Cracked Heels/Thick skin
Heel cracks can get so deep that they may be painful to walk on and may even bleed. A crack can provide an opening for bacteria or fungus to grow and spread, which could lead to an infection. That’s why it’s important to protect your heels!
Wearing tight-fitting shoes and layers of nail polish increases the risk of developing toenail fungus. Nail Fungus can be spread person-to-person in public areas, such as locker rooms and showers. Having a chronic condition that affects your circulation, such as diabetes, or HIV also increases your risk.
Symptoms of cracked heels
If the cracks are bad enough there will be pain on standing, that is not there when weight is off the heel. The edges or rim around the heel will generally have a thicker area of skin (callus). Wearing open or thin soled shoes usually make the symptoms worse.
Some people tend to have a naturally dry skin that predisposes them to the cracks. This dry skin around the heel that is more likely to crack is often due to mechanical factors that increase pressures in that area (eg the way you walk).
Other factors that can be involved in the cause of cracked heels include:
- Prolonged standing (at work or home, especially on hard floors)
- Being overweight (this increases the pressure on the normal fat pad under the heel, causing it to expand sideways – if the skin is not supple and flexible, the pressures to ‘crack’ are high)
- Open back on the shoes (this allows the fat under the heel to expand sideways and increases the pressure to ‘crack’)
- Some medical conditions predispose to a drying skin (eg autonomic neuropathy in those with diabetes leads to less sweating; an underactive thyroid lowers the body’s metabolic rate and there is a reduction in sweating, leading to a dryness of the skin)
- Skin conditions (eg psoriasis and eczema)
**Never try to reduce the hard skin yourself with a razor blade or a pair of scissors. There is a risk of an infection developing and taking too much off.
What you can do to prevent cracked heels:
- Wash your feet in warm water using a mild soap. Apply a cream that contains urea or glycerin right after, this will keep your skin moisturized.
- Drink lots of water, so you won’t be dehydrated.
- When bathing or showering, use warm, not hot water and don’t soak for more than 10 minutes as this will cause your skin to dry out.
- Choose shoes that are supportive and full backed, especially around the heel. Wearing open backed shoes allows the fat pad under the heel to expand sideways and the increased pressure can cause the heel to ‘crack’.
- Always wear socks in your shoes.
- Applying a moisturizing cream twice daily is really important to get on top of this problem. A pumice stone can be used to reduce the thickness of the hard skin.
Treatment by a Foot Care Professional
- Investigating the cause of the problem, so this can be addressed.
- Removing the hard thick skin (often the splits will not heal if the skin is not removed). This may need to be done on a regular basis. Regular maintenance by a foot care professional may be the best way to prevent the problem.
- If very painful, strapping may be used to ‘hold’ the cracks together while they heal (a maintenance program after this to prevent recurrence is very important).
- Advice regarding the most appropriate moisturizer or emollient.
- Advice about footwear and self care of the problem.
