Diabetes can cause people to experience skin changes on their feet, including cracked heels. Without treatment, the changes can lead to health complications. As such, it is important for people to regularly check their feet, moisturize, wear appropriate footwear, and more.

Diabetes describes several conditions that affect how the body processes and maintains its blood sugar level. If a person has a difficult time keeping their blood sugar within a stable range, they may experience complications that can include foot problems, such as cracked heels.

Cracked heels, also known as heel fissures, refer to hard, dry skin forming over the heels of the feet. This can cause discomfort and may lead to health complications, such as slow-healing wounds and infections.

In this article, we discuss how diabetes affects the feet, how to treat cracked heels, and how to manage other common foot health concerns that may occur with diabetes.

A person walking on dry ground.Share on Pinterest
Michael Prince/Getty Images

An unstable blood sugar level can lead to nerve damage and a circulation decrease.

Nerve damage can result in a person losing sensation in their feet. This may make it harder for a person to notice wounds, such as blisters, on their feet. As such, a person may not treat some wounds, so these cuts and sores may have a higher infection risk.

Damage to the nerves can also impact how the body keeps its natural oils and moisture in the feet. This may make it more difficult for a person to feel the formation of hard, thick sections of skin. Therefore, a person with diabetes may be more likely to develop dry and cracked skin.

Usually, a healthy blood flow delivers sufficient nutrients and immune cells to a wound, which encourages healing and prevents infections. However, as diabetes can affect circulation, it causes blood to move more slowly, which means the body may have difficulty healing the wound or stopping an infection.

Additionally, a decrease in circulation can result in changes to the skin of the feet and lead to the formation of calluses.

The American Academy of Dermatology Association (AADA) recommends the following options to help treat cracked heels at home and prevent them from coming back. These suggestions include:

  • Taking shorter baths and showers: Bathing for too long can make skin dry out, which can worsen cracked heals. It is also advisable to gently blot the skin dry using a towel.
  • Using a gentle cleanser: This can help the skin on the heels retain their natural oils and prevent dry skin.
  • Moisturizing after bathing: Applying a moisturizer to the heels immediately after bathing, when the skin is still damp, can lock in moisture. People may consider using moisturizers that contain urea, alpha hydroxy acid, or salicylic acid.
  • Applying petroleum jelly before bed: Applying a layer of plain petroleum jelly and wearing socks before bed can help heels maintain moisture.
  • Protecting the heels: People may consider using a liquid bandage during the day to create a protective barrier over the heel. This can help reduce pain, speed up healing, and prevent pathogens from entering the skin.
  • Wearing proper footwear: Wearing appropriate footwear can provide the feet with suitable support and reduce pressure on the heel. As such, people may want to avoid open-heeled shoes, such as flip flops.

In more severe cases, or if a person notices no improvement, it is advisable for them to contact a podiatrist. This term refers to an individual who specializes in the medical care and treatment of the foot.

A podiatrist can provide advice on looking after the feet and can offer more effective treatment options, which may include debridement or stronger softening or debriding agents.

Learn more about treating cracked heels.

Foot health complications that a person with diabetes may experience include:

  • Neuropathy: This refers to a potential complication of diabetes that results in nerve damage. This can lead to a person losing sensation in their feet, making it difficult to feel cuts or sores that can worsen and result in further complications.
  • Circulation decrease: A decrease in blood flow to the feet can cause injuries to heal slowly or not heal at all, making it harder for the feet to clear infections.
  • Foot ulcers: This refers to slow-healing wounds that commonly affect the feet of people living with diabetes. Without proper management, an ulcer can undergo necrosis and become gangrenous.
  • Amputation: In severe cases, when wounds do not heal on the foot, a doctor may need to surgically remove the limb.

The Centers for Disease Control and Prevention (CDC) provides tips to keep feet healthy, including:

  • Checking feet regularly: By checking the feet every day for any cuts, discoloration, sores, or other changes to the feet, a person can appropriately treat the health concern before it gets worse.
  • Washing feet: It is important to wash, dry, and moisturize the feet to keep them clean and hydrate them.
  • Avoiding going barefoot: To help prevent potential injuries to the feet, it is advisable to always wear footwear, such as shoes, socks, and slippers.
  • Wearing well-fitting shoes: By wearing comfortable shoes that provide appropriate support, people can avoid injuries to their feet, such as blisters.
  • Trimming nails carefully: It is advisable that people trim toenails straight across and keep them short. Rounded nails can grow inward, leading to infection.
  • Caring for corns and calluses: It is important to treat corns and calluses carefully because if a person attempts to remove them themselves, this could cause injury.
  • Regular foot exams: In addition to regularly connecting with other members of the diabetes healthcare team, a person may want to consider attending podiatry appointments so that a doctor can check their feet.
  • Regular physical activity: Keeping physically active supports adequate blood flow to the feet, which can help avoid foot health concerns. A person can consider feet-friendly activities, such as walking, biking, or swimming.

Additionally, it is important for a person to try to manage their blood sugar and keep it within a stable range. A person can reduce the risk of foot health complications from diabetes by:

Potential complications of diabetes can include a circulation decrease and slow wound healing. This means a person living with diabetes may be at a higher risk of foot health concerns, such as cracked heels. Without appropriate treatment, cracked heels can become painful and develop infection.

Therefore, to prevent cracked heels and potential complications, it is important for a person with diabetes to try following foot care tips, such as checking their feet regularly, moisturizing, and wearing well-fitting shoes.