Signs of skin infection are:

• Redness
• Itching
• Throbbing pain (pain my be absent, if the patient has developed peripheral neuropathy)
• Non-healing wound.

How Should a Diabetic Take Care of His Skin?

Diabetics should:

• Keep the skin clean. Persons with dry skin should use soap containing moisturisers.

• Dry off well after having a bath.

• Use talcum powder to prevent moisture in the folds of the skin, such as the groin, between the toes, under the breasts, and in armpits.

• Avoid very hot baths and showers if they have loss of sensation because they can easily burn themselves without knowing it.

• Prevent dry skin. Scratching dry, itchy skin can break the skin. Broken skin is prone to bacterial infections.

• Use moisturisers, in winters to prevent chapping of skin.

• Wear cotton underwear, which allows better circulation of air.

• Drink lots of water.

• Treat cuts quickly.

What is Diabetic Dermopathy?

Duiabetes Can hurt your feet and its effect on skin Taking Care of Diabetic Feet Common Diabetec Foot problems Signs of Foot Problems And steps Of Protecting Your Diabetic Feet Guide to Skin Care Habit For Diabetic Patient

It is a skin disorder found in up to 50% of male adults and 30% of female adults with diabetes. The lesions are round or oval. They are red or reddish brown in appearance and measure 1-3 inches. They usually occur on the thigh or shin region but may also appear on the scalp, forearm or trunk. There is no definite treatment and the lesions tend to disappear spontaneously after several years.

What is Necrobiosis Lipoidica Diabeticorum?

It is a skin condition usually on the lower part of the legs. The lesions can be small or large. The lesions are usually raised, yellow and waxy in appearance and often have a purple border. It is mostly seen in young women.

Steps on taking care of diabetic skin

# After you wash with a mild soap, make sure you rinse and dry yourself well. Check places where water can hide, such as under the arms, under the breasts, between the legs, and between the toes.

# Keep your skin moist by using a lotion or cream after you wash. Ask your doctor to suggest one.

# Drink lots of fluids, such as water, to keep your skin moist and healthy.

# Wear all-cotton underwear. Cotton allows air to move around your body better.

# Check your skin after you wash. Make sure you have no dry, red, or sore spots that might lead to an infection.

# Tell your doctor about any skin problems.

When Should the Doctor be Consulted?

Consult the doctor if there is:
• Redness, swelling, pus or pain that might indicate a bacterial infection
• Ringworm, vaginal itching or other signs of a fungal infection
• Blisters or bumps anywhere, especially on the backs of fingers, hands, toes, arms, legs or buttocks
• Rashes, bumps or pits near insulin injection sites.

Poor blood glucose (sugar) control increases risk for skin and foot infection. Nerve damage due to diabetes also makes you less likely to feel pain. If the foot or skin is injured, wounds may heal slowly. If the wound is not treated correctly, severe infection can lead to gangrene and amputation.

What Needs to Be Done?

Wash your feet and skin daily with nondrying soap. Test the water with your elbow instead of your hand or foot to make sure that it is not too hot. Pat yourself dry. Use lotion on your feet and skin, but not between your toes. Lotion between the toes helps bacteria to grow.

Inspect your feet and skin daily. Look for the following signs:

* Red spots
* Dry skin
* Calluses
* Flaking skin
* Cuts
* Ingrown nails

If you cannot see your entire foot, use a mirror, or have someone else look for you. Call the doctor if you are concerned about any wound. If the problem is serious, you may need to see a podiatrist, who specializes in foot care, or a dermatologist, who treats skin problems.

To Prevent Foot Injuries

* Never go barefoot, even for a short distance.
* Shop for shoes in the late afternoon, when your feet tend to be larger.
* Always wear comfortable shoes that have been broken in slowly.
* Wear flat shoes with good arch support and a wide toe base.
* Rarely, if ever, wear high-heeled shoes.
* Wear shoes made from leather with cotton socks.
* Shake out your shoes before you put them on, to remove any object that may have gotten into them, such as a pebble or tack.
* Cut toenails straight across, and file off rough edges. Have a podiatrist (foot doctor) or nurse trained in foot care do this if your nails are too thick to cut.
* Only have the doctor treat corns, calluses, or ingrown toenails. Never treat them yourself.
* Wear wool or cotton socks to keep your feet warm and dry. Throw away heating pads and hot water bottles. They could burn your feet and skin.
* Each time you see the doctor, take off your shoes and socks. Most of all, get your diabetes under good control. You may need help from your medical team with your meal plan, exercise, or diabetes medicine. All the foot and skin care in the world is worthless if you don’t manage your diabetes well.

