They say beauty is only skin deep. But dark patches, blisters, and blemishes often indicate a problem that reaches far beneath the surface. Skin problems may alert your doctor to the fact that you have diabetes before you have any other signs. And after you’re diagnosed with diabetes, continued skin problems may mean your condition isn’t under control. Fortunately, you can prevent many diabetes-related skin problems by keeping your blood sugar in check. Inspect the entire area of your skin regularly, and report any changes or concerns to your doctor right away. Dryness Starts a Harmful Cycle Diabetes makes people more prone to dry and itchy skin or infections. High blood sugar decreases the amount of fluid your body holds, leaving your skin parched and prickly. Nerve damage can also stifle your sweat response. As a result, your skin loses natural softness and moisture. You may notice dry skin first on your legs, feet, and elbows, but it can occur anywhere on your body. Scratching can produce cracks, creating a way for bacteria and other germs to enter. Bacteria and fungi can also invade the glands of your eyelids, your hair follicles, the area around your nails, the spaces between your fingers and toes, and your armpits or groin, among other sites. Harmful infections receive sustenance from blood sugar. Diabetics have generally weaker immune systems, making them less able to fight infections. Also, nerve damage and poor circulation slow tissue healing. As a result, people with diabetes often have more frequent and serious wounds and skin infections than people without the condition. Infected tissues often burn, appear red or swollen, itch, or form blisters or scales. Talk with your doctor if you spot any of these signs. You may need prescription medicines such as the antifungal drug Diflucan (fluconazole) to control an infection. Keep an Eye Out for Psoriasis Red, patchy, or flaky skin also may signify psoriasis—an inflammatory skin disease. This condition occurs when white blood cells mistakenly attack your skin instead of bacteria or viruses. People with psoriasis appear more likely to develop diabetes, and vice versa. The disease may not go away, but your doctor can recommend prescription medicines—including Neoral (cyclosporine), Dovonex (calcipotriene), and Vectical (calcitriol)—or over-the-counter creams to control symptoms. Recognize Diabetes-Related Skin Conditions Some types of skin conditions occur more frequently, or exclusively, in people with diabetes. Some disappear when you regain control of your blood sugar. Others require separate treatment. Some of the most common include: Acanthosis nigricans. Velvety, dark patches appear, most frequently on the back of your neck, in your armpits, or around your groin, and may be the first warning sign of pre-diabetes or diabetes. Overweight people are at greater risk. Losing extra pounds often clears your skin. Diabetic dermopathy. Changes to small blood vessels cause light brown scaly patches to form, often on the front of the legs. The patches don’t itch or hurt. A similar condition, necrobiosis lipoidica diabeticorum, causes larger spots that require treatment if they break open. Eruptive xanthomatosis. Blood fats called triglycerides form yellow, waxy bumps ringed by a red halo. They most frequently develop on your arms, legs, buttocks, feet, and the backs of your hands, and disappear when your diabetes is under control. Save Your Skin Work with your doctor to develop a skin care regimen that wards off these and other skin problems. Start by regularly washing with a mild soap. Rinse thoroughly and dry carefully. Don’t miss areas such as between your toes and under your breasts. Keep your skin moist by drinking plenty of water and applying lotion or cream regularly. Your doctor can suggest an appropriate formula. And wear cotton underwear so that air can move around your body. Key Takeaways Some types of skin conditions occur more frequently, or exclusively, in people with diabetes. They may disappear when you regain control of your blood sugar or require separate treatment. Diabetes makes people more prone to dry and itchy skin or infections, which can become serious. People with diabetes appear more likely to develop psoriasis. Work with your doctor to develop a skin care regimen tailored to you.