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Source: Diabetes Forecast, February, 2001


Healthy Skin Made Easy


Your body’s largest organ is also its most vulnerable one. As the boundary between the external world and the internal one, skin can fall victim to threats from both outside (sun, dry air, sharp objects) and inside (high glucose levels, dehydration). Having healthy skin requires caring for its environment both inside and out.


DIABETES CAN add to skin problems. High glucose levels are one reason; many bacteria thrive on sugar, making infections easier to get and harder to cure. Diabetic nerve disease and blood vessel disease are two other reasons; both can interfere with blood flow to the skin. In addition, nerve damage may dampen your ability to sense irritations and wounds, making it easier to injure yourself and not even notice.


Prevent Skin Irritation


Dry skin is a major source of skin problems in people with diabetes. There are several things you can do to counteract dryness:


* Bathe and shower in warm, not hot, water.


* Use gentle cleansers, such as mild soaps or superfatted soaps (ones to which creams or oils have been added).


* If you like bath additives, choose skin-soothing ones such as baking soda, bath oil, and colloidal oatmeal. Avoid bubble baths, which are drying.


* Bathe every other day instead of every day.


* After a bath, gently pat dry; don’t rub.


* Apply moisturizer at least twice a day, within a few minutes of getting out of the bath (see “Choosing A Skin Lotion”) and another time as well. But don’t use moisturizers between the toes.


* Add moisture to your house air with a humidifier.


* Set your thermostat on a lower temperature.


* Drink plenty of water.


* Wear gloves and a scarf in cold or windy weather to protect your skin from chapping. Other ways to prevent skin problems are:


* Keep skin dry. Where skin touches skin, such as armpits, consider using talcum powder to absorb moisture.


* Don’t scratch dry or itchy skin. Raw, open skin is more prone to infections.


* Choose unscented soaps and mild shampoos.


* Avoid feminine hygiene sprays.


* Don’t use over-the-counter corn, callus, or wart removers. The chemicals in them are too harsh for people with diabetes. Buffing calluses gently with a pumice stone is okay.


* Surgery is best left to doctors; don’t trim corns or calluses yourself.


* Keep your glucose well controlled.


Treat Injuries Right


When you have diabetes, wounds require immediate, but gentle, care:


* Treat cuts as soon as you discover them.


* Check your feet–tops and bottoms–each day for cuts, blisters, red spots, and other injuries.


* Wash cuts with soap and water.


* Don’t use mercurochrome antiseptic, alcohol, iodine, or any other harsh substance on cuts.


* Ask your doctor whether it’s okay to use an antibiotic cream or ointment if you get a cut.


* Contact your doctor right away if you get a burn, infection, cut, or other injury on your foot.


Choosing A Skin Lotion


Despite the magic results promised by ads, all moisturizers really do is keep moisture near the skin, making skin softer and smoother and reducing dryness and irritation.


Some ingredients in moisturizers, called occlusive ingredients, work by slowing the evaporation of moisture from the skin. One of the best-working of these–and also very cheap–is udder cream, such as Bag Balm. Although intended for dairy cows, many people use it for treating dry skin. It’s available in many drug stores.


Other occlusive ingredients include animal fats (such as lanolin, mink oil, and turtle oil, all of which can cause allergic reactions in some people) and vegetable fats (wheat germ oil, olive oil, cocoa butter, and many others). Two newer ingredients that are gentle on even sensitive skin are simethicone and dimethicone.


Some ingredients, called humectants, draw moisture from lower in the skin up to the top layer. These include glycerin, propylene glycol, butylene glycol, urea, lactic acid, lecithin, and sodium pyrollidone carboxylic acid.


When choosing a moisturizer, skip past the hype and read the ingredient label. Occlusive ingredients should be listed near the beginning. Other helpful ingredients include:


* Alpha-hydroxy acids (including lactic acid and glycolic acid), which help the skin retain moisture better and may make the skin look younger


* Vitamins E and C, which some evidence suggests may help skin when applied directly to it, although they can also be irritating


Ingredients that add to the cost of moisturizers but probably do not help your skin include collagen, elastin, hyaluronic acid, amino acids, proteins, aloe vera, allantoin, algae, placental extracts, liposomes, eggs, milk, and honey.


Oil-in-water preparations tend to help dry skin more than water-in-oil moisturizers. Lubriderm and Keri are oil-in-water formulations.


Avoiding moisturizers with perfumes reduces your chances of skin irritation, although it also narrows your choices considerably.


Preventing Wrinkles


People tend to think of wrinkles as a result of growing older, but age is only one culprit in wrinkled skin. Even more important than your age is how you’ve cared for your skin. The following steps slow the development of wrinkles and keep skin looking healthy.


* Wear sunscreen every day, even if your skin is naturally dark. Choose sunscreens that have an SPF of at least 30 and are marked “broad spectrum” (meaning they protect you from ultraviolet A rays as well as ultraviolet B).


* Avoid being in the sun between 10 a.m. and 4 p.m., when rays are strongest.


* When outside, wear a hat with a wide brim and tightly woven clothing that covers as much skin as possible (such as long-sleeved shirts and long pants). If you are especially sensitive to the sun, consider special sun-protective clothing that blocks more of the sun than usual.


* Don’t smoke. People who smoke get more wrinkles. Other steps that increase your skin’s beauty are:


* Eating a good diet


* Exercising regularly; it improves the flow of oxygen and nutrients to your skin and gives you a glow


* Keeping a handle on stress, which can worsen some skin conditions.