How to Care for Cuts and Scratches If You Have Diabetes

Different doctors offer treatment advice

How to Care for Cuts and Scratches if You Have Diabetes

If you have diabetes, you may want to be a little more cautious about taking care of simple cuts, scratches, scrapes and bruises. In fact, skin care of any kind is important to your health.

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Bruises are the simplest to address. As long as the skin is not broken, you really don’t need to do much of anything, except keep an eye on the area.

“A bruise is a bruise and will act like a bruise and go through the different changes in color over time,” says dermatologist Christine Poblete-Lopez, MD. “So being diabetic does not necessarily mean it will lengthen the way a bruise will resolve or not.”

If you have any type of laceration, however, you should keep a keen watch for infections because diabetics are more prone to developing infections, according to Dr. Poblete-Lopez. The signs of infection to look for around the cut are redness, warmth, tenderness and pus drainage.

“If you have any of those signs, you definitely need to bring it to the attention of your doctor, because you may need oral antibiotics,” she says.

A diabetes specialist’s approach

There are some differences of opinion among diabetes experts and dermatologists when it comes to healing wounds, so we will take a look at both.

When cleaning out a cut, for example, diabetes specialist Leann Olansky, MD, says to wash the cut with soap and water and then add an over-the-counter topical antibiotic such as Neosporin® or a prescription ointment such as Bactroban® to help prevent bacteria from entering into your subcutaneous tissue.

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The next step for Dr. Olansky is to cover the cut with a bandage to keep it moist so that it will heal faster.

“I don’t think there’s any advantage to keeping it open to the air,” Dr. Olansky says. “If the edge of a laceration gets dry, those cells dry, and you’re better off keeping a laceration, cut or a scrape moist with a topical antibiotic until you get a a scab that provides the same kind of protection as your skin.”

She does warn that some people may be allergic to the active ingredients, neomycin and bacitracin, in the topical ointments and can develop contact dermatitis. She also adds that if it’s a deep cut and you haven’t had a tetanus shot in five years, you should ask your physician about that.

Additionally, Dr. Olansky advises that, if you have diabetes, you should be especially careful with any cuts on your feet, so that you prevent any possible progression to other, more serious problems.

A dermatologist’s approach

There are different schools of thought about using hydrogen peroxide to clean out cuts or wounds. While Dr. Olansky prefers that patients use soap and water rather than peroxide because it can damage new skin cells growing back, Dr. Poblete-Lopez, recommends using peroxide because it does such a good job of preventing infections. It may depend on your condition and the severity of the wound, so it’s important to talk to your own physician.

Both doctors see a risk for contact dermatitis in topical ointments and creams, though to Dr. Poblete-Lopez, the risk is enough of a concern to recommend that patients avoid using them altogether.

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Here is what Dr. Poblete-Lopez recommends for cleaning and caring for a cut or scrape:

“Apply a mix of half peroxide, half water on a ear swab applicator or gauze to clean it and pat it dry, then put plain old petroleum jelly twice a day, to keep it nice and moist and allow the skin cells to migrate and close up the wound,” she instructs. “If it’s a cut with sutures, then I don’t have a problem using plain, undiluted peroxide.”

She adds that, contrary to popular belief, dermatologists typically do not like wounds to develop scabs, since they can delay the healing process. “We know that scabs impede the migration of skin cells as part of healing,” she says. “So by keeping it moist, you can keep the scabs off until the cut heals.”

Ultimately, how you heal will depend on your specific medical history and diabetes, as well as the severity and type of wound you are treating. So, you should work with your own doctor to figure out what works best and is safest for you.

Neosporin® is a registered trademark of Johnson & Johnson Corp.

Bactroban® is a registered trademark of the GlaxoSmithKline group of companies.

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