So, Samson has really dry skin. Like, really, really dry, leathery knees and his arms are also dry and patchy. We’ve been moisturizing his knees twice a day but they’re still rough. My other two kids have the typical baby-soft skin of childhood. We even took him to the doctor to rule out things like psoriasis and eczema, since they just looked so thick and rough. (Luckily, that’s not what it is.)
I guess what I’m wondering is – is that related to diabetes? Has anyone else noticed this?
And if so, is it a sign of the underlying damage he’s sustaining due to erratic blood sugar or the underlying autoimmune disease?
I’d think it’s most likely a sign of dehydration. Most diabetics are more prone to dehydration unless blood sugars are in non-diabetic range, and it’s really hard to compensate for systemic dehydration’s effects on the skin with external treatments. Does he have any other signs of being a bit dehydrated, like somewhat concentrated urine, pale colored tongue, etc? Might try seeing if you can get him to drink more fluids and if that does the trick.
He doesn’t have any other symptoms of dehydration. His tongue is normal, his pee is usually just a light yellow. We do try to get him to drink fluids but he’s pretty opinionated on whether he’s thirsty or not.
My son also has dry skin problems that started around the time of diagnosis. So I don’t think you are a crazy, and while I don’t know if it is underlying damage or anything like that, we have found that moisturizing helps, but of course doesn’t cure the problem. We really like the Gold Bond Diabetic moisturizer.
When I was a kid (post-diagnosis) I also had dryness and itchiness in my elbows and arms. I was never tested for eczema (is that a thing?), but used eczema lotion which helped a lot. I had the dry and itchiness for a few years (I think until age 10). Recently, the dryness and itchiness has returned (though I’m much more in control than ever) and have been using Gold Bond eczema cream that’s done a great job relieving symptoms when applied.
There’s a whole rundown on diabetic skin conditions below, but know that roughly 40% of people with diabetes (including me) have plain-old dry skin – fancy name, xerosis. Which is why so many skin creams are targeted at diabetics.
He’s probably too young to see a pumice stone as anything except a punishment, but maybe be liberal with heavy-duty moisturizers.
Thick, dry, leathery skin can also run in families. Does an ancestor on either side have this problem?
I have had some trouble with dry skin on my feet as far back as I remember. I moisturize after I shower and use a pumice stone occasionally (though I’m not sure that’s recommended for people with D). As long as I do that, it’s fine. If I don’t, they just run a little dry, but I don’t think they’ve ever cracked to the point of bleeding. My bg levels are in range more than they used to be, and I think it’s gotten better as they got better.
In my case, I don’t think the dry skin is an indication of nerve problems because my doctor checks my nerves on my feet every time I go. I have read that a lack of perspiration can result from nerve problems though. I think the dry skin on my feet is likely due to the fact that my bg levels run higher sometimes and the moisture is directed elsewhere during those times. It’s certainly possible that I do have minor nerve problems, but I’d like to think that I don’t.
Dr. Bernstein talks about this problem in his book. He recommends a few different substances to moisturize, and of course, he recommends working toward non-D bg levels.
So, follow-up: Do you think those rare few people who, say, get a beta cell transplant and and are on immunosuppressants no longer have dry skin? I guess I’m just curious about what is causing it, or whether we know…
I have problems with dry skin, too. I also have atopic dermatitis (eczema) that at times has been severe, so it’s hard to tell how much of an issue I’d have without that. I developed eczema as an adult, though I did have very sensitive skin as a kid (reacted to a lot of makeup and skin products), but don’t remember if I had dry skin specifically.
I do agree with others that I often seem to be in a mild state of dehydration. Even those of us with good diabetes control are having way more high blood sugar episodes than people without diabetes, so I think this is likely the cause rather than any sort of autoimmune damage. I do think in my case the combination of allergies, thyroid issues, and diabetes complicates the dry skin and dry eyes issues I have.
I use moisturizers but the only one I’ve been able to tolerate without either stinging like crazy or making me itchy is CaraVe cream. I also need steroid creams not infrequently, but that’s more of an eczema thing. I use Flexitol Heel Balm on my heels, which are the driest part of my skin, and that stuff works very well if I actually remember to apply it twice a day.
“People with diabetes are prone to dry skin, particularly when blood glucose levels run high. This causes the body to lose fluids and skin to become dry. Dry skin can crack and itch, which can lead to infections. You may also get dry skin with diabetes if you have neuropathy. The nerves in the legs and feet may not get the message to sweat, which is necessary to keep skin soft and moist. Keeping your skin moisturized when you have diabetes is one of the easiest ways to prevent skin problems.”
I recall reading in Dr. B’s book that he believes everyone (or the majority of) with diabetes has pssoriasis. I went to look for the page number and what I was recalling wasn’t in the book. He said it in one of his videos:
Session 44. Psoriasis - Dr. Bernstein’s Diabetes University.
In Session 44 of Diabetes University, Dr. Bernstein discusses psoriasis - a condition common to virtually all diabetics.
@TiaG Like many have mentioned, keep Samson hydrated and moisturized. Limit the number of baths he takes with soap, that further dries the skin. I prefer using Aveno bath products.
Sigh. Well, this is a depressing thread. I know keeping him moisturized is important but I was kind of hoping it was unrelated to his underlying disease process…like that it wasn’t correlated with complications at all.
This is a good point—a reason why pee might look normal even if moisture levels aren’t enough for skin, since the reason diabetics become dehydrated is to flush out excess sugar.
I have somewhat dry skin for what it’s worth, although it’s somewhat hidden by my skin’s increased elasticity. My brother though, who is non-diabetic and likely has the same connective tissue disorder, never has to moisturize, and I do.
As I understand it: 1) most lotions simply create a barrier of fat/oil to seal in moisture; 2) most pumice like agents remove the dead/damaged skin; and 3) very few topicals actually treat the skin cells. As I understand it, urea does all 3. I have used a urea based lotion, all over with great success, for years after after it was recommended by a podiatrist. He said AT LEAST 20% UREA. Gold Bond lists urea as an ingredient, but doesn’t give a % (a quick online search said 10%, but I saw no source I’d call irrefutably reputable)
“Urea appears to be a highly-active small molecule regulator of genes that impact keratinocyte differentiation, lipid synthesis and antimicrobial peptide production, together leading to improved permeability barrier function and likely antimicrobial defense as well.”
@TiaG don’t depress yourself quite yet. I am the 1 diabetic in the family, and I have the best skin. My mother and sister are constantly applying lotions and potions and going to the dermatologist for this skin problem or that.
I have also never had psoriasis. Don’t ignore the differences in individuals and genetics, even if his siblings have no issues.