The Impact of Stress from Diabetes on Your Skin

Having chronic illnesses like diabetes can be very stressful. With the right care and overtime, other ailments may go away. But a chronic illness like diabetes is something you will deal with for the rest of your life, especially if you have Type 1. Potentially, Type 2 diabetes can go into remission, but still, you will have to manage it throughout your lifetime.

A global survey conducted by the International Diabetes Federation (IDF) released in 2024 found that 77% of people living with diabetes have experienced anxiety, depression, or another mental health condition because of their diabetes. The fear of developing complications (83%) was the most common factor impacting mental well-being. Other factors include daily diabetes management (76%), stigma and discrimination (58%) and fear of needles (55%).[1]

Stress and skin problems

Stress and skin problems can go together. Research studies have found that both acute and chronic stress can have a negative impact on the overall wellness of your skin. Stress also can worsen skin conditions, according to Harvard Health. Furthermore, Harvard reports that clinical studies in healthy people have found that psychological stress can also disrupt the epidermal barrier and prolong its repair. The epidermal barrier is the top layer of the skin that locks in moisture and protects us from harmful microbes. An intact epidermal barrier is essential for healthy skin. When the epidermal barrier is disrupted, it can lead to irritated skin, as well as chronic skin conditions including eczema, psoriasis, or wounds.[2]

Connection between diabetes, stress, and skin conditions

There are several skin complications associated with diabetes, and stress, as indicated above, can exacerbate these problems in the following ways:

Bacterial and fungal infections

The primary stress hormone is cortisol, which increases glucose levels, making it harder to manage diabetes. High blood sugar increases the risk of bacterial infections. Bacterial infections can lead to swollen, red, and painful skin, which requires antibiotics for treatment. Common bacterial infections caused by diabetes include:[3]

·         Styes (infections of the glands of the eyelid)

·         Boils

·         Folliculitis (infections of hair follicles)

·         Carbuncles (deep skin infections and the tissue underneath

·         Infections around the nails

Stress also can make you more vulnerable to fungal skin infections. Candida albicans is a fungal infection that can develop in people who have diabetes. It is a yeast-like fungus that can create itchy rashes of moist, red areas surrounded by tiny blisters and scales. Common fungal infections include athlete’s foot, ringworm, and vaginal infections.[4]

Delay in wound healing

Studies indicate that psychological stress can lead to clinically relevant delays in wound healing.[5] Poor blood circulation resulting from diabetes, compounded by stress, can slow wound healing. This can impact the healing of diabetic ulcers particularly on the feet, increasing the risk of infection.

Since peripheral neuropathy can cause numbness, someone with diabetes might not feel a foot injury, cut or even a blister, which can turn into an open wound or ulcer. Diabetic foot ulceration is full-thickness penetration of the dermis (middle layer of skin) of the foot in a person. Once peripheral neuropathy develops, the annual incidence of ulcer formation increases from less than 1% to greater than 7%.[6]

Inflammation

Researchers have found that chronic psychological stress is associated with the body losing its ability to regulate the inflammatory response.[7] Stress-induced inflammation worsens conditions already prevalent in diabetic individuals, such as Acanthosis nigricans (AN), which is a skin condition characterized by darkening and thickening of the skin that occurs mainly in the folds of the skin

Increased risk of Diabetic Dermopathy

Uncontrolled diabetes often leads to poor circulation, which can be impacted by stress. Over time, poor circulation can reduce the body’s wound-healing abilities. Diabetic dermopathy is characterized by small, brownish spots on the skin, often on the shin, which have been linked to leg injuries.  Because poor circulation to the area around an injury prevents a wound from healing properly, bruise-like lesions or spots can develop. [8]

Dry, itchy skin

High blood glucose levels may cause greater loss of fluid from the body leading to dry skin on the legs, elbows, feet, and other areas. A weakened skin barrier, which can be caused by stress (as noted above), contributes to the dry skin problem. Dry skin makes you more susceptible to cracks and fissures, providing entry points for infection.

To treat dry skin, you will want to look for a moisturizer developed specifically to relieve and protect dry, cracked skin associated with diabetes, such as EASE-Z Diabetics’ Dry Skin Therapy Lotion and Dry Skin Therapy Foot Cream. The over-the-counter offerings uniquely feature active Zinc Acetate to provide relief and protection. The products are unscented and non-greasy for added comfort.

Impact on self-care

In looking at stress and skin conditions, stress often disrupts self-care routines, leading to:

·         Skipping moisturizers or failing to monitor wounds or infections.

·         Poor blood sugar management, further exacerbating skin issues.

Manage stress to protect diabetic skin

While some stress will always be with you, there are ways to manage and reduce it to prevent stress and skin problems:

·         Talk to your health care providers about your feelings: Once you acknowledge your distress, talk to your doctor, nurse, diabetes educator and any other health care providers who are part of your care and treatment. They can help solve your concerns and may suggest other health care providers who can help.

·         Try to remain positive: It is easy to focus on the negative when things challenge or trouble you. But it is important to find good in each area of your life. Focusing on the good can boost your spirits during troubled times.

·         Talk to friends and family: Your friends and family can be a major source of help in relieving stress. Be open with them about your feelings and let them know when you need them to help you.

·         Exercise daily: Exercise is a great way to reduce stress. The American Diabetes Association recommends getting 150 minutes of exercise a week.

·         Try meditation: When you meditate you focus your attention and clear your mind of thoughts to give you a sense of calm and peace and achieve balance.

It is normal to feel stressed about having a chronic condition. Develop a plan of action to keep your stress under control so that it does not result in other health problems, including the range of potential issues associated with stress and skin.