MEDICAL CONVERSATION

MORE THAN SKIN DEEP

Diabetes Singapore asks Dr Khoo Boo Peng, Consultant Dermatologist, Specialist Skin Clinic, some of the questions you are ask regarding skin ageing, thicker skin in diabetes patients and modern skin treatments.

1. What is the connection between blood sugar and skin? And how does blood sugar affect the skin in the ageing process?

Raised blood sugar level has a negative affect on both the small blood vessels and nerves in the skin. There are less nutrients and oxygen reaching the skin and there is also a decrease in the touch sensation.

As a result, the skin generally heals poorly and moreover such patients are more prone to repeated trauma to the skin unknowingly.

2. What kind of emollients should diabetes patients use to moisturise their skin?

A simple bland moisturiser will do the job. The main issue here is getting the patients to apply the cream regularly and frequently.

3. Can diabetes patients go for non-invasive skin procedures as such intense pulsed light treatment and Thermage?

Fortunately the skin on the face is more resilient to the problem of poor circulation and poor sensation as seen on the limbs. Therefore, if such procedures are done on the face, there should be no added risk involved.

4. Persons with diabetes tend to have thicker skin than their non-diabetic counterparts. Why is this so? How can it be treated?

Poor utilisation and excess of glucose seem to be responsible for the activation of fibroblasts to produce abundant matrix proteins in the skin.

However, this does not occur in all diabetic patients. It seems that the upper back and the limbs are the more susceptible areas.

There is no good treatment for this once this occurs and therefore once again optimal blood glucose control cannot be over emphaisized.

5.  Can diabetes patients take health supplements to improve their skin?  If so, what types of vitamins, minerals and herbs would you recommend?

To date, there are no special supplements or herbs, applied or taken orally that can reverse some of these chronic changes that occur on the diabetic skin. The old maxim still holds: prevention is better than cure!