Questions to Ask

1. Do I inspect my feet daily for wounds or infection?
2. Do I wash and care for my feet and skin properly?
3. Does my doctor examine my feet each time I visit?
4. Do I choose the right shoes?
5. Is there anything that I can do to improve my diabetes control?

Good skin care habits are important. When you have diabetes, you want to look good and stay healthy.

Here are a few tips for skin care.

1. Use a mild soap with warm or lukewarm water on a daily basis.
2. Dry yourself very well with a soft towel.
3. Use a skin softener, lotion, or cream on dry skin.
4. Use a mild powder such as baby powder after bathing.
5. Use a sunscreen to avoid sunburn. SPF 10-15 is best.
6. Avoid scratches, punctures, and other injuries to your skin.
7. If you do have an injury, take care of it as soon as possible. (See tips below for how to take care of an injury.)

Our skin is protection for our bodies.

Duiabetes Can hurt your feet and its effect on skin Taking Care of Diabetic Feet Common Diabetec Foot problems Signs of Foot Problems And steps Of Protecting Your Diabetic Feet Guide to Skin Care Habit For Diabetic Patient

A lifetime of healthy skin is very important, so please avoid these things on your skin:

1. Do not use strong or heavily perfumed soaps.
2. Do not let your skin become too dry. Dry skin cracks, making it easier for infection to start.
3. Do not use harsh lotions, or medicated or perfumed powder.
4. Do not stay in the hot sun too long.
5. Do not walk on hot sand or pavement without shoes.
6. Do not use a heating pad, hot water bottle, or very hot water.
7. Do not use iodine, boric acid, alcohol, or antiseptic lotions on a wound.

Sometimes we do get injured. Here are some tips to treat your wounds:

1. Take care of cuts or wounds as soon as possible.
2. Wash the area well with water.
3. Cover the wound with a dry, sterile pad or bandage.
4. Go to the clinic if cuts or bruises do not heal within 2 or 3 days.
5. Go to the clinic if you see any signs of infection.

Here are signs of infection:

* redness
* swelling
* warmth
* rash
* pain
* drainage

It’s helpful to understand why foot problems happen. Nerve damage can cause you to lose feeling in your feet. Sometimes nerve damage can deform or misshape your feet, causing pressure points that can turn into blisters, sores, or ulcers. Poor circulation can make these injuries slow to heal.

Signs of Foot Problems

Your feet may tingle, burn, or hurt. You may not be able to feel touch, heat, or cold very well. The shape of your feet can change over time. There may even be changes in the color and temperature of your feet. Some people lose hair on their toes, feet, and lower legs. The skin on your feet may be dry and cracked. Toenails may turn thick and yellow. Fungus infections can grow between your toes. Blisters, sores, ulcers, infected corns, and ingrown toenails need to be seen by your health care provider or foot doctor (podiatrist) right away.

Ask your health care provider to check your feet at least 4 times a year.

Check Your Feet Each Day

You may have serious foot problems yet feel no pain. Look at your feet every day to see if you have scratches, cracks, cuts, or blisters. Always check between your toes and on the bottoms of your feet. If you can’t bend over to see the bottoms of your feet, use a mirror that won’t break. If you can’t see well, ask a family member or friend to help you. Call your health care provider at once if you have a sore on your foot. Sores can get worse quickly.

Wash Your Feet Daily

Wash your feet every day. Dry them with care, especially between the toes. Don’t soak your feet—it can dry out your skin, and dry skin can lead to infections. Rub lotion or cream on the tops and bottoms of your feet—but not between your toes. Moisture between the toes will let germs grow that could cause an infection. Ask your health care provider for the name of a good lotion or cream.

Trim Your Toenails Carefully

Trim your toenails after you’ve washed and dried your feet—the nails will be softer and safer to cut. Trim the nails to follow the natural curve of your toes. Don’t cut into the corners. Use an emery board to smooth the edges.

If you can’t see well, or if your nails are thick or yellowed, get them trimmed by a foot doctor or another health care provider. Ask your health care provider for the name of a foot doctor. If you see redness around the nails, see your health care provider at once.

