Cracked heels

Cracked heels, also referred to as heel fissures, are a prevalent foot condition that affects many people. While often considered a cosmetic issue, cracked heels can become painful if left untreated. Understanding the causes, symptoms, and available foot crack treatment options is essential for effectively managing this condition and maintaining healthy feet.

What are Cracked Heels?

Cracked heels develop when the skin on the heels becomes excessively dry and thick, resulting in the formation of cracks or splits. Several factors can contribute to the development of cracked heels, including dry skin, increased pressure on the fat pad under the heel, and predisposing conditions like obesity, ageing, diabetes, and neuropathy.

The symptoms of cracked heels can vary from mild to severe, depending on the stage of the condition. Some common symptoms include:

• Flaky patches on the heels, indicating a need for increased moisture

• Rough, dry skin on the affected area

• Visible cracking or splitting of the skin

• Itchiness caused by the shrinking of the upper skin layers

• Bleeding from the cracks in severe cases

• Open wounds on the heels

• Pain when putting pressure on the heels or walking

• Potential infections and development of cellulitis in advanced stages

Cracked heels can be broadly categorised into the following three stages:

1. Initial Stage: In the early stages, the skin around the rim of the heel becomes dry, hard, and thickened, forming a callus. The affected area may also exhibit a yellow or dark brown discolouration.

2. Progression: As the condition progresses, small cracks appear over the callus. If these cracks are not addressed promptly, they can deepen, causing pain when standing or walking.

3. Severe Stage: In severe cases, the cracks can become deep and bleed. This stage also poses a risk of infection, potentially leading to more serious conditions such as cellulitis.

Several factors can contribute to the development of cracked heels. Some of these cracked heels causes include:

• Dry Skin: Dry skin is a primary cause, often resulting from low humidity levels, especially during winter months, and exposure to hot water without proper moisturisation afterwards.

• Increased Pressure on the Heels: Increased pressure on the fat pad under the heel, either from standing for prolonged periods or due to obesity, can cause the skin to expand sideways and crack. Wearing open-back shoes or sandals also allows the fat under the heel to spread laterally, increasing the risk of developing cracks.

• Pre-existing Medical Conditions: Certain conditions such as athlete's foot, eczema, psoriasis, thyroid disorders, diabetes, and neuropathy can also lead to cracked heels.

• Ageing: Furthermore, the natural ageing process, which reduces skin elasticity, may contribute to the formation of heel fissures.

• Foot Hygiene: Poor foot hygiene is also a major factor contributing to cracked heels.

• Obesity

• Wearing open-heeled footwear

• Standing for long periods

• Dry, cold weather

• Ageing skin

• Certain medical conditions (athlete's foot, eczema, psoriasis, thyroid disease, diabetes)

• Poor foot hygiene

• Genetics (naturally dry or thick skin)

Cracked heels, if left untreated for a long time, can lead to several complications, such as:

• Infection: Severe cracks can lead to infections such as cellulitis.

• Fungal Infections: Neglecting cracked heel treatment can spread fungal infections to the nails, causing fungal nail issues and discolouration.

• Pain and Discomfort: Deep cracks can cause severe pain and discomfort.

• Difficulty Healing: If left untreated, cracks can deepen and become harder to heal.

Preventing cracked heels is often easier than their treatment. Here are some pointers to help keep your heels smooth and healthy:

• Moisturise your feet daily, especially the heels, using thick creams or ointments containing ingredients like lanolin, petroleum jelly, glycerin, and ceramides.

• Establish a regular foot care routine that includes soaking your feet in warm, soapy water for 10-20 minutes weekly to hydrate the skin. Gently exfoliate with a loofah, foot scrubber, or pumice stone to remove dead skin.

• Stay hydrated by drinking plenty of water and other non-caffeinated beverages throughout the day.

• Wear closed-toe shoes that provide adequate heel support. Avoid open-back shoes, high heels, tight shoes, thongs, and sandals that can contribute to dry, cracked heels.

• Inspect your feet daily, especially if you have diabetes or other conditions that affect foot health, to identify any issues early on.

• Avoid standing for prolonged periods on hard floors and sitting with your legs crossed for too long, as these positions can put excess pressure on your heels.

• Eat a balanced diet rich in vitamins and minerals to support overall skin health.

