What are Cracked Heels? A Podiatrist Explains the Causes and Treatment
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A podiatrist explains what cracked heels are, why the skin around your heel splits, and how to heal and prevent the fissures.
By Jason McLellan, Co-Owner & Paediatric Podiatrist, Little Big Feet Podiatry, Brisbane
Key Facts
- What it isCracked heels (heel fissures) are splits that form in thick, dry skin around the heel under weight-bearing pressure.
- Most at riskPeople who wear open-heel shoes, walk barefoot, carry extra weight, or have skin conditions like diabetes or psoriasis, plus those in dry, cool environments.
- Common symptomsThick, dry, hardened skin around the heel that can split, and in some cases cracks deep enough to allow infection.
- Primary treatmentDebridement of thick skin by a podiatrist, moisture through wax baths and urea creams, and gentle exfoliation with a pumice stone.
What are cracked heels?
Cracked heels (fissures) are a common affliction seen by Podiatrists. Fissures generally arise from pressure (weight bearing) throughout the thick, dry outer layers of the skin surrounding the heel. Cracked heels are more likely to form when the skin lacks moisture, and in areas of excessively thickened or hardened skin. Factors giving rise to cracked heels include:
- Open heel shoes such as thongs / sandals
- Medical conditions affecting the skin such as diabetes or psoriasis
- Certain medications
- Barefoot walking
- Increased body weight causing excess pressure through the feet
- Hot baths or showers that dry out skin
- Environmental conditions such as cooler, dry environments
Can cracked heels become infected?
Cracks in the heels provide a portal of entry for living organisms such as bacteria, which may give rise to infection. In certain populations (such as diabetic patients or patients with neuropathy/nerve damage), infection can have disastrous complications.
How are cracked heels treated?
Podiatrists are qualified to safely debride the hyperkeratosis (excess thick skin) and direct patients toward home care regimes which can assist with minimising the onset of heel fissures. Wax baths (for moisture), pumice stones (to reduce the dry skin) and topical creams such as urea creams may greatly assist with cracked heels when prescribed to the correct patient.
The Comfort Co Breakdown
Cracked heels, in plainer English
Cracked heels happen when pressure lands on dry, thick skin around the heel, and they are made worse by open footwear, some medical conditions, and dry environments. They can lead to infections, especially in higher-risk people. Podiatrists treat and prevent fissures with skin debridement, moisturisers and exfoliation.
Why does the skin split?
Dry, thickened skin loses its stretch. Each step spreads the heel pad sideways, so once the skin is too hard to give, it splits rather than flexes. Keeping it soft and moisturised is what stops the cracks forming.
Written by The Comfort Co team.
The Comfort Co Solutions
It might sound a little funny, but nothing is as effective on cracked heels as urea. If you want to take your cracked heels seriously, your first stop is getting some Callusan. This cream comes loaded with the active ingredients urea and stearic acid, and it also helps repair through avocado oil and shea butter. Even if you do not have cracked heels, it is lovely for moisturising, exfoliating and strengthening your skin's barrier. You will love it either way.
Comfort Co Pro Tip
Apply your urea cream at night and pull on a pair of cotton socks before bed. The socks hold the moisture in while you sleep, so the cream has all night to soften the thick skin.
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Quick questions
What are cracked heels?
Cracked heels, also called heel fissures, are splits that form in the thick, dry outer skin around the heel. They tend to develop under weight-bearing pressure when the skin lacks moisture or is excessively thickened.
What causes cracked heels?
Contributing factors include open-heel shoes like thongs and sandals, barefoot walking, extra body weight, hot baths or showers that dry the skin, dry or cool environments, certain medications, and skin conditions such as diabetes or psoriasis.
Are cracked heels dangerous?
They can be. Cracks provide an entry point for bacteria, which may lead to infection. In people with diabetes or neuropathy, that infection can have serious complications, so cracked heels should not be ignored.
What is the best treatment for cracked heels?
A podiatrist can safely debride the excess thick skin, and home care such as wax baths for moisture, a pumice stone to reduce dry skin, and urea-based creams can greatly help when used for the right person.
Do urea creams work on cracked heels?
Yes. Urea is one of the most effective ingredients for cracked heels because it deeply hydrates and helps soften thick, dry skin. Creams that pair urea with ingredients like shea butter also help repair the skin barrier.
Sources
- DermNet. Cracked heels (heel fissures). dermnetnz.org
- Healthdirect. Cracked heels. healthdirect.gov.au