Understanding the healthcare professionals’ perspective on the management of diabetic dry skin and the role of urea-based topical application
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20243760Keywords:
Diabetes mellitus, Xerosis, Dry skin, Urea-based formulationAbstract
Background: Dermatological disorders are common in diabetes mellitus (DM), with xerosis affecting 40% of patients. Xerosis, characterized by scaling and dryness, can lead to complications such as cracks and infections. Urea-based moisturizers are effective in improving skin hydration and barrier function in diabetic patients. Objective was to evaluate the prevalence, awareness, and management of dry skin in diabetic patients and to assess healthcare professionals' (HCPs) perspectives and patients’ experience with urea-based topical treatments.
Methods: This questionnaire-based study involved 363 HCPs (dermatologists and cosmetologists) from India. Data were collected via an 18-question questionnaire in two phases (August and November 2023). The effect of urea-based formulations on diabetic skin dryness was assessed.
Results: Data were collected from 1,761 patients with DM, with 96.48% presenting with dry skin. While 48.83% of patients were aware of diabetes-related skin issues, 98.63% of them emphasized the importance of patient education on diabetes-related skin issues. Urea-based moisturizers were prescribed to 97.1% of patients, and 46.29% rated their efficacy as excellent. Most patients reported improvements in dryness and itchiness, with good overall tolerability (46.24%).
Conclusions: Urea-based moisturizers are effective and well-tolerated for managing dry skin in diabetic patients. HCPs view urea as essential for maintaining skin hydration and preventing complications associated with xerosis in DM.
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References
de Macedo GM, Nunes S, Barreto T. Skin disorders in diabetes mellitus: an epidemiology and physiopathology review. Diabetol Metab Syndr. 2016;8(1):63.
Perez MI, Kohn SR. Cutaneous manifestations of diabetes mellitus. J Am Acad Dermatol. 1994;30(4):519-31.
Lima AL, Illing T, Schliemann S, Elsner P. Cutaneous Manifestations of Diabetes Mellitus: A Review. Am J Clin Dermatol. 2017;18(4):541-53.
Stingeni L, Tramontana M, Cordera L, Castello M, Parodi A; Italian Diabetix Group; et al. Xerosis in Patients with Type 2 Diabetes: An Italian Multicentre Study. Acta Derm Venereol. 2021;101(10):adv00577.
Labib A, Rosen J, Yosipovitch G. Skin Manifestations of Diabetes Mellitus. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, et al, editors. Endotext. South Dartmouth (MA): MDText.com, Inc. 2000.
Soesman TFR, Budiastuti A, Malik DA, Widayati RI, Riyanto P, Muslimin, et al. Systematic review and meta-analysis of the effectiveness of urea-based moisturizer on dry skin in diabetes melitus patients with parameters stratum corneum hydration and xerosis assessment scale. J Pak Assoc Dermatol. 2022;32(2):299-313.
Baird SA, Skinner CM, Trail S, Frankis JS. Anhydrosis in the diabetic foot: a comparison of two urea creams. Diabetic Foot J. 2003;6(3):122-4.
Federici A, Federici G, Milani M. A urea, arginine and carnosine based cream (Ureadin Rx Db ISDIN) shows greater efficacy in the treatment of severe xerosis of the feet in Type 2 diabetic patients in comparison with glycerol-based emollient cream. A randomized, assessor-blinded, controlled trial. BMC Dermatol. 2012;12:16.
Ghosh K, Das K, Ghosh S, Chakraborty S, Jatua SK, Bhattacharya A, et al. Prevalence of Skin Changes in Diabetes Mellitus and its Correlation with Internal Diseases: A Single Center Observational Study. Indian J Dermatol. 2015;60(5):465-9.
American Academy of Dermatology Association. Dermatologist-recommended skin care for people with diabetes. Available at: https://www.aad.org/ public/diseases/a-z/diabetes-skin-care. Accessed on 12 September 2024.
Piquero-Casals J, Morgado-Carrasco D, Granger C, Trullàs C, Jesús-Silva A, Krutmann J. Urea in Dermatology: A Review of its Emollient, Moisturizing, Keratolytic, Skin Barrier Enhancing and Antimicrobial Properties. Dermatol Ther (Heidelb). 2021;11(6):1905-15.
Celleno L. Topical urea in skincare: A review. Dermatol Ther. 2018;31(6):e12690.
Lacarrubba F, Nasca MR, Puglisi DF, Micali G. Clinical evidences of urea at low concentration. Int J Clin Pract. 2020;74(187):e13626.