Dry & Cracked Heels

Cracked heels are a common problem that may develop into painful fissures or openings if left untreated. You may see dehydrated feet as a minor nuisance; however it can lead to further problems such as fungal infections and ulcerations. Foot care is an especially important issue for the increasing number of diabetic patients globally. There are numerous products that cannot only combat the dryness but may be helpful in treating a variety of skin problems, including athlete's foot and psoriasis.

While one of the main causes of dry, cracking skin is the arid winter air, other factors can impact heels. Common problems that contribute to heel fissures include but are not limited to:

• Age
• Psoriasis or other skin-related conditions
• Diabetes
• Kidney disease
• Thyroid disease
• Vitamin deficiency
• Excess weight

Skin loses its ability to stretch with age, so cracks are more common as you get older. Diabetes can interrupt the body's ability to produce oils, making the skin less supple and more susceptible to extreme dryness.

Disease and disorders such as athlete's foot, psoriasis, eczema, and thyroid disease may cause cracked heels. Excess weight can create extra pressure on the feet.

Prolonged standing in ill-fitting shoes can become a problem due to added pressure. Poorly structured feet can sometimes lead to abnormal gait that produces calluses to the heel. Water, especially running water, can rob the skin of its natural oils and this can leave the skin dry and rough. Deficiency of vitamins, minerals and zinc can lead to skin breakdown as well.

One of the first signs of dry, cracked heels is formation of thick, discolored callus tissue that may cause pain with everyday pressure-related activities like walking or running. If the callus goes untreated and continuous pressure is applied, then you may eventually notice small or even deep breaks that may cause bleeding to occur. If not properly cared for, this may cause an infection. The skin to the heels may begin to redden or become severely inflamed. Diabetics must check their feet daily because these changes can go unnoticed due to a decreased ability to feel their feet.

Conservative treatment of dry, cracked heels is easily prevented by wearing adequate supportive shoes and with regular use of moisturizers. Ideally, the goal is to prevent cracks from first forming.

• Topical creams are documented to be the best skin care treatment. Creams that use keratolytic and humectant agents containing urea, salicylic acid, alpha-hydroxy acids, saccharide isomerate, and petroleum jelly may all be successful. Apply these agents two to three times a day until healed.
• Pumice stones can remove some of the excess dead skin that is preventing proper healing.
• Bandages or coverings allow moisturizing agents to work more effectively, prevent moisture loss, and act as a barrier against bacteria growth.
• Custom insoles (orthotics) can also redistribute pressure abnormalities on the heel.

If healing is slow, your podiatrist or other healthcare practitioner may decide to remove specific callus tissue to help the healing process. Do not attempt this at home or at local pedicurist, as this can lead to infection or excessive skin removal if done improperly. Pay close attention to your feet daily and ideally you can avoid this from day one!