Cracked heels

Dehydration

One of the primary causes of cracked heels is dehydration, as dry skin on the soles of the feet loses moisture more easily when the body is dehydrated.

Athlete's Foot

This fungal infection often presents as a scaly rash and can lead to the formation of cracked skin on the heels.

Eczema (Atopic Dermatitis)

Eczema causes the skin to become dry, inflamed, and cracked, which can lead to fissures on the heels.

Uncontrolled Diabetes

Diabetes can cause nerve damage (neuropathy), impairing the feet's ability to sweat, which in turn increases the risk of callus formation and cracked heels.

Hypothyroidism

This condition occurs when the thyroid gland produces insufficient hormones, slowing the body's metabolism and reducing the natural oils that keep skin moisturized, resulting in dry, cracked feet.

Palmoplantar Psoriasis

A specific form of psoriasis that affects the palms and soles of the feet, leading to pustules, calluses, and cracks on the heels.

Juvenile Plantar Dermatosis

Also known as sweaty sock syndrome, this condition primarily affects children aged 3 to 14 and is characterized by red, dry, and scaly patches on the soles of the feet.

Sjogren's Syndrome

A rare autoimmune disorder where the immune system damages glands responsible for producing moisture, leading to dry skin, including on the feet.

Obesity

Excess weight can place added pressure on the feet, increasing the risk of developing cracked heels due to additional strain on the heels.

Pregnancy

Hormonal changes, weight gain, and increased pressure on the feet during pregnancy can contribute to skin dryness and cracked heels.

Aging

As people age, their skin becomes thinner, drier, and less elastic, decreasing natural oil production, which can lead to dryness and cracked heels.

Other Contributing Factors

• Living in dry or cold climates
• Long, hot showers
• Wearing poorly fitted or open-back footwear
• Spending extended periods standing, especially on hard surfaces
• Excessive running or physical activities that create pressure and friction on the feet
• Occupations that involve continuous pressure or friction, such as those in athletics or construction

Cracked heels can usually be diagnosed through a physical examination, though further tests may be conducted to determine the underlying cause. The diagnostic process may include the following:

Medical History and Physical Examination

During the exam, the doctor will look for visible signs of cracked heels and inquire about footwear, previous treatments, and walking habits to detect any mechanical issues that may be contributing to the problem.

Laboratory Tests

While blood tests are not generally done for cracked heels themselves, they may help identify underlying conditions contributing to the issue:

• Complete Blood Count (CBC): Can indicate signs of infection or inflammation.
• Blood Glucose Test: Helps diagnose diabetes or impaired glucose metabolism, both of which can affect skin health.
• Nutritional Tests: To check for deficiencies in vitamins such as A, C, D, and E, which are vital for skin health.
• Pedobarographic Studies: Pressure studies that assess areas of high pressure on the feet, which may be contributing to cracked heels.
• Skin Biopsy: In certain cases, a biopsy of the skin is taken to examine tissue and identify any underlying conditions.

Imaging Tests

These are not routinely required but may be useful to identify the exact cause of heel fissures:

• Dermoscopy: A non-invasive examination using a device that magnifies the skin, helping diagnose skin conditions.
• Wood's Lamp Examination: Using ultraviolet light to examine the skin for signs of infections or other conditions.
• Radiographs (X-rays): Weight-bearing foot X-rays may be used to identify any bony protrusions that might contribute to cracked heels.

There are several effective measures that can help prevent cracked heels from developing:

Moisturize Regularly:

Apply a good moisturizer to your feet both in the morning and at night to maintain smooth and hydrated skin.

Exfoliate Frequently:

Use a gentle foot scrub or pumice stone to exfoliate regularly and prevent the buildup of excess dead skin.

Wear Properly Fitting Shoes:

Choose shoes that fit well, avoiding those that are either too tight or too loose.

Avoid Walking Barefoot on Rough Surfaces:

Walking without shoes on hard or abrasive surfaces can damage the heels and dry out the skin.

Wear Non-Slip Footwear at Home:

Use non-skid socks or house slippers to protect your feet while indoors.

Use Heel Cups:

These can be purchased at drugstores or sports stores. Heel cups help relieve pressure on the heels and prevent damage.

Inspect Your Feet Daily:

Regularly check your feet for any signs of cracks forming to catch issues early.

Stay Hydrated:

Ensure you're drinking enough water to maintain overall skin hydration and prevent dryness.

Specialists to Visit

Although cracked heels are often not a serious health issue, if left untreated, they can cause discomfort. Various specialists can assist in diagnosing and managing cracked heels:

• General Physician: They can help identify the cause and provide treatment or refer you to a specialist if needed.
• Podiatrist: A foot specialist who can use techniques like debridement to remove dead skin and prevent further cracking.
• Dermatologist: A skin expert who can diagnose and treat skin-related conditions affecting your feet.
• Orthopedic Specialist: If bony or structural issues are contributing to the problem, an orthopedic doctor can offer treatment options.

When to See a Doctor?

Consult a healthcare provider if:

• The cracked heels are causing pain or significant discomfort.
• The condition is interfering with daily activities.
• You have underlying health conditions like diabetes, poor circulation, or other serious medical issues that may be contributing to the problem.

Treatment depends on the severity of the condition and its underlying cause. Options include:

1. Over-the-Counter (OTC) Treatments

• Foot Balms and Moisturizers: Applying foot balms or moisturizers with humectants (agents that retain moisture) can help treat cracked heels. Regular application will keep the skin hydrated and soft.
• Liquid Bandages: These can be applied to the affected area to seal the cracks and protect the skin from infections, while also preventing further cracking.