• Use insoles or heel pads to cushion your heels and redistribute weight. For those with more severe cases, custom shoe inserts (orthotics) may provide better support.

Diagnosing cracked heels typically involves a straightforward process:

• Physical Examination: A doctor will visually examine your heels to identify the presence and severity of cracks, fissures, and any signs of infection or other complications.

• Reviewing Medical History: They will review your medical history and ask about any conditions that could contribute to dry skin, such as diabetes, dermatitis, or thyroid disorders. You will also be asked about any symptoms you're experiencing, such as pain, bleeding, or itching associated with the cracked heels.

The treatment of cracked heels involves a combination of self-care measures and, in some cases, professional interventions:

• Self-care at Home: Soak your feet in lukewarm water for 10-20 minutes, then gently exfoliate with a pumice stone or foot file to remove dead skin. Follow up with a moisturiser to lock in hydration.

• Over-the-counter (OTC) Products: Apply heel balms or thick moisturisers containing urea, salicylic acid, or alpha-hydroxy acids multiple times a day. Look for the best foot cream for cracked heels or a specialised cracked heel cream to promote healing. You can also use a liquid bandage or specialised heel repair product to seal cracks and create a protective barrier, allowing the healing of cracked feet.

• Pain-relief Medications: If your cracked heels are causing significant pain or discomfort, heel pain relief medications containing lidocaine or benzocaine can provide temporary relief.

• Other Topical Medications: For severe cases or those that don't respond to home remedies, your doctor may prescribe stronger moisturisers, keratolytic agents, or antifungal medications to address any underlying infections.

• Debridement or Strapping: In rare cases, your provider may recommend debridement, a procedure to remove thickened, callused skin, or strapping to help hold the edges of deep heel fissures together as they heal.

Cracked heels can be a persistent and uncomfortable condition, but with proper care and management, you can minimise their impact on your daily life. Here are some home remedies for cracked heels which will help you manage and live with the condition:

• Moisturise Regularly: Apply a thick, emollient cream or ointment to your heels at least twice a day, especially after bathing or soaking your feet. Look for the best cream for cracked heels containing urea, salicylic acid, or alpha-hydroxy acids, which can help soften and exfoliate the skin.

• Wear Supportive, Well-fitting Shoes: Choose shoes that fit properly and provide adequate support for your heels. Avoid open-back sandals or shoes that don't secure your heel in place, as these can contribute to dryness and cracking.

• Use Heel Cups or Inserts: If you have deep heel cracks that are causing pain, consider using heel cups or inserts in your shoes to provide extra cushioning and support.

• Protect your Heels at Night: Before bed, apply a generous amount of moisturiser to your heels and cover them with cotton socks to help the moisturiser penetrate the skin and prevent further drying.

• Maintain a Healthy Diet: Eating a balanced diet rich in vitamins and minerals, particularly vitamin E, can help promote healthy skin and reduce the likelihood of cracked heels.

If your cracked heels do not improve with home treatment, or if you experience any of the following, it is advisable to consult a doctor:

• Severe Pain: If your cracked heels are causing significant pain that interferes with your daily activities, it's important to consult a doctor or podiatrist.

• Bleeding or Signs of Infection: If your heel cracks are deep and bleeding, or if you notice signs of infection such as redness, swelling, or discharge, seek medical attention promptly.

• Underlying Health Conditions: If you have diabetes, nerve damage, or other health conditions that affect your feet, it's crucial to have your cracked heels evaluated by a doctor to prevent complications.

• Persistent or Worsening Symptoms: If your cracked heels do not improve with home treatments or continue to worsen over time, it's important to consult a doctor or podiatrist for further evaluation and treatment.

• Cracked heels are a common foot problem caused by various factors, including dry skin, open-heeled footwear, and certain medical conditions.

• Symptoms include dry, thickened skin, small cracks, pain, bleeding, and increased risk of infection.

• Most cases can be managed at home with moisturisers and gentle exfoliation, but severe or persistent cases may require medical attention.

• If you have diabetes or other underlying health conditions, it is essential to take extra care of your feet and seek prompt treatment for any foot problems, including cracked heels.

• Preventive measures such as using a foot cream for cracked heels, wearing closed-toe shoes, and avoiding hot showers can help keep your heels healthy and crack-free.