The skin is a sensitive organ that covers the outside of your body. Many people have skin care routines to keep their faces glowing and clean, to maintain the health of the skin on their arms or legs, and to reduce wrinkles or stretch marks all over the body.

Many skin changes are normal, especially as you get older. If you have an underlying chronic health condition, changes in hormones, blood flow, nutrition, nerve sensation, and other bodily functions can appear on the skin. Conversely, chronic skin disorders can also impact other body systems and your overall health.

Maintaining healthy skin is not only about using the right moisturizer and protecting yourself from sunburn. If you notice serious changes in your skin, this can be a symptom of an underlying, chronic health condition. These changes can help your doctor diagnose the disorder so you can get appropriate treatment.

We’ve outlined some of the most common chronic health conditions and how they may affect your skin.

Arthritis

There are several types of arthritis, including osteoarthritis, rheumatoid arthritis, and childhood arthritis. The most common symptoms across all types of this chronic condition involve painful, inflamed joints that are difficult to move. The underlying cause of each type of arthritis may be different, and some of these conditions involve symptoms on the skin.

Two types of arthritis involve skin symptoms.

 

Rheumatoid arthritis

The most common symptoms of rheumatoid arthritis (RA) are aching, pain, tenderness, swelling, or stiffness in more than one joint, often the fingers or hands first. People with RA may also develop fevers, weakness, tiredness or fatigue, and weight loss.

 

Rheumatoid Arthritis And Skin

Sometimes, RA can cause changes to the skin, including these:

• Nodes or hard lumps just underneath the skin
• Red patches, which may be small or large
• Swelling or pain on the surface of the skin
• Itchiness

These are symptoms of RA rash. This rash is most common on the fingertips, but it can appear anywhere on the body, especially areas affected by joint pain. For example, in people who have RA in their feet, the rashes are more likely to appear in larger swaths on the legs.

These rashes are caused by inflammation of the arteries, called rheumatic vasculitis. When blood is not delivered to the skin, changes like patches or spots on the skin become common.

In people who develop RA rashes, the symptom can indicate a change or worsening of their arthritis, which requires further treatment. Without treatment, rashes can develop painful ulcers.

Other skin conditions that can appear due to RA include:

• Nodules or hard lumps directly under the skin, ranging from smaller than a pea to about the size of a golf ball. These are typically not painful, but they can get in the way or cause distress, so they sometimes require surgery to remove.
• Skin rashes from RA medication, which can indicate an adverse or allergic reaction. Report these symptoms immediately to your doctor.
• Hives, which may be associated with immunosuppressant drugs but are not an allergic reaction caused by the drugs.
• Livedo reticularis, which is a benign purplish rash that becomes more apparent in cold weather due to spasms in blood vessels. In extreme cases, the condition may lead to painful nodules, discoloration of the skin, and ulcers.

 

Psoriatic arthritis

Psoriasis is an autoimmune disorder that affects the skin, but in rare cases, the condition can also impact the joints. About one in three people with psoriasis develop psoriatic arthritis. Like psoriasis, it is a condition that can be supported, but it will not go away.

It is not clear why some psoriasis becomes arthritic, but treatment for this type of arthritis is similar to treatment for other types. It usually involves nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and other prescription medications.

Autoimmune Disorders

There are more than 100 types of autoimmune conditions that affect different systems in the body, turning the immune system against other cells and leading to pain, inflammation, and fatigue, among other symptoms. Many of these conditions can cause skin problems.

These chronic illnesses may have a wide range of treatments. Getting appropriate help from your doctor can reduce or clear up some of the skin conditions.

These are some common autoimmune-related skin conditions: 

• Non-segmented vitiligo: Often, vitiligo is a symptom of a different autoimmune condition like lupus, but non-segmented vitiligo is an autoimmune condition by itself. The primary symptoms of all types of vitiligo are white or lighter patches of skin that appear on the hands, feet, face, and arms; white or gray hair that is not age-related, appearing on the scalp, eyelashes, or eyebrows; and discoloration inside the mouth and nose. These patches are believed to appear when the immune system attacks melanocytes, which produce melanin.Vitiligo can be especially apparent on people who have darker skin. Although it is not a harmful autoimmune condition, it can be distressing. UV light therapy and some prescription medications may slow down the process.