2. Professional Treatments

If the cracks are severe or don’t improve after a week of self-care, professional treatment may be necessary:

• Prescription Debriding Agents: Creams containing ingredients like salicylic acid, urea, silver nitrate, and 10% glycerol can help remove dead tissue and speed up healing while reducing infection risk.
• Topical Medications: Timolol, a topical treatment, can aid in restoring the skin barrier and promoting healing in deep, painful cracks.
• Debridement: This medical procedure involves the removal of tough, damaged skin by a doctor to help heal the affected area.

Note: It is not safe to perform debridement at home with razors or scissors due to the risk of infection and excessive skin removal.

• Strapping: A doctor may wrap the cracked heels with a bandage to limit movement and facilitate healing.
• Shoe Inserts: Orthotic inserts may be recommended to redistribute pressure and offer better support to the heels. Heel pads or cups can also provide additional support.
• Tissue Glue or Adhesives: These products can be used to close deep cracks and help the skin heal by holding the fissures together.

Although cracked heels may seem like a minor issue, if left untreated, they can lead to several complications:

• Nerve Damage: Deep cracks may extend into the underlying tissues, affecting nerves and leading to a loss of sensation in the heel.

• Cellulitis: Open sores from heel fissures can become infected, leading to cellulitis, a painful skin infection.

• Foot Ulcers: Deeply cracked heels can provide an entry point for bacteria, causing infections and potential tissue damage.

• Emotional Stress: Cracked heels, especially when persistent, can cause concerns about appearance and functionality, affecting one’s quality of life and causing emotional distress.

In addition to home remedies and self-care, alternative therapies may offer additional relief for cracked heels:

Ayurveda:

Ayurvedic practitioners recommend using herbal ointments with natural ingredients to treat cracked heels. They also suggest regular foot massages with warm sesame oil, which is believed to calm the Vata dosha (one of the body's energies associated with movement).

Yoga:

Certain yoga poses can improve circulation, foot flexibility, and posture, all of which help promote overall foot health. Yoga also encourages mindfulness in foot care and can help reduce stress, which may contribute to cracked heels.

Cracked heels are generally not a major health concern and can often be managed with over-the-counter products or basic foot care. In addition to using heel balms and moisturizers, several home remedies can help treat dry and cracked heels and prevent them from coming back. These remedies include:

Honey:

Known for its healing properties, honey acts as a natural antiseptic and moisturizer, helping to heal cracks and prevent dryness.

How to use it: Mix one cup of honey with lukewarm water in a tub. Soak your feet for 15-20 minutes, gently massaging them. Afterward, dry your feet and apply a moisturizer.

Coconut Oil:

Coconut oil is effective at moisturizing and soothing the skin, as well as reducing inflammation. It can also help prevent infections that may occur in deep cracks.

How to use it: Apply a generous amount of coconut oil directly to the cracked heels to moisturize and reduce inflammation.

Oatmeal:

Colloidal oatmeal is known for its anti-inflammatory and antioxidant benefits, making it useful for treating dry, rough, and scaly skin.

How to use it: Mix colloidal oatmeal with coconut oil to form a paste. Apply it to your cracked heels, let it sit for 20-30 minutes, then gently scrub and rinse with lukewarm water.

Apple Cider Vinegar:

Known for its antibacterial and anti-inflammatory properties, apple cider vinegar can help relieve and prevent infection in heel cracks.

How to use it: Combine 1 part apple cider vinegar with 2 parts cool water in a bowl. Soak your feet in this solution for 5-10 minutes.

Banana:

Rich in nutrients that improve skin elasticity and hydration, bananas can help keep the skin on your feet moisturized. Studies have shown that banana peel gel is effective in treating cracked heels.

How to use it: Mash two ripe bananas into a paste and apply it to your cracked heels. Rinse your feet with lukewarm water after 30 minutes. Repeat daily for optimal results.

Aloe Vera:

Aloe vera is commonly used for treating dry skin due to its natural moisturizing properties. The vitamins and minerals in aloe vera help in skin regeneration.

How to use it: Directly apply aloe vera gel to your cracked heels to promote healing.

Turmeric:

With its anti-inflammatory and antiseptic properties, turmeric can help prevent infections caused by cracked heels.

How to use it: Mix a pinch of turmeric powder with castor oil and apply it to the cracks.

While cracked heels might not seem like a major issue, they can have a significant impact on daily life, causing discomfort, pain, and making it difficult to walk or stand for extended periods. Here are some tips for caring for your feet:

Limit Bath Time

• Avoid long showers or baths lasting more than 5-10 minutes. Prolonged exposure to water can dry out your skin and worsen cracked heels. Also, avoid scrubbing your skin with rough towels, as this can irritate the skin further.

Use Gentle Products

• Choose mild, fragrance-free cleansers when washing your feet. This helps preserve the natural oils in your skin, preventing further dryness and irritation.

Exfoliate Regularly

• The skin on your heels is thicker than on the rest of your body, making it more prone to dryness and cracking. To reduce cracks, soak your feet in warm water and gently exfoliate using a pumice stone, loofah, or foot file. Regular use of foot scrubs can also help keep the skin soft.

Moisturize Consistently

• Make moisturizing a priority. Apply a good moisturizer to your heels within 5 minutes of bathing, while your skin is still damp, to lock in moisture. This helps keep your feet hydrated and soft.

Establish a Bedtime Routine

• Create a nightly foot care ritual. Soak your feet in plain or soapy water for around 10 minutes, gently dry them, and exfoliate your heels. Then, apply a thicker, oil-based cream or petroleum jelly to your feet. For added hydration, wear thin cotton socks overnight to help seal in the moisture.

Protect Your Heels

• To speed up the healing of cracked heels and prevent further irritation, you can apply a liquid bandage to the cracks. This will protect the skin, reduce discomfort, and prevent infections. Additionally, wearing well-fitting shoes can help avoid unnecessary strain on your heels.