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

educational programs together with information about prod- ucts that should not be used on the skin (eg, harsh soaps or alcohol). high pH moisturizers reduce buffer capacity by washing away inherent buffering components in the skin.30 Skin surface pH influences skin barrier homeostasis, SC integrity and cohesion, and antimicrobial defense mechanisms.30 Moreover, soaps with a high pH can aggravate or predispose patients to candidal in- tertrigo that is more common in diabetics.30

Cleansing and moisturizer use may be an important measure to sustain skin pH at physiological levels in DM-affected skin, thus improving barrier function and skin condition. Consistent routine is also important in maintaining skin hydration and potentially reducing the risk for progression or complications of DFS.

CONCLUSION

• Skin disorders are common complications among diabe- tes patients, yet frequently underdiagnosed and usually neglected.

• Recognition and management of diabetes-related skin con- ditions are important in maximizing the patients’ quality of life and in avoiding bothersome symptoms and serious adverse effects.

• There is evidence suggesting that daily application of a ceramides-containing moisturizing skin care regime, particularly on compromised lower extremities, may control both pruritus and dry skin conditions.

• Optimal skin care using moisturizers is one of the measures that may help improve skin barrier dysfunction, preventing complications by providing early-stage treatment of patients with diabetes.

DISCLOSURE

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this supple- ment: This work was supported by an unrestricted educational grant from L’Oreal CeraVe USA.

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AUTHOR CORRESPONDENCE

Anneke Andriessen PhD anneke.a@tiscali.nl