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Cracked Heels: What do I need to know?

Published: September 10, 2021

Cracked heels is a condition when the skin on the bottom and boundary of the heels begin to develop a callus (thickened skin) and become dry due to external and internal factors, and if left untreated may split, creating “cracks”, or fissures. These fissures may simply be a cosmetic nuisance, however in some cases can lead to bleeding, infection, and other issues.

What are the causes and who can get them?

Certain individuals are more likely to develop Heel Fissures due to a biological predisposition or, as a side effect of medications for specific ailments. Conditions such as Psoriasis, Eczema, Obesity, Diabetes and Hypothyroidism can cause the skin to become thicker OR thinner and expel moisture at a more rapid rate, leaving the heels dry and rough.

Prolonged standing on hardwood floors, later stages of pregnancy, exposure to air, and footwear with poor cushioning, shock absorption and heel support are also common contributing factors.

If calluses and dryness of the heels are left untreated, continuous increased pressure can cause the underlying fat pad to expand until the skin eventually breaks or “cracks”. Not addressing causative factors will encourage the fissures to go deeper into the layers of the skin, creating an open wound that will be susceptible to infection and may lead to cellulitis.

How are heel fissures treated?

The first intervention for preventing Heel Fissures is adding moisture back into the skin. Moisturises that are emollient based with a mild keratolytic (descaling) agent are best to add moisture back into the skin while also reducing skin build up. These must be used daily to treat and prevent fissuring.

Use of a pumice stone or rasp can help remove superficial layers of dry/hard skin but must be used with caution as excessive rubbing may lead to wounds.

A Podiatrist is expertly trained in the treatment and management of cracked heels. Medical scalpel debridement is the main technique utilised by Podiatrists to remove excess layers of callus build up and must be accompanied by offloading treatment either using footwear or orthotics to prevent fissures from recurring.

What is scalpel debridement?

A Podiatrist uses a small sterile blade to scrape off the “dead”, hardened skin gently and professionally. This is typically pain free as the skin being removed has no nerve or vascular supply. This treatment should not be attempted at home due to risk of injury and trauma if not done correctly.

If you suspect that you might be experiencing cracked heels, please do not hesitate to call or book an appointment online with our Podiatrist here at Back in Motion, Point Cook. They will be able to assess you and then get you started on the appropriate treatment required.