Cracked Heels (Fissures)

Cracked heels, also known as heel fissures, are not often serious but they can be uncomfortable, painful and unsightly. If your cracked heels are deep or severe, occasionally they can become infected and lead to a skin infection called cellulitis. 

What do cracked heels look like?

Cracked heels generally look as they sound; small cracks in the outer layers of the skin around the base of your heel. Other signs of cracked heels include:

  • Excessively dry skin around the heels.
  • Hard, thickened skin around the heels.
  • Small, shallow cracks in the skin.
  • Larger, deeper cracks in the skin which may bleed. 
  • Pain in the heel when standing or walking, in combination with one or more of the above.

What causes cracked heels?

A large amount of force goes through the heels every day when we stand, walk and run. Over time, this can cause the skin to become dry and thick, making the skin in this area less durable and resistant to everyday stresses. This causes the skin to crack. 

Certain factors can increase your risk of developing cracked heels. These include:

  • Standing or walking for long periods of time.
  • Wearing open back (open-heeled) footwear such as flip flops and sandals.
  • Having dehydrated skin, often caused by using harsh soaps or taking long, hot baths or showers
  • Dry skin conditions – such as athlete’s foot, dermatitis, psoriasis or dermatosis
  • Health conditions that can reduce moisture in the skin, such as diabetes, an underactive thyroid (hypothyroidism) and some auto-immune disorders. 

 

Cracked heels are more common in the summer due to the regular use of open back sandals, causing the heel to be under increased multi-directional pulling forces (known as tensile stress). This is where the heel is constantly moving from side to side, forwards and backwards without the support and stability that is provided by an enclosed shoe. Hot weather can also dry out your skin, particularly if the skin burns.

Cracked heel treatment and prevention

Do ✓

  • Keep your feet hydrated! Moisturise your heels daily with a urea-based cream or balm. These range from 10-25% urea concentrations, which help to lock moisture into the deeper layers of the skin, whilst helping to reduce the build-up of hard skin. 20-25% urea heel balms are most effective for cracked heels. This is something you should continue once the condition has gone away, as it helps to prevent it from coming back.
  • Exfoliate or file hard skin – using a foot file, pumice stone or exfoliation treatments will keep hard skin down, reducing the likelihood of new cracks forming.
  • Keep your feet clean, especially when dry skin has cracked open.
  • Dry your feet thoroughly after showers, baths or any other activities that get your feet wet.
  • Wear clean, breathable socks every day.
  • Wear enclosed shoes with secure fastenings to help support your heels and the rest of your feet.
  • Use shoe inserts, heel cups or insoles that reduce friction and tensile stress, such as the ZeroSole impact range.

Don’t X

  • Do not wear open back sandals for long periods of time.
  • Do not keep your feet in wet shoes or socks any longer than necessary.
  • Do not touch heel fissures without first washing your hands thoroughly.

 

Cracked heels can be treated by a foot specialist (podiatrist) who can regularly debride (cut away) the hard skin. Do not attempt to do this yourself, as it can be easy to cut healthy skin. There is also a risk of infection which can make the problem worse. A podiatrist may also use skin glue, a glue that has been designed to hold the edges of the heel fissures together, to encourage them to close and heal.

Consult your GP or a healthcare professional if:

  • You have deep cracked heels that bleed.
  • Your cracked heels don’t show signs of healing after a week.
  • Your heel fissures appear to be infected – look out for inflammation, unusual odours or pus leaking from the fissures.
  • You have cracked heels and are diabetic, as this will increase your risk of infection and diabetes related foot complications.
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