Heel Fissures (cracked heels)
Cracked heels are a common foot problem that are often referred to as heel fissures. Cracked heels are caused by dry skin and compounded by hard skin or callus forming around the rim of the heel.
For the majority of people cracked heels are a nuisance and of cosmetic concern. However, in a minority of cases where the fissures or cracks deepen the heels can become very painful and may bleed. In some cases secondary infection can occur.
What causes cracked heels?
Some people seem to have a naturally dry skin that pre-disposes them to the cracks.
The hard skin or callus is often due to mechanical factors related to the way people walk.
Prolonged standing at work or home, especially on hard floors, increases mechanical loading.
Being over-weight increases the pressure on the normal fat pad under the heel causing it to expand sideways. If the skin is not supple and flexible the increased pressure can cause it to split.
Open-backed shoes or sandals also allow the fat pad to expand under the heel increasing pressure on the skin.
Some medical conditions pre-dispose to a dry skin for example diabetes, under active thyroid and psoriasis. Conditions like diabetes make secondary infection more likely.
Treatment and advice for heel fissures:
- Apply a good moisturising cream which is specific for the foot I can recommend for mild cases, akileine cream or for more problematic cases, flexitol heel balm
- In mild cases, a pumice stone or heel rasp can be used to reduce the thickness of the hard skin or callus
- If heel fissures are a particular problem, avoid backless shoes and sandals and purchase those that have a heel counter
- A podiatrist will remove the callus surrounding the heel and reduce the thickness, particularly where the fissures routinely occur
- If the fissure is particularly deep the podiatrist can use a tape to pull it together
- Recently, in cases of severe or multiple fissures, a skin glue has been developed which is very effective in treating this condition.
- If the fissure is infected then the podiatrist will treat the infection first and once this is under control will aim to heal the fissure
- In cases of chronic heel fissuring the podiatrist may prescribe insoles or orthoses or heel cups. These can be very effective if used regularly
- Regular routine podiatry is an excellent method of treating heel fissures and preventing them from becoming symptomatic