 

• Pemphigus: This is a rare disease that causes blisters on the skin and inside the nose, mouth, throat, eyes, and genitals. Medical advances have dramatically improved outcomes for this autoimmune condition. As recently as the 1960s, pemphigus was considered fatal, but in the 21st century, treatments prevent most deaths, with rare exceptions due to chronic skin infections.
  
  The immune system begins attacking skin cells in particular in this disorder, specifically attacking desmoglein, the protein “glue” holding the skin together. This causes cells to separate, allowing fluid to collect between the layers. Blisters begin to form, and these do not heal, sometimes leading to large swaths of blisters on the skin’s surface. These are painful, may leak pus, and can become infected.

 

• Psoriasis: This is a skin disorder in which skin cells grow too fast, causing patches of flaky, inflamed skin that may appear like large callouses. Although this is not a serious skin condition, it can be painful and cause distress related to your physical appearance.
  
  Psoriasis patches commonly appear on the head, elbows, and knees. These can be itchy, flaky, painful, or unsightly.
  
  Between 10 and 20 percent of people with psoriasis develop psoriatic arthritis, which causes painful joint inflammation. There are several treatment options, including topical ointments, prescription medications, and ultraviolet (UV) light.

 

• Scleroderma: This is an autoimmune condition that causes an abnormal growth of connective tissue around blood vessels and in the skin, causing the skin to become thick and hard. Many people develop mild scleroderma, which can be distressing but not harmful. However, some types of scleroderma are severe and can be life-threatening, as tissue changes affect internal organs.
  
  Symptoms of scleroderma include tightness and thickening of the skin around the fingers and toes, red spots or broken blood vessels on the face, changes to the skin color on the fingers when they are cold (Raynaud’s phenomenon), and ulcers on the fingertips, which might lead to infections or gangrene. Internal changes include calcium deposits in connective tissue, progressive problems swallowing, and increasing shortness of breath.
  
  Like other autoimmune conditions, there is not a cure for scleroderma, but there are some treatments, including medications for heart burn or upset stomach and immunosuppressants.

Diabetes

Both type 1 diabetes and type 2 diabetes are associated with the body being unable to process and store glucose, or sugar. When the body stores sugar in the blood and does not send it to cells for energy, your health can suffer in various ways.

Both types of diabetes affect all your body systems, including your skin. Typically, type 1 diabetes appears in children and is more associated with heredity. Type 2 diabetes begins in adulthood and may be associated with diet or lifestyle, along with genetics.

Here are some of the skin conditions that can indicate either type of diabetes. If you experience these, you may have prediabetes, undiagnosed diabetes, untreated diabetes, or worsening diabetes symptoms. You should consult your doctor for a diagnosis. 

• Acanthosis nigricans (AN): This is a patch of darker skin that may feel velvety or softer than other areas of your skin. While it may have a bruise-like appearance, it does not typically hurt.These patches can appear along the armpit, groin, or neck, with the neck being the most common area. The change in skin color and texture indicates that there is too much insulin in your blood, and it can be a sign of prediabetes.

 

• Blisters: This is a rare skin condition among people who have diabetes, but it is possible that you may see blisters develop on your skin. These can become large blisters, a cluster of blisters, or both.
  
  Blisters tend to form on the hands or feet first and then on the legs or forearms. They appear like blisters that develop after being burned or getting a sunburn, but unlike those blisters, they do not hurt.

 

• Diabetic dermatopathy: Commonly called shin spots, these are small, hard-to-notice depressions in the skin that may become brown or discolored. These lines appear without pain or other symptoms, and they typically fade after one or two years, especially once you receive treatment for your diabetes.
  
  They are most common on the shins, but they can also appear on the thighs, arms, torso, or other parts of the body. They are common in people with diabetes.
• Digital sclerosis: Hard, thickening skin on the fingers and toes can make it difficult to move these parts of your body. Fingers may become stiff as though you have arthritis, but the skin on the back of your hands will appear waxy and thick.
  
