1. How can a dermatologist aid the medical team treating a person with diabetes?

Dermatologists provide unique expertise on the skin manifestations of diabetes and can provide targeted therapies and skin care recommendations to optimize skin health. Numerous skin conditions arise in the setting of diabetes, and a dermatologist can assist patients with optimizing skin care practices to treat and prevent skin complications.

 

2.  When should someone see a dermatologist, instead of their diabetes physician?

Diabetes is a complicated medical condition that affects almost every part of the body, including the skin. Given the myriad of complications associated with diabetes, a collaborative team of specialists is often required to address the unique needs of diabetic patients, and a dermatologist should be included anytime persistent skin conditions arise. Blistering or ulceration in particular should prompt consultation with a dermatologist to prevent further complications.

 

3. Is it common for you to see a patient with a skin condition who does not know they have diabetes? 

Dermatologists may be the first line in helping detect and diagnose diabetes. Skin changes such as acanthosis nigricans, presenting as velvety, brown pigmented patches around the neck and armpits may be the first warning signs of diabetes. If these changes are seen, a blood test can be ordered to screen for diabetes. Early diagnosis and detection of diabetes leads to improved outcomes. Total body skin exams from Pinnacle Dermatology are an important way to detect early changes that could signal diabetes.

 

4. What skin regimens do you recommend that a person with diabetes maintain?

Patients with diabetes are particularly prone to dry skin. A daily skincare routine is important to minimize the impact of dry skin leading to itch and eczema. There are several steps patients with diabetes can take to minimize the impact of dry skin. The most important part of a diabetic skin care routine is the use of a fragrance-free moisturizer daily to help restore and maintain the skin barrier. Other steps to reduce skin dryness include shortening showers and lowering the water temperature from hot to warm. The longer and hotter the water exposure, the dryer the skin becomes. Furthermore, patients should limit the use of soap to the armpits and groin on a daily basis. The use of soap or bodywash daily on the rest of the body exacerbates dryness and can contribute to worsening itch or eczema.

Patients with diabetes are also prone to ulcers, which can lead to infections. The most common location for neuropathic ulcers is the foot. Routine foot exams by a dermatologist, and the patient, are important to aid in the detection of early sores or ulcers that may be otherwise masked by diabetic neuropathy. Early detection and management of ulcers leads to improved skin health, and reduced infection risk.

 

5. November is National Skin Care Month. What is the “latest” in skin care that you emphasize with your patients?

The most important part of any skin care routine is wearing a sunscreen daily on the face, rain or shine, summer or winter. Even if a patient is largely limited to indoor activities or driving, UV exposure passes through windows, which can contribute to skin cancer development and premature aging. Sunscreens have improved dramatically over the past few years and are more cosmetically elegant than in the past. A dermatologist can help you select the ideal sunscreen for your skin. The newest innovation in sunscreen is the formulation of mineral based, tinted powdered sunscreens that allow for simple, quick application.