Diabetic Skin Changes Can Benefit from Moisturizer and Cleanser Use: A Review

December 2019 | Volume 18 | Issue 12 | Original Article | 1211 | Copyright © December 2019

Robert S. Kirsner MD PhD,a Gil Yosipovitch MD FAAD,b Shasa Hu MD FAAD,cAnneke Andriessen PhD,d Jason R. Hanft DPM FACFAS,e Paul J. Kim DMP MS,fLawrence Lavery DPM MPH,g Luigi Meneghini MD MBA,h Lee C. Ruotsi MD ABWMS CWS-P UHMi

aUniversity of Miami Hospital Wound Center and Chief of Dermatology, University of Miami Hospital, Miami, FL;
Harvey Blank Chair in Dermatology, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery,
University of Miami Miller School of Medicine, Miami, FL
bMiami Itch Center, Miami, FL; Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery,
University of Miami Miller School of Medicine, Miami, FL
cDr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL;
Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Sylvester Comprehensive Cancer Center, Miami, FL
dAndriessen Consultants, Malden, Netherlands, and Radboud University Nijmegen Medical Centre, Netherlands
ePodiatric Surgery Specialist, Foot & Ankle Institute of South Florida, South Miami, FL; South Miami Hospital, South Miami, FL
fMedStar Plastic & Reconstructive Surgery, MedStar Health Inc., Washington, DC;
Georgetown University School of Medicine, Washington, DC
gUT Southwestern’s Comprehensive Wound Care Center, Dallas, TX; Plastic Surgery, Orthopaedic Surgery,
and Physical Medicine & Rehabilitation, UT Southwestern Medical Center, Dallas, TX
hGlobal Diabetes Program, Parkland Health and Hospital System, Dallas, TX; Internal Medicine,
University of Texas Southwestern Medical Center, Division of Endocrinology, Dallas, TX
iCatholic Health Advanced Wound Healing Centers, Buffalo, NY

Abstract
INTRODUCTION: Diabetes mellitus (DM) associated skin changes, which may be the first sign of DM in undiagnosed patients. Frequently these patients present with dry skin, which may benefit from the use of gentle cleansers and moisturizers. A review paper was developed to explore DM-associated skin changes and possible benefits of cleanser and moisturizer use.

METHODS: For this purpose, an expert panel of physicians involved in the care of patients with DM selected information from literature searches coupled with expert opinions and experience of the panel.

RESULTS: A defective skin barrier predisposes the skin to water loss leading to dryness, hyperkeratosis and inflammation. Skin changes that may benefit from the use of gentle cleansers and moisturizers are, amongst others, diabetic foot syndrome, ichthyosiform skin changes, xerosis, and keratosis pilaris. Adherence to treatment is a considerable challenge making education essential, especially about the need to keep skin clean and what skin care to use. Specifically designed diabetic skin care that contains anti-aging ingredients, urea, and essential ceramides, has demonstrated benefits for dry/itchy skin.

CONCLUSIONS: Skin disorders are common complications among either diabetic patients with patients with DM and may lead to serious adverse events. Evidence suggests that daily application of optimal skin care using gentle cleansers and moisturizers is one of the measures that may help improve skin barrier dysfunction, preventing complications by providing early-stage treatment of patients with diabetes.

J Drugs Dermatol. 2019;18(12):1211-1217.

INTRODUCTION

Diabetes mellitus (DM) is a common and debilitating disease that also affects the skin. Thirty percent (30%) to 70% of patients with DM have associated skin diseases. The severity of skin disease may vary, ranging from benign to deforming to life-threatening.1 These diabetic skin changes may allow insight into patients’ glycemic control and may be the first signs of DM in undiagnosed patients.2 Recognition and management of DM-related skin conditions are im- portant in maximizing patients’ quality of life and in avoiding serious complications.2

Maintaining an intact skin barrier by preventing and treating skin dryness may improve skin conditions in patients with diabetes.3 Currently gentle cleansers and moisturizers are un-