Treat Corns and Calluses Gently

Don’t cut corns and calluses. Ask your health care provider how to gently use a pumice stone to rub them. Don’t use razor blades, corn plasters, or liquid corn or callus removers—they can damage your skin.

Protect Your Feet from Heat and Cold

Hot water or hot surfaces are a danger to your feet. Before bathing, test the water with a bath thermometer (90F to 95F is safe) or with your elbow. Wear shoes and socks when you walk on hot surfaces, such as beaches or the pavement around swimming pools. In summer, be sure to use sunscreen on the tops of your feet.

Wear shoes to protect your feet from hot surfaces.

You also need to protect your feet from the cold. In winter, wear socks and footwear such as fleece-lined boots to protect your feet. If your feet are cold at night, wear socks. Don’t use hot water bottles, heating pads, or electric blankets—they can burn your feet. Don’t use strong antiseptic solutions or adhesive tape on your feet.

Always Wear Shoes and Socks

Duiabetes Can hurt your feet and its effect on skin Taking Care of Diabetic Feet Common Diabetec Foot problems Signs of Foot Problems And steps Of Protecting Your Diabetic Feet Guide to Skin Care Habit For Diabetic Patient

Wear shoes and socks at all times. Don’t walk barefoot—not even indoors.

Wear shoes that fit well and protect your feet. Don’t wear shoes that have plastic uppers, and don’t wear sandals with thongs between the toes. Ask your health care provider what types of shoes are good choices for you.

New shoes should be comfortable at the time you buy them—don’t expect them to stretch out. Slowly break in new shoes by wearing them only 1 or 2 hours a day.

Always wear socks or stockings with your shoes. Choose socks made of cotton or wool—they help keep your feet dry.

Before you put on your shoes each time, look and feel inside them. Check for any loose objects, nail points, torn linings, and rough areas—these can cause injuries. If your shoes aren’t smooth inside, wear other shoes.

Be Physically Active

Physical activity can help increase the circulation in your feet. There are many ways you can exercise your feet, even during times you’re not able to walk. Ask your health care team about things you can do to exercise your feet and legs.

1:- Corns and calluses are thick layers of skin caused by too much rubbing or pressure on the same spot. Corns and calluses can become infected.

2:- Blisters can form if shoes always rub the same spot. Wearing shoes that do not fit or wearing shoes without socks can cause blisters. Blisters can become infected.

3:- Ingrown toenails happen when an edge of the nail grows into the skin. The skin can get red and infected. Ingrown toenails can happen if you cut into the corners of your toenails when you trim them. If toenail edges are sharp, smooth them with an emery board. You can also get an ingrown toenail if your shoes are too tight.

4:- A bunion forms when your big toe slants toward the small toes and the place between the bones near the base of your big toe grows big. This spot can get red, sore, and infected. Bunions can form on one or both feet. Pointy shoes may cause bunions. Bunions often run in the family. Surgery can remove bunions.

5:- Plantar warts are caused by a virus. The warts usually form on the bottoms of the feet.

6:- Hammertoes form when a foot muscle gets weak. The weakness may be from diabetic nerve damage. The weakened muscle makes the tendons in the foot shorter and makes the toes curl under the feet. You may get sores on the bottoms of your feet and on the tops of your toes. The feet can change their shape. Hammertoes can cause problems with walking and finding shoes that fit well. Hammertoes can run in the family. Wearing shoes that are too short can also cause hammertoes.

7:- Dry and cracked skin can happen because the nerves in your legs and feet do not get the message to keep your skin soft and moist. Dry skin can become cracked and allow germs to enter. If your blood glucose is high, it feeds the germs and makes the infection worse.

8:- Athlete’s foot is a fungus that causes redness and cracking of the skin. It is itchy. The cracks between the toes allow germs to get under the skin. If your blood glucose is high, it feeds the germs and makes the infection worse. The infection can spread to the toenails and make them thick, yellow, and hard to cut.

Duiabetes Can hurt your feet and its effect on skin Taking Care of Diabetic Feet Common Diabetec Foot problems Signs of Foot Problems And steps Of Protecting Your Diabetic Feet Guide to Skin Care Habit For Diabetic Patient

All of these foot problems can be taken care of. Tell your doctor about any foot problem as soon as you see it.

