Autonomic neuropathy

The main effect of autonomic neuropathy on the feet can be loss of sweating, resulting in dry inelastic skin less capable of resisting shearing and pressure. The skin may then become split and cracked particularly around the heels resulting in a portal for infection.

The classic signs of autonomic neuropathy are:

  • Dry, split skin
  • Distended veins over the top of the foot and ankle
  • Bounding pulses

Heels of feet showing signs of dry and split skin

The recommended treatment for anhidrosis (unusually dry skin leaving it flakey and in some cases thickened and liable to crack) is a Urea based cream. Individuals with diabetes suffering from anhidrosis can obtain this via prescription. An example of a Urea based cream, which is recommended by The College of Podiatry, can be found on the Flexitol website. This website includes information regarding the appropriate use of Flexitol to enable you as a clinician to advise your patients and also downloadable support materials for clinical use.