Cracked Heels

Why we get heel fissures and callus & how we can treat them 

What – Very thick, dry and cracked skin around the heel of the foot, which is often uncomfortable and may cause severe pain

Why? – There are a number of reasons why we get cracked heels… Some causes can be linked with and can include: Hot, dry weather that removes moisture from exposed skin, Diabetes with onset of autonomic neuropathy, Lymphoma, Thyroid problems, Downs syndrome, Kidney disease or use of diuretics, Dry skin conditions such as venous stasis or contact dermatitis, eczema, and psoriasis, Pregnancy or weight gain or use of inappropriate footwear (eg. thongs)…. We know this last one is a hard pill to swallow here in beautiful sunny Perth.

Risk Factors –

Weight: overweight patients are at increased risk due to added pressure requiring increased elasticity in the skin.

Lifestyle: can include poor dietary lifestyle habits or standing on your feet for most of the day. 

Pathology: patients with conditions including diabetes with onset of autonomic neuropathy, lymphoma, thyroid problems, Downs syndrome, kidney disease or use of diuretics, dry skin conditions such as venous stasis or contact dermatitis, eczema, and psoriasis.

Inappropriate footwear: summer footwear such as thongs and flimsy sandals or rubbing straps can increase the risk for cracked heels due to rubbing, pressure and exposure of the heel to hot conditions that cause the skin to dry out.

You may also just have a genetic predisposition for dry and cracked heels.

Treatment – If the skin on your feet starts to become very thick, cracked, and painful or even start t9o bleed, you may want to see a podiatrist to find treatment. We can help in a number of ways. Typically, treatments consist of a combination if:

Remove dead skin and wear down any calluses around the heels or in the cracks (fissures) to leave the heels smooth – by a Podiatrist. 

If the heel cracks have become very deep and have started to blead, we will treat and manage the areas as per standard wound care instructions.

Taping: the cracks (if the skin is not broken) may be strapped with sports tape to prevent further splitting and to retain moisture (note. this is not recommended for patients with fragile skin, diabetes, end-stage kidney disease, peripheral neuropathy and/or peripheral vascular disease).

Address underlying individual pathology and risk factors in relation to the cracked heels to help decrease degree of severity in reoccurrence and things to consider when self-managing the problem at home.

Avoid thongs / sandals and walking barefoot on hot surfaces, instead use supportive enclosed shoes that will protect the heel area.

Moisturising with urea based creams or Vaseline based creams can be very useful in reintroducing moisture to the skin at the heels and can help prevent cracking of the skin.

Silicon heel cups can be used and inserted inside shoes to assist with retaining moisture. In elderly patients and patients with diabetes, end-stage kidney disease, peripheral neuropathy and/ or peripheral vascular disease, cracked heels can lead to pressure injuries because of pressure overload and the patient should be assessed accordingly.

If you are suffering from foot pain or suspect that you are at risk of having dry cracked heels book an appointment with one of our Podiatrists for a complete diagnosis in addition to discussing the best treatment options for you.

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