  An appropriate diagnosis and treatment plan can prevent the skin change from spreading to your arms, shoulders, upper back, chest, and even neck and face. In some cases, you may develop this type of skin on your feet or ankles instead of your hands, which can change the skin around your knees, making it difficult to walk, stretch, or bend your legs.
  
  Digital sclerosis is more common in people who have undiagnosed or untreated diabetes, or diabetes that is difficult to treat.
  
• Dry skin: People with diabetes are more likely to struggle with itchy, dry skin due to poor circulation. In the short term, a moisturizing skin cream without perfume or scents can help to ease the problem and prevent cracking or pain. The best way to treat this skin condition in the long term is to get good treatment for diabetes. 

 

• Eruptive xanthomatosis: An outbreak of small, reddish-yellow bumps may seem like a rash or pimples at first, but it can be a symptom of diabetes. Unlike pimples, they do not fade after a few days. Instead, they begin to develop a yellowish color. They will also be itchy or feel tender.
  
  These are most common on the backs of the knees, thighs, buttocks, or in the crook of the elbows. However, they can appear anywhere on the skin. This is not a common skin condition for people with diabetes, and it indicates that your diabetes is not controlled.

 

• Granuloma annulare: Raised bumps that seem like a rash, which can either match your skin’s color or become reddish, are not directly associated with diabetes. In fact, people who develop this condition often do not have diabetes. However, developing granuloma annulare across large areas of skin, with bumps coming and going quite often, has been associated with diabetes.

 

• Necrobiosis lipoidica: Patches of yellowish, brownish, or reddish skin (which might start like pimples or raised bumps) can indicate problems with your blood sugar. When left untreated, this area can grow and spread across more of your skin, leaving a patch rather than a series of bumps. The skin will appear hard and swollen.
  
  While this condition typically becomes discolored, you may also develop skin that has a porcelain appearance, areas that become itchy or painful, or areas that show more blood vessels than normal skin. This condition may come and go at first, but if you are concerned about the potential for diabetes, it is important to have a dermatologist check the patch.

 

• Open sores: If your blood sugar is too high for too long, you will experience difficulty with your blood circulation. This can lead to damage in several body systems, often starting with your nerves. When your skin does not receive adequate blood flow, it will become more difficult for any wounds to heal.
  
  The most common type of open sores are called diabetic ulcers. They typically appear first on the feet.

 

• Skin infections: Because of delicate skin or cracks in the skin’s surface, along with immune system problems, people with diabetes are more likely to get skin infections. The skin becomes painful and swollen, feels hot, and may develop itchiness or a rash. You may develop dry, scaly skin, which can cause further breaks and cause the infection to spread. In some cases, your skin may ooze a discharge like pus or a white discharge.
  
  It is important to get help from a doctor. They can potentially diagnose your diabetes and give you appropriate medical treatment for your skin infection.

 

• Skin tags: Everyone develops skin tags from time to time. A skin tag is a small growth on the skin that hangs from a stalk. Skin tags may become slightly irritated or painful, but they typically do not indicate serious underlying conditions.
  
  They can either be removed, or they will go away on their own. If you develop a lot of skin tags, it can indicate untreated type 2 diabetes.

 

• Xanthelasma: Sometimes, diabetes can increase the levels of fat in the blood, which can lead to patchy, scaly, or yellowish areas around your eyes. When your diabetes is under control, these patches will fade away.

Lupus

This condition is an autoimmune disorder, with specific serious symptoms that are not associated with other autoimmune conditions. When the immune system fails to recognize the body’s own cells, many organ systems can become hurt or show symptoms, including your skin.

Common symptoms of lupus include:

• Joint and muscle pain
• Rashes
• Mouth sores
• Fatigue
• Anemia
• Blood clots
• Fever
• Hair loss
• Eye disease
• Chest pain
• Kidney problems
• Light sensitivity
• Sunlight sensitivity
• Memory problems

One common symptom of lupus on the skin is a butterfly-shaped red rash across the nose and cheeks. However, rashes can also appear on any part of the body exposed to sunlight or UV light. When these rashes appear, you may also experience an increase in symptoms like joint pain, fatigue, and fever.

