Diabetes and skincare

Diabetes affects some 380 million people worldwide, a number that is steadily increasing. In the near future one in 10 adults will be affected by diabetes. This disease has multiple adverse effects for our health, many of them related to the skin. How can we reduce the risks and protect our skin?

People with longstanding diabetes (high blood sugar) are more prone to skin problems. One in three people with diabetes is affected by skin disorders, which are often the first warning of the presence of the disease. High blood glucose levels cause biochemical changes in the skin that alter its structure and functions. These changes induce dryness, loss of elasticity and premature skin ageing.

People with diabetes more easily develop the following skin conditions:

Infections caused by bacteria and fungi (especially Candida albicans), resulting in inflammation, itchiness, redness, blisters and flaky skin. The most problematic areas are under the breasts, around the nails, between the fingers and toes, at the corners of the mouth and in the armpits and groin.
Changes in skin colour, such as the appearance of light brown patches (acanthosis nigricans) and thickening at the back of the neck, in the armpits and groin and below the chest. Vitiligo is also common, resulting in areas of discoloured skin on the chest and belly.
Diabetic dermopathy (shin spots), which typically emerge as small, light-brown, circular, scaly patches around the shins (not to be confused with age spots).
Blisters, sores, warts, flakiness, cracking, itchiness, ingrown nails and increased sensitivity to sunlight. Most skin conditions affect the feet because diabetes affects blood circulation.
Prevention and care
Fortunately, most of these problems can be easily prevented or resolved before they develop into a serious health problem. Here are some tips.

Wash using a mild soap and dry the body thoroughly, especially where skin makes contact (e.g., folds).
Use moisturizers (but not between the fingers/toes). Keeping the skin hydrated is one of the simplest ways to prevent problems.
Avoid very hot baths and showers that may dry the skin excessively.
Inspect red spots, blisters and sores that could end up becoming infected.
Keep an eye out for lumps or any changes in the feet and visit a specialist for a checkup at least twice a year.
Treat cuts immediately after first washing them with soap and water.
Keep blood pressure and cholesterol under control so as to improve circulation and maintain healthy skin.
Drink plenty of fluids (water and sugar-free drinks) to keep the skin hydrated.
Eat foods rich in omega-3 fatty acids to nourish the skin. These include fish like salmon, sardines, tuna and mackerel, as well as tofu, nuts and flax seeds.
People with diabetes need to be aware that their disease requires extra attention to the skin. If you observe any changes, make an appointment with a reputable dermatologist.

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BB, CC, DD, EE creams…

These pairs of letters are not codenames for operating systems, usually identified with letters of the alphabet. They rather describe multifunction or all-in-one creams that, for years, have promised countless benefits for the skin. But what are the differences between the BB, CC, DD and EE versions? Do they actually work or are they merely effective marketing strategies?

BB creams have been on the Western market for some five years, although the name has existed for far longer. In fact, the German dermatologist and allergist Christine Schrammek claims to have developed the first Blemish Balm (BB) cream in 1967 to treat the skin after peeling treatments. The original formula contained zinc oxide, titanium dioxide, licorice root and panthenol — an anti-inflammatory, protective, soothing and moisturizing cocktail that gave the product considerable appeal.

But the brightest idea was to add a colour and so create a moisturizing make-up. In the 1980s these tinted balms were being used to protect facial skin postoperatively.

Slaves to time
In a society marked by hurry, this idea was destined, sooner or later, to catch on. Five minutes out of the shower to put on a BB cream and you can hit the streets with your head held high. The nightmare of applying moisturizers, serums, primers, foundations and makeup was over.

BB creams were sold in the Asian market, early on in this decade, as a cosmetic revolution that did away with the lengthy traditional routines of Japanese and Korean women before the mirror.

The US industry took up the idea, renaming the invention Beauty Balm and adding in a few extra marketing draws, such as sunscreen and anti-ageing ingredients.

The idea worked: in the USA, sales of BB creams multiplied by 20 over 2011 to 2012… Still, for some cosmetic specialists, BB creams were no longer just tinted moisturizers.

A touch of colour with CC…
The target buyer of the BB cream is young. To target the next segment, aged over 30, the industry soon invented the CC cream, with the CC standing for colour correction or complexion correction, depending on the brand.

Added to the formula for perfect skin was colour control and luminosity, promising a unified skin tone and improved coverage of pores. The CC creams are more similar to the classic make-up in that they cover up imperfections. They also usually have a sun protection factor (SPF) higher than the​​ BB creams as well as active antioxidants. But they do not do much more than their BB predecessors.

Then came DD …
Maybe this was why, in 2013, some brands advanced to a DD formulation, where DD means daily defence or dynamic do-all, again according to the brand.

In theory, DD creams — intended for maturer skins — combine the skincare properties of BB creams and the corrective powers of the CC creams. The key selling proposition, in this case, is their capacity to combat inclement environmental conditions (most especially pollution).

However, they are not very different from their predecessors in terms of ingredients (antioxidants and sunscreen), although they may have a higher SPF (up to 50). Nevertheless, as they are meant to be used as make-up once a day, protection from harsh UV rays lasts only a few hours.

Some brands, to differentiate their products from the competition, add the ability to activate melanin and so boost tanning as an extra benefit. It remains to be seen whether these creams really work, however.

And now, EE …
Joining this particular cosmetic alphabet in 2014 were the EE creams, letters referring variously to extra exfoliating, enlighter effect or even energy enhancer — another way of saying that they contain a potent antioxidant called tocopherol.

EE creams are also all-in-one creams in that they combine different skincare steps in a single container and so prove attractive to timepressed consumers. In theory, they accelerate exfoliation, moisturize the skin and even tone. But they do not do any more than other creams separately.

Still, as in the case of their sister BB, CC and DD products, strategic marketing has delivered them to the shelf so that consumers can decide to try them, at least once — even as they intuit that they are just another product designed to capitalize on alphabetic cosmetics. Lack of time and selfies rule!