Cracked heels, also referred to as heel fissures, are a common foot condition, which can cause discomfort or even pain. They result from dry skin and are accompanied by thickened skin, plus sometimes yellow or brown calluses around the heel edge.
Often, the only problem with cracked heels is their appearance. However, in some cases, the condition can be severe if the cracks become infected.
According to the National Foot Health Assessment 2012, 20 percent of adults in the United States have experienced cracked skin on their feet. Women were 50 percent more likely to report the condition than men.
If the cracks in the heels are deep, they can be painful, hurting when a person stands up, and they may sometimes bleed.
People should see a doctor if they experience soreness, redness, swelling, or severe pain in any area of the foot for more than a few days.
In this article, we outline some steps that can be taken at home to treat and prevent heel cracks in minor cases of the condition.
Moisturizing treatments in the form of creams, lotions, and ointments can help retain moisture in the skin. This may prevent the skin from drying out and cracking. Moisturizing treatments can also help fix skin that is already cracked.
In mild cases of cracked heels, moisturizing two or three times per day may fix the problem. Rubbing any calluses gently with a pumice stone and applying a moisturizer can also help. However, be careful not to overuse the pumice stone, which can make cracked heels worse.
The following steps may help treat cracked heels:
1. Using an emollient or humectant moisturizer
Emollients penetrate the skin and reduce water loss. They fill the gaps between skin flakes, which makes the skin feel smooth, soft, and flexible. They help to reduce water loss in the skin.
Humectants penetrate the outer skin layer, attract water from the air, and maintain moisture. They also help to increase the water capacity of the skin.
In dry conditions, humectants may draw moisture from the lower skin layers instead of from the atmosphere. This may result in more dehydrated skin overall. Combining a humectant with an occlusive may help seal in moisture.
If you want to buy humectant moisturizers, then there is an excellent selection online with thousands of customer reviews.
2. Applying an occlusive moisturizer over the top
Once the emollient or humectant is absorbed, people can apply a thick layer of an occlusive moisturizer over the top just before bed to seal the moisture in.
Occlusive moisturizers coat the skin in a thin film that prevents moisture evaporating from the outermost layer of the skin.
Examples of occlusive moisturizers include:
- petroleum jelly
- mineral oil
- silicones, such as dimethicone
Petroleum jelly is considered to be the most effective occlusive moisturizer, reducing water loss from the outer skin by more than 98 percent.
Although occlusives work well to lock in moisture, they can be greasy, sticky, and messy.
3. Wearing 100 percent cotton socks to bed
Wearing 100 percent cotton socks to bed after applying petroleum jelly to the heel may help to:
- keep the moisture in
- allow the heel skin to breathe
- prevent the bed sheets from becoming stained
The skin on the heels should soften after this routine is repeated for a few days.
100 percent cotton socks are available online.
4. Applying a keratolytic to thickened skin
When the heel skin is thick, applying a keratolytic may help thin it, as well as the other treatments.
Keratolytics are agents that thin thickened skin, cause the outer skin layer to loosen, and help with removal of dead skin cells. This process allows the skin to keep in more moisture.
Examples of keratolytics include:
- alpha hydroxy acids, such as lactic acid and glycolic acid
- salicylic acid
Products that contain both keratolytics and humectants may be the most useful. For example, urea is both a keratolytic and humectant that moisturizes and removes dry, cracked, and thickened skin.
5. Gently rubbing thickened skin with a pumice stone
Gently rubbing a pumice stone against the heel, once the skin is moisturized, may help reduce the thickness of the hard skin and calluses. Pumice stones are available here.
6. Using a liquid bandage
Liquid, gel, or spray bandages can be used to cover the cracked skin. These may provide a protective layer over the cracks, help reduce pain, stop dirt and germs entering the wounds, and aid faster healing.
People should see a podiatrist or dermatologist if their heels are severely cracked, or if self-treatment does not improve cracked heels after a week.
In severe cases of cracked heels, or if medical care is required, a doctor may:
- remove dead skin
- prescribe stronger softening or removal agents
- apply medical glue to seal cracks
- prescribe an antibiotic if there is an infection
- strap the heel with dressings or bandages
- recommend shoe inserts, heel pads, or heel cups
- help the patient change how they walk
Dry skin usually causes cracked heels. When weight and pressure are applied to the fat pad under the heel, the skin expands sideways. If the skin is lacking in moisture, it becomes stiff, less elastic, and prone to cracking.
Other causes include:
- standing for long periods of time, particularly on hard flooring
- open-back shoes
- poorly fitting shoes
- friction from the back of shoes
- a poor way of walking
- dry, cold weather
Some conditions make people more likely to have dry skin and a greater risk of cracked heels. These include:
The following steps can help avoid dry skin on the feet, and heel cracks:
Avoiding baths and showers making dry heel skin worse
People with dry skin should aim to:
- avoid hot water, using warm water instead
- limit time in a bath or shower to 5-10 minutes to avoid more moisture loss
- use a fragrance-free, mild cleanser
- gently blot skin with a towel to dry
- apply a moisturizer immediately after drying
Applying a moisturizer to heels immediately after washing
After a bath, a shower or a foot soak, people should immediately smother a moisturizer over the feet to trap in moisture. Ointments and creams are more effective than lotions and irritate the skin less.
The American Academy of Dermatology recommend applying an ointment or cream that contains oil or shea butter for dry skin. They also suggest that ointments and creams containing the following, may soothe dry skin:
- lactic acid
- hyaluronic acid
- mineral oil
Avoiding harsh soaps or scented skin care products
While it is important to keep cracked heels clean, dry, and free from infection, harsh soaps can dry out the skin further. Using a mild cleanser helps keep more moisture in the skin of the heel.
There are also emollient products that can be used in the bath and shower instead of soap.
Skin care products that contain fragrance, alcohol, retinoids, or alpha hydroxy acid can sometimes be too harsh for dry, sensitive skin. Avoiding these products may protect the skin's natural oils.
Wearing closed-heeled shoes
Wearing shoes or boots with a closed heel can help heal and prevent cracks to the back of the foot. Shoes with closed heels with cushioning give support to the problematic area. People should avoid open-heeled shoes, those with thin soles, and ill-fitting footwear.
Wearing padded socks, shoes with a non-slip sole, and inserts or orthotics recommended by a foot health professional may also protect the soft tissue of the foot.
Wearing cotton socks with shoes may help reduce friction as well. They can also soak up sweat and moisture, allow the skin to breathe, and help prevent the skin drying out.
Cracked heels can be treated quickly and easily at home with moisturizers and products that thin the skin. To prevent cracked heels, people should ensure that a moisturizer is applied daily to the feet to prevent them drying out.
People should never try and treat cracked heels at home if they are associated with a medical condition. Instead, they should seek the advice of a doctor.
If the cracks are severe, it is important to get the advice of a specialist to prevent the wounds becoming infected.