Patient Education

Cracked Heels

 Description

On occasion, particularly during dry weather or times when you’re wearing sandals a great deal, you may notice that your heels have taken on the texture of a rough concrete wall. They’ve gotten thick, coarse, and may have even adopted foul language just to shock you. Eventually, you may find that your heels have begun to crack in spots. Now, those cracks might be minor ones, or they may be deep enough that they bleed and make it quite painful to walk. In some rare cases, they may even become infected.

You see, heels are under a lot of pressure pretty much any time you stand up. If you weigh a bit more than average, or if you’re on your feet a great deal (either at work or at home) the pressure is even greater. Under that pressure, the fatty pad under your heel (which usually serves as a kind of cushion for the weight coming down your leg and into your foot) tries to expand outward. If your skin is dry, or if you’re wearing open-heeled shoes that offer no support to shore up that expansion, the skin around your heel may begin to crack. Which can be pretty unpleasant, actually, since skin is generally nicest when it stays in one piece.

Sometimes dry or cracked heels may be a symptom of an underlying condition, such as diabetes or hypothyroidism, which can reduce sweating and therefore make your feet a bit more dry. Some skin conditions can also be at the root of the problem, such as eczema or psoriasis. If you’re concerned about these conditions, you’ll want to check with your podiatrist during your visit for advice about treatment.

Symptoms

Cracks in your heel are a pretty easy symptom to spot. However, you’re also likely to have associated symptoms, such as dry or thickened skin, sometimes appearing with a yellowish or brownish callus along the heel. If your cracks are deep, they may bleed, and if infected, they may become inflamed (red, warm to the touch, swollen and painful). The pain will likely occur while you’re standing, rather than when you’re just lying around on the couch watching your favorite sitcom.

Diagnosis

Your podiatrist can usually make the diagnosis by performing a visual examination, although he or she will probably ask you if there’s any pain while you stand, and will likely check to be sure there are no signs of infection. If an underlying condition such as diabetes or thyroid problems is suspected, your podiatrist may suggest further testing.

Treatment

In general, treatment involves moisturizing the skin of the heel and providing support for it. You can remove some of the dry skin on your heel by gently rubbing a pumice stone over your heel when you shower or bathe (or if you don’t do either, you can probably just soak your feet in warm water for awhile and then use the pumice stone). Then, when your feet are all nicely dried off afterward, you can smear on some moisturizing cream (ones with oil bases tend to work best) to keep your skin supple and less susceptible to cracking. By the way, DON’T go after your dry skin with a pair of scissors or a razor. Cutting off calluses yourself can lead to bad complications like cutting too deep and getting infections. Think of children trying to cut their own hair: it really doesn’t ever work the way it’s supposed to.

Avoid wearing open-heeled shoes (things like flip flops or other sandals) for awhile, or at least alternate their use with shoes that do have heels. You can also purchase a heel cup to provide further support, keeping your heel from that outward spreading that leads to cracking. If the cracks are pretty severe or persistent, your podiatrist may be able to tape your heel up in order to provide additional support, or he or she may use a special kind of glue (designed for use with the skin-this isn’t the stuff you used to adhere dry macaroni noodles to construction paper when you were a kid) to pull the cracks in your heel together and allow them to heal.

Infected cracks may need additional help, such as antibiotic medications, but your doctor can give you excellent advice about that.