Thin Skinned Diabetics…Literally…Diabetes and Eczema

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It's funny, really. Growing up, I was the "sensitive" one with tender feelings, "thin-skinned." I had a perfectly average amount of adolescent acne. I was subject to outbreaks of hives before big tests—though interestingly, never, ever before a performance, even the ones in a 5000-seat opera house. Then, about 2 years before my daughter was born, I had a nasty outbreak of eczema. It was my first year at an important new job, so I thought nerves. As it went on for awhile, I thought hormones. Finally had the sense to get a prescription steroid cream which gradually cleared it up. I later found out that my students joked that they thought I was shooting up!

Early last summer, the seeds of another bout with eczema were planted, though I didn't know it at the time. All it was at first was very itchy skin on arms and legs. But after scratching at it, the classic little scabs started to appear and the itching was relentless. But this time around, I am diabetic and I was scared of anything remotely connected to steroids. I got to a dermatologist and came away with a very greasy salve that I applied twice/day. It did have cortisone in it and I tested my blood sugar many extra times/day plus tightened up my carb intake a little extra. It worked over the course of 3 weeks.

Now, as a diabetic, I also heal slowly, so for quite awhile I will live with these little red splotches all over forearms and shins where the scabs were.

But here's the thing: I really am thin-skinned. The cortisone creams can cause thinning skin, which apparently was not known when I used it for quite awhile in 1971. So now, one is advised to not use it for more than 3 weeks.

And it turns out my new meds, which I have been gradually adding since last May have all combined to make a perfect storm of dehydration. So my thin skin is also very dry skin. Just in case any of you dear hearts have a combo like this, take extra care with your skin!: levothyroxine for hypothyroidism, hydrochlorothiazide which is a diuretic, oxycodone 2/day for chronic pain, OTC Benadryl for allergy relief.

It is rather hellish to get through and after months of coping, I have a ways to go yet. There are some odd outlying areas of itchiness that still need attention months later. How hellish? At its peak, I would be scratching at my forearms in my sleep and my husband would have to embrace me to make me stop!

Enough. I don't think skin problems are uncommon for us, but I haven't seen a lot written about them I hope this might help some of us……Blessings, as ever…..Judith in Portland

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Judith, I have had eczema for over 30 years. Managing it is a balancing act, no hot water, no soap, use some sort of cream instead of soap, no perfumes, a skin moisturiser which you put on after showers. See your pharmacist for a range of skin care preparations to help you manage this 'plague'. The more you can manage it the less cortisone creams you will need. Hugs, Maureen.

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I forgot to say, too, that wearing cotton, silk or linen is very helpful, man made fibres cause rashes and itchiness. Also bed clothes should be cotton, my sheets, blankets, etc. are all cotton. I wake up feeling slimy hot and itchy if I have polyester cotton bedding to contend with.

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Maureen, Eucritta----Thank you. This is very helpful. It hadn't occurred to me that this could require life long attention, but my continuing difficulties with those pesky "outliers"---the small persistent patches, is making that clearer every day.

So. The fabric element I'm already on top of: I started finding poly/cotton sheets uncomfortable years ago. I do have one bamboo set, but I think that's ok. And my clothing now is almost all cotton and silk. I have a few shawls that are silk/wool blends, but they are very light weight and I don't use them everyday.

But "lotions and potions"---many questions. I am currently using the top-of-the-list dermatologist recommended daily lotion---it's called Cetaphil and is supposedly formulated for eczema--without steroids. Plus a pretty organic Body Shop Vitamin E lotion.

I was NOT given any recommendations on a non-soap cleanser. What do you use, Maureen? I can see clearly now that it could make a big difference.

Eucritta---What's the anti-fungal cream that you use? I did a Candida diet back in 2007 after recurring bouts of oral thrush due to antibiotics (related to yeast infections). So I definitely appreciate the value of such things!

Thanks again, dear friends. This is very helpful...Blessings.

PS--I have good relations with my Primary Care Doc and also the pharmacists at my regular place. By the time I called for an appointment on the eczema, I needed to see any dermatologist anywhere before I scratched myself to the bone....

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Judith, I use Cetaphil Gentle Skin Cleanser in the shower and for washing my hands, I also use their moisturiser and face moisturiser. You can also get a shampoo, not sure if Cetaphil do a shampoo, but look for one designed for eczema if you need one. I never use organic/herbal lotions, over the years I have found that they mostly always cause rashes. Because you have somehow decreased the water in your skin, all moisturisers should be water based. Yes, its for life, just like diabetes LOL. Good luck
Oh I have a lovely smooth bamboo fabric tee shirt, but can only wear it in the winter as it makes me sweat in the summer (we get very hot here). Shawls, jackets etc. are ok in a mix fibre as you can take them off in public if they irritate.
Eucrita, thanks for the information about the cream, if I get another flare up I will remember that.

