Yes, diabetes often causes itchy feet, a symptom known medically as pruritus. This itchiness is not due to a single factor but results from systemic changes diabetes causes in the body, particularly affecting the skin and nerves in the lower extremities. Understanding the underlying mechanisms—from skin dryness to nerve damage and secondary infections—is the first step toward finding effective relief.
Systemic Causes of Diabetic Itch
One of the most frequent causes of diabetic itch is severe dry skin, or xerosis, often pronounced in the feet. Chronic high blood glucose levels (hyperglycemia) cause the body to excrete excess sugar through increased urination. This process draws fluid from other tissues, including the skin, leading to dehydration and dryness.
Poor blood circulation, a common complication of diabetes, further impairs the skin’s ability to maintain moisture and repair itself. Reduced blood flow, especially to the extremities, means the skin receives fewer nutrients and less oxygen. This diminished supply compromises the skin barrier function, resulting in rough, flaky, and cracked skin prone to itching.
Systemic dryness is compounded by damage to the autonomic nerves, which control the sweat glands. When these nerves malfunction, the feet lose the ability to sweat normally (anhidrosis), which is necessary for natural moisturizing. The combination of fluid loss, impaired circulation, and reduced natural lubrication creates persistent, generalized itchiness.
Nerve Damage and Abnormal Sensations
A distinct cause of itchiness is Peripheral Diabetic Neuropathy, which involves damage to nerve fibers in the legs and feet due to long-term high blood sugar. Damaged nerves misfire and send abnormal signals to the brain, which are interpreted as a persistent itch. This nerve-related itch is known as neuropathic pruritus, often occurring without a visible rash or skin lesion (pruritus sine materia).
This sensation is often described as more intense than a surface itch, sometimes accompanied by tingling, burning, or “pins and needles.” The itch can be chronic and may feel worse at night, disrupting sleep. Neuropathy affects small sensory nerves, leading to the release of inflammatory substances called cytokines that further irritate nerve endings and trigger the itch response.
Neuropathy can also reduce protective sensation, causing a person to scratch aggressively without realizing they are breaking the skin. These micro-injuries become entry points for pathogens, significantly raising the risk of infection. The presence of this neuropathic itch highlights the importance of diligent blood sugar control.
Infections and Related Skin Conditions
Diabetes creates an environment where infectious agents, particularly fungi and yeast, easily thrive on the skin, causing localized, intense itching. Elevated glucose levels mean excess sugar is present in the sweat and skin surface, providing a food source for these organisms. Fungal infections, like tinea pedis (Athlete’s Foot), are significantly more common in people with diabetes.
These infections typically present as red, scaly, and intensely itchy areas, often between the toes or on the soles of the feet. Yeast infections, primarily caused by Candida albicans, flourish in warm, moist areas, especially when blood sugar is poorly controlled. If scratching compromises the skin barrier, a minor fungal infection can allow bacteria to enter, leading to a secondary bacterial infection like cellulitis.
Bacterial infections are a serious concern because a compromised immune system and reduced circulation make it harder for the body to fight pathogens and heal wounds. An itch accompanied by redness, swelling, warmth, or pus requires immediate medical attention, as it may signal a rapidly progressing infection. Any skin break or persistent itch should be treated seriously to prevent escalation.
Strategies for Relief and Prevention
The primary strategy for relieving diabetic-related itch is achieving and maintaining optimal blood sugar management. Consistent glucose control addresses the root cause by limiting nerve damage and improving circulation. This reduces systemic factors contributing to skin dryness and infection risk.
For topical care, focus on hydrating the skin without causing irritation. Apply a gentle, fragrance-free moisturizer daily, preferably one containing urea or ceramides, to the entire foot, but avoid applying it between the toes to prevent fungal growth. Use lukewarm water for washing, and use mild, hypoallergenic soaps to minimize irritation.
Daily foot hygiene and inspection are essential preventative measures. Examine your feet every day for signs of dryness, scaling, redness, blisters, or small cuts, and ensure your feet are thoroughly dried after washing. Wear clean, moisture-wicking socks and ensure your footwear is properly fitted to prevent trauma to the skin.
Consult a doctor immediately if you notice signs of an infection, such as increased warmth, swelling, or drainage. If the itching is accompanied by severe burning or open sores, seek medical attention. If over-the-counter treatments fail to provide relief after two weeks, a medical professional can determine if a prescribed antifungal or nerve-specific medication is necessary.