"Cracked heels are a very common foot problem, and are often referred to as heel fissures," explained Podiatrist Gregory Blasko, D.P.M. "Cracks occur when the skin on the heels is just too dry to support the pressure on the foot. As the foot expands, the dry skin on the heels splits."
"The skin gets its flexibility from moisture, so it can become inflexible if the skin is too thick and hard or if it is too dry. Normally, when pressure is put onto the heel from the body's weight, it would usually stretch and spread out a little to cope with the weight. However, if the heel cannot stretch because the skin is inflexible it will split."
"Callouses typically form when a person walks with bare feet or in sandals or flip flips. As a person's skin is exposed to the air and dries out, calluses create thickened, dry skin around the heel. The calluses split from the pressure caused by walking, standing or running. When they open or crack, they officially become fissures."
Factors that can also be involved in the cause of cracked heel skin include:
- prolonged standing
- open backed shoes, sandals or flip-flops
Preventing Cracked Heels
Invest in a good foot cream: Look for rich, heavy moisturizing creams or even oils to rub into dry feet. Try to do this as soon as you get out of the tub or shower for the best absorption.
Try petroleum jelly: It may take a while to soak in, but petroleum jelly is a good way to restore moisture to cracked heels. Try coating your feet in petroleum jelly at night before bed, slip on some socks, and let it soak in overnight while you are asleep.
Ease off the soaps: It's important to keep cracked heels clean and dry, but a harsh soap can dry out feet. Use a gentle, mild cleanser.
Keep water lukewarm. Instead of a hot bath or shower, keep water a little cooler. Very hot water will dry out the skin. In addition, don't vigorously scrub or towel dry your feet. Gently pat skin dry.
Drink plenty of water: Drink lots of water to help rehydrate your skin as you heal those cracked heels.
- some medical conditions predispose a person to drying skin, such as diabetes
- skin conditions, such as psoriasis
- being obese or overweight
"The two biggest risk factors for cracked heels are diabetes and obesity," Dr. Blasko continued. "Diabetics are likely to experience cracked heels because of damage to nerves in the feet from uncontrolled blood sugars, which can lead to neuropathy and predispose the person to dry skin. People with diabetes are even more likely to sustain an infection from cracked heels than non-diabetics. If you are diabetic, it is important to examine your feet frequently and look for signs of cracks or infection.
"Obesity increases a person's chances of having cracked heels because there is even more weight on the heel pad, which causes it to expand out further. Dry skin is unable to handle the added pressure and often cracks.
"Additionally, people who don't regularly moisturize their feet with a good, oil-based lotion or moisturizer are more likely to experience heel cracks and fissures. Not drinking enough water and poor nutrition are also risk factors for cracked heels, as are regularly taking long, very hot baths and showers. Heel fissures may also occur due to mechanical factors that can increase pressure on the heel, such as the way a person walks.
"If your heels are cracked and painful, and the condition doesn't improve with an over-the-counter foot lotion, visit a podiatrist to treat the problem," Dr. Blasko advised. ""If the fissure is not treated, it could start to bleed and become infected. In addition, if you spot any signs of a skin infection, such as soreness, redness, or swelling, around a dry, cracked area, seeks medical attention."
Podiatric treatment of cracked heels may involve the following:
- Prescription medications to treat an infection
- Physician guidance regarding the most appropriate moisturizer or emollient, footwear and/or self care of the problem.
- Orthotics may be needed to alter the way you walk to prevent thick skin from developing (these may be indicated in the cases of a heel callus)
- A heel cup worn inside the shoe may be used to keep the fat pad from expanding sideways * Removing the hard thick skin by debriding it (Note: Sometimes the splits will not heal if the skin is not professionally removed. Debriding may need to be done on a regular basis, but should never be attempted through self-care or by a non-medical provider.)
- If the skin is very painful, strapping may be used to 'hold' the cracks together while they heal
Gregory A. Blasko, D.P.M., is affiliated with Salem Community Hospital's Medical Staff and the Ankle & Foot Care Centers, which provide comprehensive care and treatment options for a wide variety of conditions affecting the feet, ankles and lower extremities. His office is located at 2380 Southeast Boulevard in Salem, 330-337-8870.