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Thanks for posting about this Judith, I have had mild to severe eczema(aka A-topic dermatitis) since I was 18. It is mild on my body but severe on my hands and feet. We are lucky to live in Portland, one the top doctors in the field works at OHSU. I have been through a long list of therapies and just started another. For the vast majority of the time I have used a topical steroid ointment. I've tried light therapy and even a mild form of x-ray therapy(it actually helped a lot but insurance won't cover it). I have recently started a course of cyclosporine(autoimmune suppresent) and it seems to be helping, but its hard on my stomach, I'm glad its only for a month.

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Here are some tips I've learned over the years:
Laundry cleaning and body soaps are the biggest help to controlling eczema on my body.
Use dye/scent free laundry detergents, no dryer sheets
Double rinse clothes before drying
I use only Dial "Basic" hand/body soap, its $1 for 3 bars at the Dollar Store!
Rinse off more than I think I need to in the shower.
I use Dry Idea deodorant, this is the only one that I can tolerate and it works well.
Don't use lotions on your skin, only use creams.
Cetaphil cream is the best but Vanicream is also good. Cetaphil is cheapest at Costco. Vanicream can be found at Walgreens but oddly enough its more expensive than Cetaphil.

One thing your might consider is going to the OHSU dermatology clinic and getting a "patch test" done. It will help narrow down allergens that could be triggering it. Mine ,unfortunately, appears to be like my diabetes.....autoimmune driven.

As for topical steroids affecting BG's, they have absolutely no effect on mine and I have used them off and on for the 4 years I've had T1.

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Kevin, my dear, thank you muchly. I've been thinking about your post a couple days. I have Kaiser insurance and I don't know if it would allow me to see someone at OHSU, but I will explore the possibility, including just paying for it myself if a visit is not too expensive. PS---I also have fibromyalgia and some of the top docs in the field of chronic pain are also at OHSU!

All your tips are also very helpful. I also have shown no tendency to run higher BS #s while using the cortisone "grease"---whew!

One more thing----After all the worst patches were healing well, only THEN did it show up on my hands, so that is new to me yet. It's mostly the heel of my hands, and the area on the edge of the palm below the little finger. A little bit on web between thumb and forefinger and a little on 1st 2 fingers. It is relentlessly itchy.

Now my question might seem silly, but here we go: I eat a fair amount of "finger food"---my small handfuls of nuts, sandwiches on my 4-carb pitas, etc. Is there any problem with using the Cetaphil and eating "finger food"?

Thanks again, one and all. I'm going to print this all out and take it with me to my next doc appointment. It is such a relief to hear from others with so much experience....Blessings, as ever, Judith

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I'm glad to be of any help on this subject Judith, its something I've lived with for 30 years. It does sound like your hand are being affected just like mine.

I doubt Kaiser will cover any OHSU dermatology but its worth a try. You might just ask about patch testing at your Kaiser dermatologist, it's likely they do it too.
As for the Cetaphil cream and eating, its fine. That is why creams are recommended over lotions, creams absorb into the skin, lotions just put a layer on top.

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Phew. Thanks Kevin. My dermatologist and I joked about the "greasy" steroid not affecting blood sugar unless maybe I ingested it, which I couldn't imagine at the time.

Do you happen to know if there are any theories floating around about why specific areas, like our hands flare-up? My legs and arms continue to heal while the heels of my hands stay bad......Blessings....

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Thought I'd give you an update on my Eczema. My dermatologist put me on Cyclosporine(a potent immunosuppressant) that I've taken for a month now. I has completely cleared up my hands and feet! It comes at a bit of a cost though, the dosage was so high that I was having acid indigestion constantly and getting some muscle aches. Apparently Cyclosporine amplifies the effect of Statins.
Just had the one month blood test and things are good there. We decided to halve the dose of both my statin and cyclosporine. I'll let you know if the lower dose keeps my Eczema at bay.

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Judith,

I have been a type 1 for 30 years and hypothyroid for 5 years. Needless to say, i have found a few tricks that work for me after countless dermatologist visits with a prognosis of "diabetics heal slowly". As well as a combination of meds and hormones.
My body Eczema and adult acne is calmed by Nerium cream. I also heal! Not just more quickly, I actually heal. I had terrible problems healing in the winter. For some reason, I respond well to this product. I hope this helps! http://www.neriumbiotech.com/research.htm

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