Cracked heels, also known as fissures, are very common, especially in winter. The dry air wicks moisture from the skin, leaving it more susceptible to drying out. According to the National Foot Health Assessment 2012, 20% of adults in the United States experience cracked skin on their feet, with women 50% more likely to have cracked skin. In general, you can treat your cracked heels yourself until they heal. However, severe cracks may require medical attention. Keep reading to learn how to treat and prevent cracked heels!
What Causes Cracked Heels?
There are common causes and medical causes. The first sign of a cracked heel is that you form calluses (areas of dry, thickened skin) around the rim of your heel. The more you walk, the more the fat pad under your heel expands. This expansion causes the calluses to crack. Risk factors of naturally forming a fissure include:
- Cold temperatures or low humidity
- Walking barefoot or with open-backed sandals
- Using harsh scented soaps; these can strip your skin of its natural oils
- Standing for long periods
- Wearing shoes that don’t fit properly or support your heels
- Taking long, hot showers or baths
Medical causes of fissures tend to be more severe and typically require medical intervention. Diabetes often causes dry skin, and nerve damage may prevent you from noticing that your feet are cracked and painful. Other conditions that may cause fissures include:
- Fungal infection
- Vitamin deficiency
- Atopic dermatitis
- Juvenile plantar dermatitis
- Palmoplantar keratoderma-causes abnormal thickening of the skin on the soles and palms
Don’t treat cracked heels on your own if a medical condition causes them. Special treatment from a podiatrist is usually needed. In any case, a podiatrist should evaluate severe fissures, regardless of your medical history. This will help you heal faster and avoid complications, such as infection. Some medical treatments for severe cracks include:
- Removing dead skin
- Prescribing more substantial softening or removal agents
- Applying medical glue to seal cracks
- Prescribing an antibiotic for infection
- Strapping the heels with dressings or bandages
- Recommending shoe inserts, heel pads, or heel cups
- Helping the patient change the way they walk
How To Prevent Cracked Heels
Some complications of cracked feet include loss of feeling in your heel, cellulitis (an infection), and diabetic foot ulcer. If you are experiencing an infection, you may feel pain and have redness and swelling around the fissures. If you think you have an infection, call your doctor, as they should address that promptly.
To prevent cracked feet, probably the most important thing you should focus on is your footwear. Avoid flip-flops and sandals with open backs. You should also stay away from shoes with tall, skinny heels and shoes that are too tight. Instead, wear custom shoe inserts to cushion the heel and even out weight distribution. Wear shoes with a sturdy, wide heel that supports and cushions your heels when possible. Other prevention methods include:
- Wearing clinically tested, padded socks
- Using silicon heel cups to keep your heel moisturized and to help prevent the heel pad from expanding
- Drinking plenty of water to stay hydrated
- Using a pumice stone a few times a week (avoid removing calluses yourself if you have diabetes or neuropathy, as you may create a wound and increase your risk of infection)
If you already have cracked heels and have taken steps to help them heal, keep in mind that it may take a few weeks for that to happen. During and after this time, make sure to wear shoes that fit and practice proper foot care to help prevent new cracks from forming. In mild cases, moisturizing two to three times a day may be enough to fix the problem, but what type of moisturizers should you be using?
What Type of Moisturizer Should You Use?
To know which types of ointments and creams to use on your feet, you need to know the difference between humectants, occlusives, and emollients.
- Humectants (hydrators) bond with water molecules from various environmental sources and hold them on the skin’s surface. These are great to use in humid environments. Common humectants are hyaluronic acid and glycerin. If you live somewhere dry, pair your humectant with an occlusive, which helps seal in moisture.
- Occlusives contain moisturizing ingredients that create a physical barrier on the skin to prevent water loss and lock in hydration. Examples of these include Vaseline, mineral oil, waxes, etc.
- Emollients: contain moisturizing ingredients that soften skin, which helps keep it supple and decreases inflammation (your skin will feel more comfortable and less itchy). Emollients are butters, oils, esters, lipids, and fatty acids. These have occlusive properties, which help rebuild skin barriers and prevent dry skin.
You want to use an emollient or a humectant first. Once that is absorbed into the skin, apply a thick layer of an occlusive moisturizer just before bed. Petroleum jelly (Vaseline) is one of the most effective occlusive moisturizers, reducing water loss from the outer skin layer by more than 98%. After applying, put on a pair of 100% cotton socks. This will help lock in moisture and will keep your sheets stain-free. After a few days of following this routine (applying once in the morning and once at night), the skin on your heels should begin to soften.
If you have particularly thick, stubborn skin on your heels, you can use a keratolytic. Keratolytics are agents that thin out your thickened skin by loosening the outer layer and removing dead skin cells. This process allows the skin in the treated area to retain more moisture. Look for products that contain alpha-hydroxy acids, like acetic acid and glycolic acid. Think about pairing the use of a keratolytic with a humectant. That way, you moisturize and remove dry, cracked, and thickened skin simultaneously.
Take Care Of Your Feet with The Foot & Center
To treat and prevent cracked heels, it’s essential to treat your feet with an ointment or cream at least twice a day, to avoid long, hot baths and showers, and to wear the proper shoes for your feet. Here at The Foot & Ankle Center, we can help treat many different ailments, cracked heels just being one of them. If you need a trustworthy and top-of-the-line podiatrist, contact us to book an appointment here!