Diabetic Skin Care

Diabetic skin is particularly susceptible to oxidative damage from excess glucose, the sun and the environment. Skin barrier breakage is also the most dangerous side effect of diabetes and excessive glycation. TrueLipids® products were specifically designed with the diabetic in mind. Our technology helps the skin to overcome its vulnerabilities:

  • Deficient lipid production
  • Abnormal pH
  • Susceptibility to infection
  • Susceptibility to free-radical oxidative damage
  • Inflammation
  • Chemical sensitivities

Our founder, Cheryl Lee Eberting, M.D. trained under the past president of the American Wound Healing Society and has extensive experience in the care of diabetic foot ulcers, pressure ulcers, and venous stasis disease. These three conditions are all very common amongst diabetics and can be greatly minimized with the proper dedication and care for your skin.

Diabetic Foot Ulcers

Diabetic foot ulcers begin as a small crack in the skin or with a minor wound. To minimize cracking and peeling of the feet, and to restore healthy skin to the toes and heels, apply the TrueLipids ointment under a small piece of saran wrap followed by a sock at night time for a few weeks. Once your cracks have resolved and you can see your skin lines again (yes, you will be able to have normal skin lines—the little lines that make our finger prints unique), then switch to the TrueLipids Ceramide+ Cream twice a day. This product not only helps to optimize the skin barrier and to maintain NORMAL skin on the feet, but it also helps to keep the skin on the feet and legs cycling normally too. This can help to prevent build up of old dead skin that cracks and ends up infected.

Minor Cuts, Scrapes and Burns

For even the most minor cuts, scrapes and burns, be sure to wash the area very well with soap and water and keep a thick layer of TrueLipids Boo Boo balm on the area at all times. Never allow the area to dry out or scab as this often leads to prolonged healing time, higher rates of infection and more scarring. Pay very close attention to the skin and watch for any signs of infection (redness, exudate, increasing pain). If you are concerned for infection, contact your physician immediately for treatment. Early treatment can make the world of difference between a minor wound and a years-long diabetic foot ulcer or chronic venous stasis ulcer on the legs. To learn more about diabetic skin care and the effects of glycation and carbamylation, please visit our blog.

Pressure Ulcers:

While pressure ulcers may not be extremely common in diabetics, when they do happen, they can be particularly vexing due to the impaired wound healing capabilities of diabetic skin. The most important things you can do to prevent pressure ulcers is to avoid sitting or lying in one position for very long. The skin barrier loses circulation and dies when it has too much pressure on it and must be allowed to heal by the offset of any pressure. Watch for signs of pink, slightly scaly skin in areas that get a lot of pressure. Be sure to avoid putting pressure on this skin until it has returned to normal. Consider applying a thick layer of TrueLipids Boo Boo Balm to this skin as an effective skin protectant. Keep the area covered with the balm at all times until the skin barrier looks normal. If you do develop a pressure ulcer, visit your doctor immediately and begin treatment to avoid long term problems.

Prevention is Key: Compression Stockings

Always, always, always wear protective shoes. And always wear at least knee-high compression stockings if your physician has cleared you to do so (some people should not wear compression stocking if they have severe arterial disease that would not tolerate compression). Compression is one of the most effective and cheap ways to prevent the onset of ulcerations on the lower legs and feet. If you think of how much pressure there is inside a column of fluid that is as tall as you are (your venous system), at the bottom of the column, there is an extraordinary amount of outward pressure that leads to extravasation of blood and lymph into the soft tissue of the lower legs. This excess fluid leads to a traffic jam of sorts; the good cells that need to come and go end up getting trapped and cannot go where they need to go or do what they are supposed to do. This is what leads to the break down of the skin on the ankles and lower legs and causes stasis ulcers and stasis dermatitis. Usually about 21mmHg (21 millimeters of mercury) pressure is sufficient for most people; however, higher levels of compression are appropriate for some cases.

Consider Treating Your Toenail Fungus Infection to Minimize Breakdown of Your Skin Barrier

Many diabetics have pretty significant onychomycosis (toe nail fungus infection). This is often associated with a fungal infection of the feet as well and leads to a break down in the skin barrier. Treatment options for onychomycosis have improved drastically with the introduction of laser treatment for onychomycosis. In some studies, this modality has shown close to 90% clearance of onychomycosis. In the diabetic foot, treatment with laser may be limited by neuropathy. Neuropathy is the loss of or diminished perception of sensation of hot, cold and pain in the lower legs. Treatment with the laser for onychomycosis involves heating the toe nail itself up to a temperature that kills the fungus, but doesn't scar the toe nail. It is best to have this treatment done only if you have intact sensation in your feet so you can give the laser operator feedback as to whether or not the laser light is too hot.

Proper Laundering of Compression Socks is Important When Treating Toenail Fungus

Don’t be afraid to wash and dry your compression socks in the washer and in a high heat dryer. Many diabetics have fungal infections in their toe nails and these infections can be spread by your stockings if they are not laundered correctly. Hand washing is NOT sufficient for killing fungus that lives in the socks that come in contact with infected toenails. A recent study however, showed that a high heat drying can kill up to 94% of fungus that is trapped in dirty socks.

Why use TrueLipids products?

Ceramide 3: Ceramides like Ceramide 3 have been shown to inhibit the matrix metalloproteinase enzymes in the skin that break down collagen and elastin and contribute to aging and wrinkling after sun exposure. This molecule has also been found to be deficient in aged skin and is known to contribute to a young, healthy skin barrier.

Niacinamide: This molecule has been shown to improve fine lines and wrinkles and to be very soothing to sensitive skin. Also has an antioxidant capacity, stimulates more ceramide production (which then may prevent collagen/elastin breakdown as above), stimulates keratinocytes to differentiate and increases the thickness of the epidermis like tretinoin does (through a different mechanism). In addition, niacinamide has been shown to be very effective in controlling the redness of rosacea, helping to decrease oil production in acne-prone skin and helping with atopic dermatitis, eczema, radiation dermatitis and cutaneous lupus.

18-B glycyrrhetinic Acid: Arguably the most effective non-hydroquinone skin lightening and skin brightening active. It has great anti-inflammatory properties and has been shown to be extremely effective in decreasing pigmentation and hyperpigmentation. Though not a sunscreen, this molecule has been shown to inhibit some of the forms of DNA damage caused by UV radiation. This may be why it is so effective in helping to lighten melasma, age spots, and pigmentation.

Gluconolactone: A wrinkle-fighting, free-radical scavenger with anti-oxidant properties. Gluconolactone is a polyhydroxy acid that does NOT cause sunburn cells (mutated skin cells after sun exposure) like alpha-hydroxy acids do. Though not considered a sunscreen, gluconolactone has also been shown to prevent/contribute to the repair of some forms of DNA damage caused by ultraviolet radiation (UV, sunlight) exposure. Because it effectively inhibits water loss from the skin, it contributes greatly to a very effective moisturizing system.

Cholesterol Esters and Phytosphingosine: These two lipids are a very important part of a youthful, healthy skin barrier, and they have been shown to be deficient in aged and dry skin. By supplementing these lipids to the skin, a youthful, healthy skin barrier can form.