Benefit of Special shoes for Diabetic Foot problems

Special shoes can be made to fit softly around your sore feet or feet that have changed shape. These special shoes help protect your feet. Medicare and other health insurance programs may pay for special shoes. Talk to your doctor about how and where to get them.

Do not soak your feet. Dry your feet well, especially between your toes

* Look at your feet every day to check for cuts, sores, blisters, redness, calluses, or other problems. Checking every day is even more important if you have nerve damage or poor blood flow. If you cannot bend over or pull your feet up to check them, use a mirror. If you cannot see well, ask someone else to check your feet.

* If your skin is dry, rub lotion on your feet after you wash and dry them. Do not put lotion between your toes

* File corns and calluses gently with an emery board or pumice stone. Do this after your bath or shower.

* Cut your toenails once a week or when needed. Cut toenails when they are soft from washing. Cut them to the shape of the toe and not too short. File the edges with an emery board.

* Always wear shoes or slippers to protect your feet from injuries.

* Always wear socks or stockings to avoid blisters. Do not wear socks or knee-high stockings that are too tight below your knee.

* Wear shoes that fit well. Shop for shoes at the end of the day when your feet are bigger. Break in shoes slowly. Wear them 1 to 2 hours each day for the first 1 to 2 weeks.

* Before putting your shoes on, feel the insides to make sure they have no sharp edges or objects that might injure your feet.

Taking Care of Diabetic Feet With Doctor’s help

Duiabetes Can hurt your feet and its effect on skin Taking Care of Diabetic Feet Common Diabetec Foot problems Signs of Foot Problems And steps Of Protecting Your Diabetic Feet Guide to Skin Care Habit For Diabetic Patient

* Tell your doctor right away about any foot problems.

* Ask your doctor to look at your feet at each diabetes checkup. To make sure your doctor checks your feet, take off your shoes and socks before your doctor comes into the room.

* Ask your doctor to check how well the nerves in your feet sense feeling.

* Ask your doctor to check how well blood is flowing to your legs and feet.

* Ask your doctor to show you the best way to trim your toenails. Ask what lotion or cream to use on your legs and feet.

* If you cannot cut your toenails or you have a foot problem, ask your doctor to send you to a foot doctor. A doctor who cares for feet is called a podiatrist (puh-DY-uh-trist).

1. Nerve damage. One problem is damage to nerves in your legs and feet. With damaged nerves, you might not feel pain, heat, or cold in your legs and feet. A sore or cut on your foot may get worse because you do not know it is there. This lack of feeling is caused by nerve damage, also called diabetic neuropathy (ne-ROP-uh-thee). It can lead to a large sore or infection.

2. Poor blood flow. The second problem happens when not enough blood flows to your legs and feet. Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral (puh-RIF-uh-rul) vascular disease. Smoking when you have diabetes makes blood flow problems much worse.

These two problems can work together to cause a foot problem.

Duiabetes Can hurt your feet and its effect on skin Taking Care of Diabetic Feet Common Diabetec Foot problems Signs of Foot Problems And steps Of Protecting Your Diabetic Feet Guide to Skin Care Habit For Diabetic Patient

For example, you get a blister from shoes that do not fit. You do not feel the pain from the blister because you have nerve damage in your foot. Next, the blister gets infected. If blood glucose is high, the extra glucose feeds the germs. Germs grow and the infection gets worse. Poor blood flow to your legs and feet can slow down healing. Once in a while a bad infection never heals. The infection might cause gangrene (GANG-green). If a person has gangrene, the skin and tissue around the sore die. The area becomes black and smelly.

To keep gangrene from spreading, a doctor may have to do surgery to cut off a toe, foot, or part of a leg. Cutting off a body part is called an amputation (amp-yoo-TAY-shun).

Effect of Diabetes on skin

Diabetes can hurt your skin in two ways:

1. If your blood glucose is high, your body loses fluid. With less fluid in your body, your skin can get dry. Dry skin can be itchy, causing you to scratch and make it sore. Also, dry skin can crack. Cracks allow germs to enter and cause infection. If your blood glucose is high, it feeds germs and makes infections worse. Skin can get dry on your legs, feet, elbows, and other places on your body.

2. Nerve damage can decrease the amount you sweat. Sweating helps keep your skin soft and moist. Decreased sweating in your feet and legs can cause dry skin.