Diabetic Dermopathy: Appearance, Treatment, and More

Medically Reviewed By Kelly Wood, MD
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Diabetic dermopathy is not harmful, but it may serve as an indicator of potential complications from diabetes. Diabetes affects your skin’s health because changes in blood vessels and nerves result in damage. One kind of diabetes skin change is called diabetic dermopathy.

Read on for pictures and information about diabetic dermopathy.

Diabetic dermopathy and diabetes

a woman is applying lotion to her legs
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Diabetes is a disease of the entire body, affecting every organ system. Damage to the blood vessels and nerves from diabetes can cause skin changes.

These skin changes may make it harder for a wound to heal because blood flow is compromised. This means oxygen and nutrients have a harder time getting to damaged skin. Also, nerve damage from diabetes may make it less likely for someone to feel an injury, causing wounds to go unobserved and untreated.

One early skin change of diabetes is called diabetic dermopathy. The condition is harmless, and lesions usually heal on their own, but diabetic dermopathy may indicate disease progression in diabetes.

Symptoms of diabetic dermopathy

Approximately 30–70% of people with diabetes will experience skin changes at some point. These changes range from nonthreatening cosmetic changes to life threatening conditions like gangrene.

Skin changes can also be a monitoring tool that indicates blood glucose changes. Your doctor will assess your skin thoroughly as part of your diabetic monitoring regimen. Try to do the same and report any skin changes.

Diabetic dermopathy often presents as flat or slightly concave, rounded patches less than 2.5 centimeters in diameter. These patches generally occur on the shins and are sometimes mistaken for age spots. They may be brown, reddish, or purple in color and may be scaly.

In people with dark skin tones, skin changes due to diabetic dermopathy may appear darker or the skin’s natural dark pigmentation may mask these lesions. It is important to check with your dermatologist to evaluate any changes in your skin.

Diagnosing diabetic dermopathy

The diagnosis of diabetic dermopathy is clinical, meaning that it does not require a biopsy to examine the cells. In fact, biopsy may lead to further problems, since wound healing is compromised in people with diabetes.

Your physician will examine your skin, taking into account the number, location, size, and color of lesions. They may check for blanching, which involves lightly pressing a lesion with the fingertip, to watch for paler skin than usual.

Blanched skin appears white because the blood squeezes out of the capillaries in the area. Diabetic dermopathy lesions are not blanchable.

Your doctor will ask about the presence or absence of a scaly coating, how long the lesions have been present, and whether they hurt or itch. Diabetic dermopathy lesions are painless and do not itch.

Treating diabetic dermopathy

According to the American Diabetes Association, experts consider diabetic dermopathy a harmless condition that generally does not require treatment. It resolves itself, and the lesions do not open up, so they pose a low risk of infection.

Diabetic dermopathy spots go away on their own over a period of 12–24 months, according to a 2020 paper. As older lesions disappear, new ones replace them.

One small 2020 study showed significant improvement in blood flow using low level laser therapy. The researchers administered the therapy to participants three times weekly for a month. At the end of the study, the diameters of diabetic dermopathy lesions shrunk.

The 2020 paper from earlier went on to show that the use of a lotion containing modified collagen and glycerin may give promising results, but the 2020 study above only had 10 participants, so experts need further information before saying that the lotion is effective on a large scale.

It may also be possible to conceal diabetic dermopathy lesions with cosmetics if you so desire.

Managing diabetic dermopathy

You can manage diabetic dermopathy as part of a cumulative program of diabetes management. Because it occurs with vascular deterioration caused by diabetes, doctors can sometimes see it before making a diagnosis of diabetes. However, it does also occur with late-stage changes in blood vessels caused by diabetes.

Once diabetic dermopathy begins, improving blood sugar management will not affect the condition.

Therefore, a great way to manage diabetic dermopathy is to manage your diabetes as a whole. This can involve:

  • maintaining your blood sugars and glycosylated hemoglobin levels
  • getting regular exercise
  • eating a nutritious diet
  • keeping your appointments for lab testing
  • working closely with your doctor on medication changes

Risk factors for diabetic dermopathy

Diabetic dermopathy has several risk factors. These include:

  • Male biological sex: Diabetic dermopathy occurs most often in males.
  • Age: People more than 50 years old tend to have increased risk of the condition.
  • Other conditions: An example is concurrent cardiovascular disease.

People with diabetic dermopathy are also at risk of other diabetes complications, including:

  • Retinopathy: This involves damage to the retinas of the eyes.
  • Neuropathy: It involves damage to nerves.
  • Nephropathy: This describes damage to the kidneys.

Preventing diabetic dermopathy

It may not be possible to prevent all lesion development in diabetic dermopathy. However, there is a noninvasive test called nailfold videocapillaroscopy that can evaluate the condition of small blood vessels. Doctors commonly use it to assess for retinopathy, but it could potentially be useful to monitor the condition of vessels in the skin.

Early detection of vascular changes combined with careful management of blood sugar levels could reduce the appearance and number of dermopathy lesions.

Summary

If you have diabetes, you may develop diabetic dermopathy. The condition does indicate damage to small blood vessels, and it may occur with more dangerous complications of diabetes.

Diabetic dermopathy itself is not dangerous, nor does it cause discomfort.

Contact your doctor for an assessment of any new or bothersome skin lesion. Manage your diabetes by eating a balanced diet, exercising regularly, monitoring your blood sugar levels, and taking medications correctly.

If diabetic dermopathy occurs and distresses you, minimizing its appearance with cosmetics may help you feel better about your skin condition.

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Medical Reviewer: Kelly Wood, MD
Last Review Date: 2022 Aug 30
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  4. Labib, A., et al. (2022). Skin manifestations of diabetes mellitus. https://www.ncbi.nlm.nih.gov/books/NBK481900/
  5. Mirhoseini, M. et al. (2016). A study on the association of diabetic dermopathy with nephropathy and retinopathy in patients with type 2 diabetes mellitus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125061/
  6. Naik, P. P., et al. (2020). Clinical significance of diabetic dermatopathy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733392/