What Causes Dry, Itchy Diabetic Skin?

If you have diabetes, one side affect you might not have expected is itchy skin. Persistently high blood sugars are the cause, which can result in complications that can cause itching:

• Diabetic neuropathy
• Fungal growth
• Reduced blood circulation
• Severe dry skin

Diabetic neuropathy: High blood glucose levels can damage nerve fibers, particularly in the hands and feet, resulting in diabetic polyneuropathy or peripheral neuropathy. Even before nerve damage occurs, high levels of cytokines circulate in the body. They are inflammatory substances that can lead to itching. Persistent itchiness might indicate that a person with diabetes is at risk of nerve damage because of increased cytokine levels. Also, after neuropathy develops, many people also experience itching as a symptom. [1]

Poor circulation: Poor circulation also can cause skin itching. Diabetes can affect the lining of the blood vessels so they deliver blood and nutrients less efficiently. That can lead to diabetic neuropathy.  The legs are most vulnerable to decreased circulation.[2]

Fungal infections: Fungal infections, which create itchy rashes surrounded by tiny red blisters and scales, can develop among people with diabetes. The fungal infection, referred to as “Candida albicans,” is fueled by the excess sugar in the body. The fungus often can cause an extreme burning along with itchiness.[3] Areas that are moist, such as between fingers and toes, in moist folds in the skin, in the corners of your mouth, in armpits, can be prime areas for fungal infections

Severe dry skin: Dry skin causes itchiness, and results from too much glucose in the bloodstream. When this happens, the body will try to get rid of the glucose by pulling it from the cells and releasing it in urine. That way it can produce enough urine to remove the excess sugar. This can make skin itchy and dry. [4]  

High blood sugar also can damage the skin barrier, which makes someone more likely to itch in response to irritants. [5] Irritants can include, among other things, soaps, chemicals, and cosmetics.

Another cause of itching among diabetics is an adverse side effect or allergic reaction to a new medication.

Kidney or liver failure

It also is possible that dry, itchy skin is the result of kidney or liver failure, which are complications of diabetes. Kidney disease can cause some seriously itchy skin called uremic pruritus.  Pruritus is a term for itching and uremic refers to a high level of waste products in the blood because of poor kidney function.

Because not all itching is related to uremia, this condition is now called chronic kidney disease-associated pruritus (CKD-aP). It does not cause a rash, but the skin can become red and irritated from the constant scratching. [6]

Treating diabetic skin to

Taking good care of your skin, which means keeping it soft, calm, and free from infection, is a critical part of managing the disease. Here are things to do along with keeping you blood sugars under control, which will ultimately benefit your skin.

• Avoid hot showers, since hot water can remove moisture from the skin. Dry off well after your shower, especially in areas prone to building up moisture,
• Do not apply lotion between toes since moisture can attract fungi.
• Use a mild, moisturizing soap. Avoid soaps and other body products that contain fragrances, colors and other additives that may affect your skin.
• Apply skin lotion while skin is still damp after a bath or shower.
• Avoid scratching if you can since scratching can create openings in the skin where bacteria can enter.

If you are not getting relief from itching after a few weeks, see your doctor. Your doctor will examine dry or patchy skin to see if diabetes is the cause or if you have some other underlying skin condition that requires prescribed medication.

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[1] Nall, Rachel, “Does diabetes cause itching,” Medical News Today, January 20, 2024. https://www.medicalnewstoday.com/articles/diabetes-and-itching

[2]  LeBrun, Nancy, “Can Itching Be a Symptom of Diabetes?” verywell health, April 2, 2024. https://www.verywellhealth.com/diabetes-and-itching-6455835

[3] Nall, Rachel, “Does diabetes cause itching”

[4] “Diabetes and Your Skin,” CDC, Accessed June 28, 2024. https://www.cdc.gov/diabetes/signs-symptoms/diabetes-and-your-skin.html

[6] Weasler, Patty, RN, BSN, “Can Kidney Disease Cause Rashes and Itchy Skin,” verywell health, May 10, 2024. https://www.verywellhealth.com/rash-kidney-disease-itchy-skin-5272591