across and file sharp edges. If you cannot do this safely, ask for help
6. Never walk barefoot, including at home, in temples or on hot surfaces and sand
7. Wear well fitting, soft footwear with socks. Check inside shoes for stones before wearing them
8. Do not cut corns or calluses yourself or use corn plasters with acids
9. Avoid hot water bottles, heating pads or sitting too close to a fire or heater, as you may not feel a burn
10. Have your feet examined by your doctor regularly

DermNet lists good diabetes control, regular examination of at risk feet, careful toenail trimming and appropriate footwear as key prevention measures.

When should I see a doctor urgently?

Seek medical care the same day if you notice:

• An open sore, blister or wound on the foot that is not healing, as the AAD advises contacting your doctor right away
• Redness, warmth, swelling or pus around a wound
• A foot that changes colour, becomes cold, or is suddenly very painful or numb
• A boil or infection with fever or feeling unwell
• A black area of skin on the toes or foot

If someone with diabetes has a spreading infection with high fever, confusion, extreme drowsiness or breathlessness, call 112 or 108 for an ambulance in India.

When to see a dermatologist

See a dermatologist or your diabetes doctor if:

• You have itching, rashes or fungal infections that keep coming back
• You get repeated boils or skin infections
• You notice dark velvety patches or many new skin tags
• You have spots, patches or yellowish bumps on the shins, eyelids or elsewhere
• Your skin is very dry and cracked despite moisturising
• You have nail changes, thick toenails or ingrown nails

Foot wounds, spreading redness and fever need an in person examination first. For ongoing rashes, itching and skin changes, Dr. Maria offers online consultations where you can share photos and discuss a skin care plan that fits alongside your diabetes treatment.