Other skin diseases may be associated with lupus. According to the Lupus Foundation of America, about 66 percent of people with lupus develop some form of skin disease. Between 40 and 70 percent of those individuals report that their skin conditions get worse when exposed to sunlight.

A subtype of lupus impacts your skin directly. Cutaneous lupus erythematosus is associated with lesions, sores, and rashes, which are more likely to appear on parts of your skin that have been exposed to sunlight. Specific types of cutaneous lupus include:

• Chronic cutaneous/discoid lupus. These are disk-shaped, round lesions or sores that appear on the face or scalp, although they can also appear on other areas of skin. These are thick and scaly.
  
  About 10 percent of people who develop discoid lupus later develop lupus in other body systems. If discoid lesions remain on the skin for a long time, they may become cancerous.

 

• Subacute cutaneous lupus. Lesions or areas of red, scaly skin appear where the organ has been exposed to sunlight. These have distinct edges and often look like red rings.
  
  Although these lesions may become discolored, they often go away as the skin heals, and they do not leave scars. This type of lupus not only appears due to UV light but also because of exposure to fluorescent light.

 

• Acute cutaneous lupus. This is a condition associated with other systemic types of lupus, and it typically appears during symptom relapse or flareups. The most common form of this rash is the butterfly-shaped rash on the face, but it can also appear on the arms, legs, or torso if exposed to sunlight.
  
  Like with subacute cutaneous lupus, the rash will not leave a scar, but it may cause skin discoloration as it heals. 

The main approach to managing lupus-related skin disorders is to manage lupus. Treatment may involve using a topical gel or cream containing steroids or taking prescription corticosteroids. Preventative measures include avoiding direct sunlight, using sunblock, wearing a hat and sunglasses, and seeking out shade whenever possible.

Thyroid

Some of the most common symptoms associated with thyroid disease appear in hair, nails, and skin. The thyroid gland itself is a small butterfly-shaped gland located in the neck, but the hormones secreted by this gland are vital for regulating your heart rate, breathing, and body weight, among other systems. Another common symptom of thyroid disease is inexplicably gaining or losing weight.

Here are some symptoms of thyroid problems:

• Dry skin
• Pale or cool skin
• Moist skin
• Velvety, warm skin
• Deep lines on your palms and the soles of your feet
• Yellowish or orange tint to your palms or soles of your feet
• Wounds that heal slowly
• Redness or flushing on your face or palms
• Sweating more or less than before
• Painless lumps on the skin
• Patches of scaly, discolored skin
• Skin patches that feel hard and waxy
• Reddish spots with no itching or pain that come and go
• Darker skin around your mouth or on your gums
• Darker skin in the creases of your palms

Hair and nails that grow faster or slower, dry and brittle hair and nails, and other areas that begin to swell can also indicate thyroid disease.

Other Chronic Skin Illnesses

These are other common chronic skin disorders:

• Acne: Although this is not a life-threatening illness, acne is considered a chronic condition in some people. Depending on severity, acne can leave scars on the surface of the skin, and outbreaks can lead to skin infections.
  
  Acne is also a symptom of other systemic or chronic illnesses like polycystic ovarian syndrome, congenital adrenal hyperplasia, and insulin resistance.
   
• Eczema: Also called atopic dermatitis, this is a skin disorder that typically begins in childhood, although it can appear later in life. Inflammation, redness, and irritation on the skin are common symptoms that may come and go.
  
  Typically, this type of dermatitis is very itchy and uncomfortable, but scratching these areas can lead to further swelling and redness. It can also damage the skin, leading to cracks, scaling, “weeping” clear fluid, and crusting.
  
  Currently, medical researchers do not know what causes eczema, but it appears to be related to genetics, environment, and the immune system.

 

• Epidermolysis bullosa: This is a group of rare skin diseases that cause fragile skin that frequently breaks, tears, and blisters. These symptoms typically begin just after birth and during infancy, may range from mild to severe, and have no known underlying cause. Treatment involves managing wounds, pain, and skin health.
  
