Dry skin, particularly of the feet, is so common that its relevance in causing serious medical complications is often overlooked. The main problem is the loss of the protective barrier of normal skin and the increased risk of infection.

Normal skin is a highly structured and complicated balanced arrangement of layers with a mix of specific cell types, water/lipids and antimicrobial molecules. The integrity and function of these components is interrupted in diabetes and particularly when nerve damage stops normal sweat gland function. The result is dry skin.

A number of additional processes contribute to the serious problems resulting from dry skin. For example, dry skin can be itchy and the relief of pruritis by scratching will result in further damage to the skin. Changes to arterial blood blow as is common in diabetes patients compromise normal healing. Change in foot shape as occurs in diabetic neuropathy causes pressure points and this results in physical damage being concentrated in one place. All these factors contribute to the risk of a diabetic ulcer, of abscess formation and of gangrene.

The normal functioning skin is a very effective barrier, this is both in a physical sense to trauma and in an antimicrobial sense. The integrity of the barrier should be maintained by adequate hydration of the skin and not allowing it to dry out. Topical creams, ointments and foams are developed for this very purpose. The makeup and use of these treatments are carefully researched so that precise rehydration can be achieved. This is why looking at the ingredients label on the packaging can be a bit baffling. There are many components that contribute to making up a suitable preparation.

The presence of dry skin may result in a more obvious breakdown of the regenerative layer of the skin such as occurs in eczema. Many patients treat such problems using cortisone based creams because symptoms are relieved quickly. ‘There are, however, different and alternative available treatments for this problem pimecrolimus might be considered. There are a variety of approaches and a visit to the dermatologist is a useful exercise for diabetes patients with any obvious skin problems.