Healing Cracked Heels

Cracked heels, also known as heel fissures, are a common foot condition that can cause discomfort and, in severe cases, pain. Often seen as a cosmetic issue, cracked heels can actually lead to more serious complications if left untreated. This blog post by Manly Cove Podiatry aims to offer an in-depth guide to understanding, treating, and preventing cracked heels, ensuring your feet stay healthy and comfortable year-round.

Understanding Cracked Heels

Cracked heels occur when the skin around the heels splits apart, a condition exacerbated by dryness. While this can be a mere cosmetic concern for some, for others, it can evolve into painful fissures that may even bleed or become infected.

Why They Occur

The skin around the heels is often drier and thinner than the rest of the foot, making it more susceptible to cracking. Pressure from walking or standing, especially with open-back shoes, can expand the fat pad under the heel, increasing the skin’s tendency to split. The situation is worsened by factors such as dry air, inadequate hydration, poor foot care, and certain medical conditions like diabetes or eczema.

Contributing Factors

Several factors can contribute to the severity and frequency of cracked heels, including:

Environment: Dry, cold climates sap moisture from the skin, increasing the risk of cracking.
Hygiene and Care: Neglecting foot care, such as regular moisturising and exfoliation, can lead to dry, cracked heels.
Health Conditions: Certain conditions, like diabetes, can affect skin hydration and integrity, making the skin more prone to cracking.
Lifestyle Choices: Prolonged standing, especially on hard surfaces, and wearing inappropriate footwear can exacerbate the condition.

Causes of Cracked Heels

Cracked heels result from a combination of factors that impair the skin’s natural barrier, leading to dryness and fissuring. Identifying these root causes is crucial for effective treatment and prevention.

Skin Dryness: The most direct cause of cracked heels is excessively dry skin (xerosis), which loses elasticity and becomes brittle, leading to cracks.
Pressure and Mechanical Factors: Standing for long periods, especially on hard floors, increases pressure on the heels, causing the skin to expand sideways and crack if it’s not supple.
Obesity: Carrying excess body weight can exacerbate the pressure on the fat pad under the heel, increasing the likelihood of cracking.
Nutritional Deficiencies: Lack of vitamins, minerals, and hydration can negatively affect skin health, making it more prone to dryness and cracking.
Aging Skin: As skin ages, it loses moisture and elasticity, making older adults more susceptible to cracked heels.
Ill-fitting Shoes: Shoes that don’t fit properly or that leave the heel exposed can contribute to the problem by not supporting the heel adequately or by facilitating the skin’s dryness.
Medical Conditions: Certain conditions, such as diabetes, eczema, psoriasis, and thyroid disorders, can affect skin hydration and integrity, leading to more severe heel cracks.

Symptoms and Complications

The symptoms of cracked heels can range from mild to severe and may include:

Visible Cracks: The most obvious sign, these can vary in depth and severity.
Dryness and Flaking: The skin around the heels may be rough, flaky, and dry.
Redness and Itching: As the skin stretches and cracks, it can become inflamed and itchy.
Pain: Deep cracks can be painful, especially when walking or applying pressure.
Bleeding: In severe cases, the cracks may bleed, especially if they are deep or if pressure is applied.
Infection: Without proper care, cracked heels can become infected, leading to more serious complications. Signs of infection include increased warmth, redness, swelling, and pus.

Home Remedies for Healing Cracked Heels

Effective management of cracked heels often begins at home with simple remedies that focus on moisturising, exfoliating, and protecting the skin. Here are some proven strategies:

Moisturising Treatments

Intensive Moisturisers: Look for thick creams or ointments containing urea, salicylic acid, or alpha-hydroxy acids that can penetrate deep into the skin to hydrate and repair.
Petroleum Jelly: Applying a thick layer of petroleum jelly over your heels and covering them with socks overnight can significantly soften the skin.

Exfoliation Methods

Gentle Exfoliation: Use a pumice stone or foot file on damp heels to gently remove dead skin. Be careful not to over-exfoliate, which can lead to further skin damage.
Soaking: A warm, soapy water soak can soften the skin, making it easier to exfoliate. Adding Epsom salts or essential oils can enhance the soothing effects.

Natural Remedies

Honey: Known for its moisturising and antibacterial properties, honey can be used as an effective foot mask to heal and soften cracked heels.
Coconut Oil: After exfoliating, apply coconut oil to moisturise the skin deeply. Its antimicrobial properties also help prevent infections.

Overnight Treatments

Shea Butter: Apply shea butter to your feet before bed and wear socks to lock in moisture. Its rich fatty acid content deeply nourishes the skin.

When to See a Podiatrist

While many cases of cracked heels can be effectively managed at home, certain conditions necessitate professional care:

Deep or Bleeding Cracks: If cracks penetrate deeply into the skin or bleed, professional treatment can help heal these fissures and prevent infection.
Signs of Infection: Redness, warmth, swelling, or pus around the heels are indicators of an infection that requires medical attention.
Underlying Health Conditions: Individuals with diabetes, peripheral arterial disease, or immune system disorders should see a podiatrist for any foot-related issues, including cracked heels, to prevent complications.
Persistent Pain: If cracked heels cause persistent pain or limit mobility, a podiatrist can assess and treat the underlying causes.

A podiatrist like Manly Cove Podiatry can provide specialised treatments such as professional debridement (removal of dead skin), prescribe stronger moisturisers, and suggest custom orthotics to redistribute pressure on the heels. In severe cases, they may recommend specific medications or therapeutic ointments to facilitate healing and prevent recurrence.