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What are Cracked Heels?

Cracked heels, medically known as heel fissures, are a common foot problem characterised by the formation of fissures around the heels. These fissures usually occur in the outermost layer of the skin and are associated with abnormally dry and thickened skin.

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For many, they can be a cosmetic problem and pain free, or at worst slightly uncomfortable. However, in some situations, the cracks can become painful and lead to serious medical problems if left untreated.

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When small cracks in the skin penetrate into the deeper layers of the skin (dermis), the deep fissures can bleed and become painful, making it difficult to walk and making you more susceptible to pathogens.

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Causes of Cracked Heels

There are several common causes of cracked heels including:

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1. Dry Skin: The most common cause of cracked heels is dry skin. Lack of moisture leads to a build-up of thick hard skin, which can eventually crack and become uncomfortable.

2. Biomechanical Abnormalities: Biomechanical factors can also contribute to the development of cracked heels.

3. Dehydration: When the body lacks sufficient water, skin hydration suffers, which can lead to dryness and cracking.

4. Age: As we age, the skin naturally loses elasticity and moisture, causing it to become dry and potentially leading to cracks in the heels.

5. Unsuitable Footwear or Bare Feet: Wearing shoes open-backed shoes such as sandals and thongs, shoes with thin soles or going barefoot can lead to dryness and potential cracking. Unsupportive and ill-fitting shoes can lead to more mechanical stress, causing cracks.

6. Standing for Long Periods: Those that have jobs that require extended periods of standing, particularly on hard surfaces, are prone to heel cracking.

7. Excessive Weight: Carrying excess weight can put increased pressure on the fat pad under the heel, causing it to expand sideways and potentially develop cracking if the skin lacks flexibility.

8. Skin Conditions: Certain skin conditions like atopic dermatitis, tinea, eczema, and psoriasis can contribute to dryness and cracking of the skin, including the heels.

9. Systemic Conditions: Medical conditions such as diabetes, hypothyroidism, and Sjogren's syndrome can contribute to dry and hard skin.

10. Lack of Foot Care: Neglecting regular foot care routines, such as moisturising and exfoliating, can cause you to develop dry, cracked heels.

11. Dry Climates: The summer heat in Sydney dehydrates the skin.

12. Improper Diet: Lack of essential vitamins, minerals, and omega-3 fatty acids can impair skin health and lead to dry and cracked skin.

13. Medication: some medications can cause dry, cracked heels.

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Symptoms of Cracked Heels

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• Visible Cracks: The most noticeable symptom is the presence of visible cracks or fissures on the heels. These may vary from superficial to deep, potentially causing pain.

• Hard, Thick Skin: Often, cracked heels are preceded by the development of a thick, hard layer of skin (callus) around the rim of the heel.

• Dryness and Peeling: The skin around the heels may appear particularly dry, flaky, and may start peeling.

• Redness or Inflammation: The affected area may show signs of redness or mild inflammation, especially if the cracks are deep.

• Pain: Depending on the severity of the cracking, the person may experience pain, especially when standing or walking.

• Bleeding: In extreme cases, deep cracks in the heels can cause bleeding.

• Difficulty Walking: Severe cases of cracked heels can cause discomfort while walking.

• Signs of Infection: Increased redness, swelling, warmth, or even pus.

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When to See A Podiatrist

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Self-care measures are usually the first treatment option, such as using a heel balm and a pumice stone to get the skin soft around the heel. However, if your heels aren't improving with the use of balm and a pumice stone, it's likely time to visit a podiatrist.

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If left untreated, heel fissures can become more dangerous and become deep or infected. Extreme symptoms include pain, bleeding, difficulty walking or signs of infection.

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How Can a Podiatrist Help?

There can often be multiple causes of cracked heels, so it's important to get a comprehensive lower limb assessment to accurately determine the root cause(s). Since causes can range from environmental factors, skin conditions, biomechanical issues, or systemic health problems, the treatment required will vary.

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At North Sydney Podiatry, we will determine the most suitable treatment for your condition. The treatment you receive will be personalised based on the severity of your cracked heels, underlying health conditions, and lifestyle factors.

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Our podiatrists take a holistic approach to your treatment to prevent further complications as well as help prevent future occurrences of cracked heels. Our preventive advice includes recommendations on proper foot care, suitable shoes, and necessary lifestyle modifications.

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If your cracked heels are found to be a symptom of a more serious underlying health issue, early detection and treatment can prevent further complications.

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Treatment For Cracked Heels
Heel Balm

There are several non-surgical treatment options we apply including specialised heel balms which makes the skin soft and promotes healing of the cracks.

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Debridement

In cases of severe heel fissures or calluses, podiatrists may also perform debridement, which involves using sterile instruments to achieve safe and controlled removal of hard, dead skin.

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Orthotic Devices

If biomechanical issues are contributing to cracked heels, we may recommend custom orthotics. These devices redistribute foot pressure, thereby reducing the pressure on the heels.

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Advice on Footwear

Our podiatrists can assess your current shoes and provide advice on the best shoes to avoid exacerbating the condition and to provide adequate support for the feet.

 

Antibiotics or Antifungals

In cases where there's a bacterial or fungal infection in the cracks, our podiatrists may suggest appropriate antibiotics or antifungal medications.

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Complications of Cracked Heels

Cracked heels, if left untreated, can lead to several complications that may impact your overall quality of life.

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1. Pain and Discomfort: Over time, the cracks can become deeper, causing significant pain and discomfort ultimately limiting your mobility. This can especially be felt when standing or walking.

2. Risk of Infection: Deep cracks can expose the underlying dermal layer to the external environment, increasing the risk of bacterial or fungal infections. Once an infection sets in, it can be difficult to manage and may lead to more serious complications, particularly in people with compromised immune systems, or those with diabetes as it can lead to a diabetic foot ulceration.

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Who Is at Risk of Developing Cracked Heels?
 

1. Individuals with Dermatological Conditions

2. Older Adults

3. People with Diabetes

4. Individuals with Hypothyroidism

5. Obese Individuals

6. Individuals with Nutritional Deficiencies

7. People with Prolonged Standing Habits

8. Individuals Using Harsh Soaps or Cleansers

9. Prolonged usage of thongs or bare feet walking 

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Remember, if you're in a high-risk group and prone to experiencing cracked heels, it's crucial to seek consultation from your local podiatrist for proper diagnosis and management. Regular care for your feet is essential to prevent the progression and complications of this condition.

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​Frequently Asked Questions