  It is believed that epidermolysis bullosa is genetic. It is a mutation in a gene inherited from either parent that changes how proteins hold skin together. In severe cases, blisters and tears also appear inside the body.

 

• Hidradenitis suppurativa: Sometimes called acne inversa, this is a chronic skin inflammatory disorder that causes pimple, bumps, or boils on the skin, as well as tunnels or tracts underneath the skin. Hard bumps just under the surface of the skin, or pus-filled bumps erupting onto the skin, can become painful lesions with drainage or seepage.
  
  Hidradenitis suppurativa starts in hair follicles, but it can progress to other parts of the skin. The exact cause of the disorder is not known, but medical researchers believe it is due to a combination of hormones, environment, and genetics. 

 

• Ichthyosis: This skin disorder is associated with a genetic mutation, although some types of ichthyosis are idiopathic or caused by some prescription medications. The main symptom of this condition is dry, itchy, scaly, rough, and reddened skin.
  
  More severe forms of this disorder can affect the internal organs. People with this genetic disorder typically need treatment throughout their lives.

 

• Moles and melanoma: Moles are common skin patches that most people have, but changes to moles or the appearance of new moles can indicate melanoma, or skin cancer. Moles that change shape, get bigger, develop ragged edges, become darker, have uneven colors, or become dry, cracked, or even bleed should be checked by a dermatologist.

 

• Rosacea: Sometimes also called acne rosacea, this chronic disease causes pimples and reddened skin, most often on the face. Sometimes, the condition causes eye damage. In advanced stages, skin begins to thicken.
  
  Treatments for rosacea focus on reducing outbreaks and soothing the skin, but there is no cure.

 

• Seborrheic dermatitis: While this condition is most common on infants, called cradle cap, it can appear in adults too. Scaly, greasy patches appear on the scalp or other parts of the skin. In babies, these will go away on their own, but in adults, these reddish, swollen, crusty areas may be chronic.

Changes to Your Skin Can Indicate Changes in Your Overall Health

If you notice any painful, distressing, or unsightly changes to your skin, set up an appointment with a dermatologist. While you can gather useful information to help you understand underlying chronic illnesses or chronic skin disorders and how they impact your health, it’s important to get an appropriate diagnosis and treatment plan from medical professionals.

Early intervention and appropriate treatment can help many skin problems to lessen or clear up. Do not ignore warning signs. Ask a dermatologist for help.

References:
About Chronic Diseases. (January 2021). The Centers for Disease Control and Prevention (CDC).
Arthritis Types. (February 2019). The Centers for Disease Control and Prevention (CDC).
Rheumatoid Arthritis (RA). (July 2020). The Centers for Disease Control and Prevention (CDC).
How Does Rheumatoid Arthritis Affect the Skin? (October 2017). Medical News Today.
Psoriatic Arthritis. (December 2019). National Health Service (NHS).
Autoimmune Diseases that Affect the Skin and Connective Tissue: A List of Autoimmune Diseases and Their Symptoms. (June 2020). Medical News Today.
Overview of Pemphigus. (June 2015). National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD).
Diabetes: The Differences Between Types One and Two. (December 2020). Medical News Today.
Diabetes: 12 Warning Signs that Appear on Your Skin. American Academy of Dermatology Association (AAD).
Lupus Symptoms. (October 2018). The Centers for Disease Control and Prevention (CDC).
How Lupus Affects the Skin. (2021). Lupus Foundation of America.
Thyroid Disease: A Checklist of Skin, Hair, and Nail Changes. American Academy of Dermatology Association (AAD).
Permanent Conditions: Common Skin Diseases and Conditions. (March 2017). Medical News Today.
Overview of Acne. (August 2020). National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD).
Acne as a Chronic Systemic Disease. (November 2013). Clinical Dermatology.
Atopic Dermatitis. (September 2019). National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD).
Epidermolysis Bullosa. (March 2020). National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD).
Hidradenitis Suppurativa. (February 2019). National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD).
Ichthyosis. (March 2020). National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD).
Overview of Rosacea. (April 2016). National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD).