Caring for Diabetic Skin

If you are diabetic, you may find that wounds heal more slowly because diabetes reduces blood flow to specific areas, especially the feet and legs. Even worse, the nerves often do not function as they should, so you may not even know you have a foot injury. Within a short period of time, a minor foot injury can become infected, leading to gangrene, which requires an amputation.

You must be extremely careful at all times in regard to the care of your feet. You should check your feet every day, using a mirror to see the heel, sides, and sole of your foot. If you still cannot see certain spots, have another person help you. Watch for any swelling, area of redness, cuts, or bruises. Wash your feet carefully in warm water each day. Test the water in the bathtub with your elbow before placing your feet in the water. You may suffer a serious burn if you accidentally place your feet in water that is too hot. Since the diabetic foot has poor circulation and cannot detect burning temperatures, never use any heat product on the foot, such as heating pads, hot water bottles, or electric blankets.

Following the bath or shower, allow your feet to air-dry or gently pat them dry with a soft towel rather than using a forced-air blow dryer. Trim the toenails by cutting straight across, not angling them down at the edges. Trim them often enough so that no nail becomes long enough to cut an adjacent toe. You should file each nail smooth after cutting.

Never walk barefoot, whether indoors or outdoors. You may step on a tack, nail, or piece of glass and carry it in the foot for several days before detecting it. Choose house slippers with hard soles rather than thin rubber soles or fabric soles, such as moccasins. For outdoor use, avoid plastic or vinyl shoes, which are less flexible than others; canvas and leather shoes stretch better and allow the foot to breathe. New shoes should only be worn for short periods until they are broken in. Check carefully for red spots while breaking them in. You should always wear good socks (i.e., cotton) to prevent foot damage, and replace them if they develop a hole. If you try to mend them, the mended area may cause undue pressure on the foot.

Several nonprescription products normally applied to the skin for minor healthcare conditions pose special dangers to the diabetic patient and must never be used. For instance, people with plantar or common warts may choose topical salicylic acid medications or plasters that slowly dissolve the wart. However, they are not safe for the diabetic, since they create an artificial wound that may not heal. Similarly, there are several products for corn and callus removal, such as salicylic acid products, various stones and files, and extremely dangerous "corn planes" containing a razor blade. All must be avoided by the diabetic. If warts, corns or calluses bother you, make a special appointment with the physician handling your diabetic care.