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Over half a billion of adults live with Diabetes Mellitus worldwide, and up to 50% of these can develop skin side effects from their condition, as high glucose levels can damage blood vessels and reduce nutrient supply. Diabetes-related skin complications range from mild conditions such as dryness and itchiness or hyperpigmentation, to more severe conditions such as infections and ulcers. Although the use of moisturising creams and lotions could effectively manage these complications in their early stages, awareness and willingness to address skin-related issues remain low among both patients and healthcare professionals (HCPs). Unless patients can consult a Dermatologist, they are unlikely to receive adequate advice and tend to use generic moisturisers as they do not perceive the benefits of specialised products.
Currently, a few solutions specially formulated and explicitly indicated for dry, Diabetic skin are on the market, as some dermocosmetic brands have recognised the needs of patients living with Diabetes. Brands such as Cerave, Gold Bond and Bioderma have incorporated at least one moisturiser for Diabetic skin into their offerings, carefully crafted with science-backed and Dermatologist-approved ingredients such as urea and ceramides.
We estimate the dermocosmetics market for Diabetic skin, especially moisturising solutions for Diabetes-related skin Xerosis, at 7.6 billion USD and project it to grow, reaching 8.4 bn USD by 2030 and 8.9 bn USD by 2045 in North America and Europe. The absence of a prominent leader in Diabetic skincare, combined with current low levels of patient awareness, leaves an opportunity to capture the market.
As a result, Diabetes represents a growing avenue for dermocosmetic brands, which could establish themselves as valuable partners for patients. To seize this opportunity effectively, companies must first ensure that their solutions are tailored to these patients’ specific needs and address key barriers to adoption through, for instance, educational campaigns and collaboration with HCPs.
Diabetes Mellitus, or Diabetes for short, is a chronic condition that affects the body’s ability to produce or use insulin effectively, resulting in high glucose levels. In 2021, approximately 537 million adults (20-79 years old) were living with Diabetes worldwide, including 112 million in North America and Europe 1. If poorly controlled, hyperglycaemia (high glucose levels) can cause changes in blood vessels and nerves, impacting the healthy functioning of various organs, including the skin.
High glucose levels in the bloodstream typically prompt the body to extract fluid from its cells to produce more urine to eliminate this excess. This commonly results in xerosis (abnormally dry skin) and sometimes pruritus (severe itching of the skin). As the skin becomes dryer, it loses flexibility and its ability to withstand trauma, which may result in skin breakdown.
Additionally, high blood glucose can cause fatty deposits to form inside blood vessels, leading over time to a narrowing of these vessels and lower blood flow. The reduced blood supply can lead to skin hyperpigmentation, such as Diabetic Dermopathy (reddish-brown spots located on the shins) and Acanthosis Nigricans (dry, dark patches of skin).
In more serious cases, skin damage can take longer to heal as high glucose levels prevent white blood cells from reaching the infected site quickly. This also increases exposure to bacterial and fungal infections as well as ulcers. If left untreated, the infection may ultimately spread to muscle and bone. A notorious example of these more extreme complications is Diabetic Foot Ulcers, which can require amputation of a toe, foot, or part of a leg if left untreated for too long 2.
The cascading effect of hyperglycaemia on the skin can be prevented with better glucose control, regular exercise to improve blood circulation and appropriate skincare to strengthen skin resilience. The medical community recommends various behavioural changes such as taking shorter showers, using mild soaps, and moisturising the skin daily to manage early-stage skin complications, namely xerosis and pruritus. Moisturisers can play an important role in healing dry skin and preventing skin breakage. By relieving itching, they prevent patients from scratching their skin, which could cause the skin to tear and allow an infection to set in. Moisturising is particularly important to prevent chapping in cold or windy weather.
Although estimates vary across studies, it seems that at least 50% of people living with type 1 and type 2 Diabetes experience skin issues ranging from Xerosis to Diabetic Foot Ulcers 3, making these a highly prevalent side effect. This means that ~268.5 million adults worldwide are concerned, with 56 million in North America and Europe. Xerosis stands out as an especially prevalent skin condition among patients living with Diabetes, with reported occurrence rates reaching up to 40% 4. These patients are also more likely to develop Pruritus than the general population, particularly if they have dry skin or Diabetic Neuropathy 5. Global evidence suggests that the occurrence of Diabetes associated Pruritus ranges between 18.4% to 27.5% 6. As illustrated below, we can therefore estimate that ~214.8 million adults living with Diabetes also have Xerosis, and 123.2 million have Pruritus worldwide. This translates to ~44.8 million with Xerosis, and 25.7 million with Pruritus in North America and Europe.
