People with diabetes are more likely to have skin problems than the general population. A person with type 1 or type 2 diabetes has a 30 percent chance of developing a skin condition.

Because type 1 diabetes is an autoimmune disorder, it’s linked to other autoimmune disorders, including some that affect the skin. In addition, the long-term complications of any type of diabetes can set the stage for certain skin problems over time. These skin problems can also occur in type 2 diabetes. Here are some skin problems to keep on your radar.

1. Psoriasis

Psoriasis is an inflammatory skin disease that affects 60 million people globally. Type 1 diabetes and psoriasis frequently go hand in hand. Having one of these conditions puts you at a higher risk for the other.

Usually, psoriasis causes itchy plaques on the skin. An overactive immune system makes the skin cells grow faster and pile up in certain areas, such as the knees, elbows, and scalp. These plaques may appear shiny with silver or white-tinted scales. Certain subtypes of psoriasis may look different and produce pustules or other skin symptoms. Just like type 1 diabetes, psoriasis has autoimmune and genetic components.

There is no cure for psoriasis. Treatment aims to control the symptoms and reduce the risk of other conditions linked to psoriasis, including psoriatic arthritis.

2. Diabetic Stiff Skin

People who have had type 1 diabetes for several years are at an increased risk of a skin problem known as diabetic stiff skin or digital sclerosis. This condition makes it harder to bend your fingers because it thickens the skin on the back of the hands. The affected areas can also look yellowish and waxy.

Experts think diabetic stiff skin occurs because of a reaction between sugar and proteins in the skin. It affects 1 out of every 3 people with type 1 diabetes. Unfortunately, there’s no cure, but achieving tighter control of your blood glucose (sugar) levels can help.

3. Diabetic Dermopathy

Diabetic dermopathy (also known as diabetic shin spots) is the most common diabetes-related skin problem. It affects up to 70 percent of adults with diabetes and is caused by changes in the small blood vessels. People who have had diabetes for at least 10 years or have other complications of diabetes, like retinopathy (eye problems) or neuropathy (nerve problems), are more likely to develop diabetic dermopathy. The condition can be a sign that your hemoglobin A1c or blood glucose levels aren’t in the ideal range.

Symptoms usually develop on both shins. Lesions can also appear on the front of the thigh, forearms, scalp, side of the foot, or torso. The spots are round or oval-shaped and reddish or brown-colored. They’re sometimes mistaken for age spots. At first, diabetic dermopathy can cause raised markings, but eventually, they become flat or indented in the skin. The spots can also appear as a result of minor trauma, often ignored due to diabetic neuropathy.

There’s no treatment, but diabetic dermopathy itself isn’t harmful. The marks aren’t painful or itchy. Better blood glucose control may help the spots go away.

4. Skin Infections

People with diabetes need to be vigilant about caring for their skin. They may be more prone to dry skin. As a result, bacterial infections and fungal infections (like yeast infections) are more common in people with diabetes. Moisturizing the skin regularly helps to keep it healthy and strong.

If you suspect a skin infection, it’s important to seek treatment from your health care provider right away so you can get the right treatment before it gets worse.

5. Hives

Hives are an itchy inflammation of the skin. They are common, whether or not you have diabetes. They can range from tiny pea-sized spots to larger blotches the size of a dinner plate. Studies show that children with type 1 diabetes get hives more often than those without diabetes. Hives are caused by an immune system reaction.

Hives are usually short term, lasting less than six weeks. In some cases, they may come and go within just 24 hours. However, chronic hives that continue for more than six weeks may be related to an autoimmune reaction.

Allergies, insect bites, medications, foods, or infections can trigger hives. Mild cases may go away without treatment. Otherwise, your doctor may prescribe antihistamines, immunosuppressants, or corticosteroids.

6. Lupus Rash

Another autoimmune disorder associated with type 1 diabetes is systemic lupus erythematosus (SLE, the most common form of lupus). SLE can cause a wide range of symptoms, but one of the most common is inflammatory skin rashes. It’s tricky to diagnose lupus because the symptoms can mimic other diseases. As a result, people with lupus wait an average of six years from the time they first have symptoms until their doctor determines the cause.

One study estimated that 1.8 percent of people who have type 1 diabetes also have SLE. This rate is much higher than that seen in the general population — one study found that in North America, about 0.02 percent of people develop SLE.

According to the Lupus Foundation of America, 1 in every 3 people with lupus has at least one other autoimmune disease, such as type 1 diabetes. Ten percent of people with lupus have a specific type that only affects the skin, called cutaneous lupus. Rashes can be part of the disease for any type of lupus.

Finding the right treatment for lupus can be a challenge. Since there’s no cure, treatment aims to reduce the symptoms, regulate the immune system, and prevent organ damage. Multiple drugs can help with different aspects of the disease. For instance, your doctor may prescribe steroids, biologics, immunosuppressants, and anti-inflammatory drugs. Antimalarial drugs are used to prevent rashes and sun sensitivity.

7. Vitiligo

Vitiligo is another skin condition that’s more likely to occur in people with type 1 diabetes or other autoimmune disorders. People with vitiligo develop white patches of skin because their immune system destroys the type of skin cells that give it color. Usually, these changes start to happen early in life, either in childhood or before age 20. If you grow hair on the areas affected by vitiligo, it’ll turn white.

There’s no cure for vitiligo, but dermatologists can prescribe medications and therapies that help restore the skin’s color or slow the disease’s progression. Some people choose to cover vitiligo with makeup or tanning products. For those who have lost color on large areas of the body, treatment to remove color from the rest of the skin may be considered.

8. Lipodystrophy

Lipodystrophy is a disorder of adipose tissue, the bottom layer of the skin, and it’s one of the most common complications of subcutaneous (under-the-skin) insulin injections. Lipodystrophy may appear as lipohypertrophy or lipoatrophy.

Lipoatrophy is defined as a large, often deep, retracted scar on the skin that results from serious damage to fatty tissue beneath the skin. Lipohypertrophy appears as thickened, “rubbery” tissue swelling that’s generally firm, but in some cases, it can result in a soft lesion. This makes it easy to miss during a standard medical examination.

Lipodystrophy can happen for a couple of reasons:

• Insulin itself — The insulin you inject can promote the growth of fat cells.
• Injection habits — Not rotating your injection sites and reusing needles can damage the tissue.

Addressing lipodystrophy is important because it can interfere with how your body absorbs insulin. This can lead to unpredictable blood sugar levels, causing either very high or very low blood sugar unexpectedly.

Your health care team can help you correctly inject insulin and show you how to rotate injection sites to prevent and heal lipodystrophy. If you successfully adjust how you inject your insulin, your lipodystrophy should clear up within several weeks

Talk to Your Doctor

If you are concerned about your skin, talk to your diabetes care team. They can help you understand your risk factors for developing skin conditions. If you do show signs of an autoimmune condition like psoriasis or lupus, your diabetes care team can refer you to the appropriate specialist.

Connect With Others Who Understand

On myT1Dteam, the social network for people living with type 1 diabetes and their loved ones, more than 3,000 members come together to ask questions, give advice, and share their stories about their lives with diabetes.

Have you dealt with skin complications from diabetes? What skin disorders are part of your personal or family history? Share your experience below, or start a conversation by posting on your Activities page.