Diabetes and Your Skin in Hawaii: Signs to Watch and Daily Foot Care

Diabetes can change your skin, from dry, itchy patches to cuts that heal slowly. Feet need extra care, since small sores can turn serious. Check your skin and feet each day. See a provider for any wound that is not healing.

You slip off your rubber slippers after a day of errands. You notice a small blister on your heel you did not feel. It looks minor, but with diabetes, small things deserve a closer look.

Book my visit or call (808) 263-3233 to get your skin checked.

How can diabetes affect your skin?

High blood sugar can affect blood flow and nerves. It can also make it harder for skin to fight germs. Over time, that can show up on your skin.

The American Academy of Dermatology notes skin changes can be an early sign of diabetes. Some changes are mild. Others need care right away.

November is Diabetes Awareness Month. It is a good time to learn what to watch for.

What skin changes should you watch for?

Here are common skin signs linked with diabetes:

• Dry, itchy skin: often on the legs and feet

• Dark, velvety patches: often on the neck, underarms, or groin

• Slow-healing cuts or sores: especially on the feet

• Skin infections: red, warm, or swollen areas

• Fungal rashes: in skin folds, between toes, or around nails

• Small skin tags: often on the neck or eyelids

• Light brown spots on the shins: sometimes called shin spots

Seeing one of these does not mean you have diabetes. It is a reason to get checked. If you already have diabetes, tell your provider about any new change.

Why do feet need extra care?

Diabetes can lower feeling in the feet. You may not notice a blister, cut, or burn. Slower blood flow can also make wounds heal more slowly.

A small sore that goes unseen can grow and become infected. That is why daily foot checks matter so much.

The American Diabetes Association recommends checking your feet every day. It only takes a minute or two.

How do you check your feet each day?

Pick a time, like after your shower or before bed. Then:

• Look at the tops, soles, heels, and between each toe

• Use a hand mirror, or ask someone to help

• Look for cuts, blisters, redness, swelling, or cracks

• Check your toenails for thickening or color change

• Feel for warm spots or areas that hurt

Gently wash your feet each day with lukewarm water. Test the water with your elbow first, since feet may not sense heat well. Dry well, especially between your toes.

What is different about diabetes skin care in Hawaii?

Island life is easy on the soul but can be hard on feet. Many of us wear slippers or go barefoot most of the day.

Here is what to keep in mind:

• Hot sand and pavement: can burn feet you cannot fully feel

• Reef and lava rock: can cut feet in the water or on trails

• Humidity: keeps skin damp and helps fungus grow between toes

• Strong sun: can burn the tops of feet that rarely see sunscreen

• Slippers: leave toes and heels open to scrapes

Wear reef shoes in the ocean. Use sunscreen on the tops of your feet. Choose closed shoes for yard work and hiking.

What should you avoid?

These habits can lead to problems with diabetes:

• Walking barefoot on hot sand, pavement, or rocks

• Cutting corns or calluses yourself

• Using sharp tools on ingrown toenails

• Soaking feet for a long time

• Putting lotion between your toes, where it stays damp

Do use a plain, fragrance-free lotion on dry heels and legs. Ingredients like ceramides help support dry skin.

When should you see a provider?

See a dermatology provider for:

• A rash that does not go away

• Thick, discolored, or painful toenails

• Dark, velvety patches of skin

• A new spot or growth that changes

Get same-day urgent care for a foot sore that drains or will not heal. Also go for redness that spreads, a foot that feels hot, or a fever. If a wound turns black or smells bad, get emergency care.

Keep working with the provider who manages your diabetes. Do not change any medicine without talking to them.

At Hawaiian Islands Dermatology, we check rashes, fungal infections, nail problems, and skin growths. A licensed, dermatology-trained PA and a real medical dermatology clinic means you get a clear answer. Doug Williams, MPAS, PA-C, has more than 20 years focused only on dermatology. Your provider will tell you what fits your skin.

Live on a neighbor island? Telehealth is available for neighbor island patients. We accept Quest and Medicaid for telehealth visits.

Common questions

Can skin changes be the first sign of diabetes?

Sometimes, yes. Dark velvety patches, frequent infections, or slow healing can be clues. A provider can help with next steps, like blood tests with your primary care team.

Why is my skin so dry with diabetes?

High blood sugar can pull water from the body. Nerve changes can also reduce sweating on the feet. A gentle lotion on dry areas helps many people.

Are fungal infections more common with diabetes?

They can be. Warm, damp skin in Hawaii adds to the risk. Keep skin folds and the spaces between toes clean and dry.

Can I still wear slippers?

Many people with diabetes still do. Check your feet each day, and pick sturdy slippers that fit well. Wear closed shoes for hiking, yard work, and rocky areas.

Is a skin tag a sign of diabetes?

Skin tags are common in many people. Having a lot of them can be linked with blood sugar problems. Mention them at your next checkup.

Ready to see us in Kailua, Oahu?

Notice a skin change with diabetes? We can help you sort it out.

Doug Williams, MPAS, PA-C, and our team see patients at 1051 Keolu Dr #107 in Kailua, Oahu. We offer telehealth for neighbor island patients, and we accept most major insurance for medical visits. We are open Monday to Friday, with one Saturday clinic each month.

Book my visit or call (808) 263-3233.

Last updated: November 2, 2026.

This article is general education, not medical advice.