Diabetes can cause peripheral neuropathy or nerve damage to the feet. Most think of feeling loss when they hear the term neuropathy. However, there are other forms of neuropathy. An autonomic neuropathy causes damage to the nerves that control sweating. Sweat is an important way of controlling moisture balance of the skin. If there is not enough sweat on the feet then the skin will dry out and start to crack.

Dry and cracked skin can be a serious problem. A crack in the foot can result in infection because germs or bacteria can get into the crack. In a foot with circulatory troubles cracks may not heal and could even turn into gangrene. It is thus very important to treat dry skin and prevent the development of cracks.

Dry skin on the feet is typically treated with moisturizing creams. There are all sorts of different moisturizing creams on the market. There is not one single cream that works for everyone. Your foot health care provider should be able to prescribe a cream. Sometimes it is a matter of trying several different creams in order to find one that works best for you.

A trick to improving the effect of the cream is to use “under occlusion” or in other words to trap the cream against the skin to increase penetration and effect. This can be accomplished by applying the cream to the foot and then putting a layer of plastic (vegetable bag or plastic wrap) over the cream and holding it on with a sock. One should sit down for the treatment because the bags can be very slippery. Sometimes 30-60 minutes of cream “under occlusion” is all that is required to help moisturize the skin. In other cases it may be necessary to keep the cream and plastic in place on overnight.

Not all creams can be used for under occlusion; therefore, check first with a pharmacist. After a few weeks of nightly occlusion the skin is typically a lot better and the cream is continued without occlusion and the occlusion can be repeated as necessary. A pumice stone or rough washcloth can be used to smooth down the dry skin after the cream treatment (either when the bags and socks come off or in the morning).

Fungal infections and other skin disorders can also cause dry skin on the feet. Persons with diabetes should not try to self diagnose or self treat the dry skin. Professional foot health care is highly recommended for dry skin. If left untreated cracks and infections could develop.

Timothy P. Kalla, BSc, DPM, FACFAS