Although most of our residents are protected from exposure to the outdoor winter elements the majority of the time, the winter weather can still have harsh effects on those indoors. It’s important for post-acute care pharmacy providers to remind other care providers that proper skin care is even more prudent for those residents with diabetes. Up to one-third of diabetic patients will experience skin complications related to their condition at some point in their lives. The most common types of complications are bacterial infections, fungal infections, and itching. Commonly seen bacterial infections are eye styes, boils, folliculitis, carbuncles, and infections around the nails. Commonly seen fungal infections are Candida albicans (moist red, itchy areas surrounded by tiny blisters and scales that typically occur in skin folds), athlete’s foot, ringworm, and yeast infections. Itching that is seen in diabetic residents can be the result of either bacterial or fungal infections, but may also be the result of dry skin or poor circulation. When itching is caused by poor circulation, the lower legs are normally the most affected area.
Skin Care and Diabetes: Why It’s Different in the WinterChronic high blood glucose levels can impair the ability to fight infection and can increase the overall risk for infections; however, this risk can be further enhanced when the skin is dry. When dry skin occurs, small cracks or breaks in the skin can be an entry point for bacteria or fungus into the body. During the winter, skin dries out for a number of reasons. Drier air, heating systems, hotter water temperatures, more clothing, and more irritating fabrics such as wool can all be contributing factors. [Tweet “A winter guide for skin care and diabetes. #longtermcarepharmacy #skillednursing”]
Skin Care and Diabetes: Steps for Good HealthMost of the skin conditions listed above can be treated easily when identified early; however, good skin care is important to help prevent the skin problems from developing at all. The following tips can assist you with providing good skin care for your residents.
- Keep skin clean and dry.
- During showers, avoid very hot water.
- Moisturizing soaps may help, but avoid highly perfumed products such as bubble baths, antibacterial soaps, and bath products that contain alcohol. These types of products are more drying, and perfumes may cause irritation.
- Very hot water can irritate the skin and cause itching.
- After showering, dry the body well and moisturize.
- Dry skin folds well as these areas have a higher likelihood for fungal infections.
- Avoid applying moisturizing lotions between the toes as the extra moisture may promote fungal growth in this area.
- If dry skin does occur, minimize itching as much as possible. Scratching can cause open areas that may allow entry of microbes.
- Don’t forget about the face and lips. These are two areas that have the most direct exposure to the air.
- Creams and ointments generally work better than lotions because they are thicker and more protective.
- Creams and ointments are more likely to contain petroleum jelly, mineral oil, glycerin, and shea butter, which help keep moisture in the body.
- Check feet often, specifically monitoring for any dryness, cuts, sores, or areas of redness.
- Proper fitting socks and shoes are important to prevent the development of blisters or sores.
- If the resident has nerve or circulation damage, these conditions may affect the feet sweating properly resulting in dry feet.
- Maintain stable blood sugar control.