Diabetics are often instructed or advised not to soak their feet. This advice does not necessarily apply to all diabetics, and foot soaking for relaxation is a luxury that many diabetics can enjoy from time to time. However, some caution is advised to protect a diabetic's skin from unnecessary harm.
Diabetes already causes the skin to become dry due to the way excess blood sugar harms the functioning of the nerves that control sweat glands. The act of soaking the foot in water makes this dryness even worse by drawing out the skins natural lubricating oils. This is especially true of Epsom salts. While many assume soaking is moisturizing the foot, it is in actuality drying it even further. Therefore, soaking the feet can cause harm to a diabetic's skin if done frequently enough by making the skin drier and more likely to crack, develop wounds, and allow bacteria to enter the body. An occasional soak will not cause these things, but regularly soaking will.
Diabetics with open wounds should not soak their feet unless directed to do so by the physician treating the wound. Our doctors occasionally use special types of soaking as a treatment for certain wounds or infections. However, the routine use of unsterile water in a bathtub, foot soaker, hot tub, or whirlpool may worsen some wounds and wound infections, and soaking in these instances should not be performed unless directed to by the physician treating the wound.
Hot water soaking is discouraged in diabetics due to a potential for a diabetic to scald their own skin. Diabetes can limit one's ability to properly feel temperature with their feet and legs, and even if one feels the water temperature with their arms (the hands can have the same feeling loss) the foot skin can become damaged by the water since the discomfort of staying in the warm water for too long will not be felt. If the water temperature is not checked with the arms and it is in actuality far too hot, then one risks scalding their foot without feeling the pain.
Finally, diabetics with burning pain from their diabetic nerve disease (neuropathy) should not use cold water soaks to try and alleviate the pain, especially if they also have poor circulation. Coldwater causes the microcirculation of the foot to shut down, and can lead to tissue damage or even gangrene if circulation is poor enough and cold water soaking is regularly performed Additionally, cold water rarely reduces the pain from diabetic neuropathy to any significant degree, as the burning sensation has nothing to do with skin temperature.
If a diabetic must soak their feet for relaxation or comfort, it should be infrequent (a couple of times a month), and should only last 15-20 minutes in length. The water should be only moderately warm, and the temperature must be checked with one's arm, or by someone else without diabetes or peripheral neuropathy. Unless directed to do so by our doctors, or anyone else treating a wound, diabetics with open sores should avoid soaking.