Insulin resistance happens when your body’s cells stop responding well to insulin, the hormone that controls blood sugar. This problem often leads to visible skin changes that can signal deeper health issues.
One common skin sign is acanthosis nigricans. It shows up as dark, thick, velvety patches on the skin, usually on the neck, armpits, or groin. These patches form because high insulin levels in the blood stimulate skin cells to grow too much. People with central obesity, where fat builds up around the belly, often have this sign along with skin tags called acrochordons. These small, soft growths hang off the skin like flaps. Studies show that combining central obesity with these skin signs predicts metabolic syndrome better than either alone. Metabolic syndrome includes high blood pressure, high blood sugar, excess belly fat, and abnormal cholesterol, all raising risks for type 2 diabetes and heart disease.
Skin tags and acanthosis nigricans point to insulin resistance because they link to changes in fat tissue. In fat from the belly area, certain gene groups turn on or off in ways tied to these skin issues and metabolic problems. This suggests the skin changes reflect trouble in how fat cells handle sugar and inflammation.
For people with diabetes from insulin resistance, skin can face other troubles. Repeated insulin injections or device use, like continuous glucose monitors, can cause lipohypertrophy. This is lumpy fat buildup under the skin from not rotating injection sites enough. It makes insulin absorb unevenly, worsening blood sugar control. Poor skin care raises infection risks too, as diabetes weakens healing.
Inflammatory skin conditions like hidradenitis suppurativa also connect to insulin resistance. This causes painful lumps, abscesses, and tunnels under the skin in areas like armpits and groin. Extra weight adds friction there, trapping bacteria and worsening flares. While not everyone with insulin resistance gets this, obesity and metabolic issues make it more likely.
Spotting these skin clues early helps. Dark patches or tags might mean checking blood sugar and waist size. Simple steps like better diet, exercise, and site rotation for injections keep skin healthier and blood sugar steadier.
Sources
https://www.frontiersin.org/journals/clinical-diabetes-and-healthcare/articles/10.3389/fcdhc.2025.1691675/full
https://theglucoseneverlies.com/24-skincare-t1d-dr-messer/
https://www.healthcentral.com/condition/hidradenitis-suppurativa/hs-in-bipoc-community
https://pubmed.ncbi.nlm.nih.gov/41404505/?fc=None&ff=20251218234500&v=2.18.0.post22+67771e2
