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  • Writer's pictureDr. Ndidi Ufondu, DPM

Cracked Heels – More Than Just Dry Skin?


Cracked heels, also known as heel fissures, are a common foot condition marked by deep cracks and thick calluses on the bottom of the heel and along the edges. Although cracked heels may initially seem like just a cosmetic nuisance or sign of dry skin, they can lead to more serious complications if ignored. This article explores the causes, symptoms, and treatments for cracked heels and why periodic evaluation of heel cracks by a podiatrist is recommended.

What Causes Cracked Heels?

The thick skin on the bottom of the feet serves the important purpose of protecting underlying structures against the impact and pressure of standing, walking, and running. However, this skin can become prone to excessive dryness and thickening resulting in painful cracks and fissures. Contributing factors include:

  • Excessive pressure and weight-bearing stress on the fat pad under the heel

  • Loss of moisture from the skin on the bottom of the foot

  • Aging related decline in skin elasticity

  • Genetics – some people are simply predisposed

  • Trauma or injury damaging the heel skin

  • Medical conditions like eczema, psoriasis, athlete’s foot

  • Nutritional deficiencies of vitamins and minerals

  • Endocrine disorders like thyroid disease or diabetes

Signs and Symptoms

In addition to visible deep cracks and thick, flaky yellow calluses on weight bearing areas of heels, symptoms may include:

  • Dry, itchy, flaky, scaly skin

  • Redness, irritation, swelling around cracks

  • Bleeding from cracks widening with walking

  • Tenderness, pain, burning, stinging

  • Difficulty bearing weight on heels

  • Episodes of cracks opening, healing, reopening

  • Fissures prone to infection due to bacteria entering

  • Impaired mobility and gait changes from heel pain

Complications of Cracked Heels

If the cracks repeatedly split open and fail to fully heal, complications can arise:

  • Infections – bacteria entering the open fissures cause redness, drainage, swelling, fever, and spreading cellulitis. Diabetics are at high risk.

  • Ulcerations – deeper tissue injury under calluses leading to chronic wounds.

  • Cellulitis – cracks provide an entry point for dangerous skin infections requiring antibiotics.

  • Gangrene – severely damaged skin and tissue death in rare cases. Requires debridement.

  • Bleeding – ongoing blood loss from widened cracks.

  • Gait impairment – altered walking pattern from heel pain. Stress injuries result.

Podiatrist evaluation helps diagnose infection early and prevent progression when cracks become problematic.

Podiatrist Treatment for Cracked Heels

Podiatrists take a multi-pronged approach to closing fissures, alleviating discomfort, restoring skin integrity, and preventing recurrence.

  • Debridement – Trimming dead, callused skin with a scalpel. Smoothes areas prone to cracks.

  • Topical medications – Prescription urea creams soften and hydrate thickened skin. Antifungals treat underlying infections.

  • Padding & taping – Cushioning pads take pressure off tender areas. Tape pulls cracked edges together.

  • Wound care – Antiseptic dressings protect open cracks from infection. Advanced dressings aid healing.

  • Custom orthotics – Inserts redistribute weight off pressure points like heels.

  • Prescription moisturizers – Lotion compounds tailored to very dry, cracked skin.

  • Steroid injections – Potent anti-inflammatory effect for stubborn cracks.


At-Home Prevention Between Treatments


Daily self-care is imperative between podiatry visits for optimal healing.

  • Moisturize feet morning and night with thick urea or ammonium lactate creams and petroleum jelly.

  • Gently exfoliate with a pumice stone after bathing when skin is softened. Don’t aggressively scrub open cracks.

  • Avoid going barefoot and use protective footwear – shoes, boots, slippers.

  • Wear clean, breathable socks that wick moisture. Change frequently if sweaty.

  • Stay well hydrated and use humidifiers if the air is very dry.

  • Apply corn and callus removal creams with acids like salicylic acid to loosen thick skin.

  • Disinfect and cover any open cracks with antibiotic ointment and bandages.

  • Eat foods rich in vitamins A, C, D, E, iron, zinc to optimize skin health.

Cracks that repeatedly reopen or show signs of infection warrant reevaluation by a podiatrist to get the fissures healed. Consistent at-home care keeps feet smooth.

When to See the Podiatrist

Consult a podiatrist if:

  • Cracks persist despite home treatments

  • Signs of infection develop – redness, warmth, green discharge, foul odor, fever

  • Diabetic with poorly healing cracks

  • Ulceration, bleeding, or drainage from fissures

  • Impaired walking from pain

  • Associated conditions like tinea pedis, psoriasis, hypothyroidism

With customized treatment plans and vigilant at-home care, podiatrists can effectively resolve cracked heels before severe complications arise. Don’t ignore painful heel fissures.

Key Takeaways

  • Cracked heels stem from excessive pressure, dryness, genetics, medical conditions damaging thick heel skin.

  • Deep, painful fissures can lead to infections, wounds, bleeding, and difficulty walking if not treated.

  • Podiatrists use debridement, moisturizers, padding, orthotics, and injections to close cracks.

  • Daily self-care like hydration, exfoliating, moisturizing, and protective footwear prevents recurrence.

  • Diabetics and those with signs of infection should see a podiatrist promptly for evaluation of cracked heels.

FAQs

Q: Are cracked heels normal?

A: It is common to develop some dryness and thickness on the heels, but deep painful cracks warrant medical attention to avoid complications.

Q: How can I repair cracked heels overnight?

A: There is no overnight fix, but wearing socks, hydrating, and applying a thick moisturizer before bed can significantly soften and improve cracked heels.

Q: Will cracked heels go away on their own?

A: Superficial cracks may temporarily self-resolve with consistent moisturizing. But deeper chronic fissures need active treatment or they can worsen over time.

Q: Is Vaseline or petroleum jelly good for cracked heels?

A: Yes, applying petroleum jelly and covering with socks overnight is an excellent way to deeply moisturize and soften thick, cracked heel skin.

Q: Can cracked heels lead to amputation?

A: Extreme cases of heel cracks becoming infected chronic wounds could in rare cases require partial amputation. But with proper podiatry care, wounds and infection can be resolved.

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