How to fix cracked heels

Why do heels crack?

Cracks usually start with dry, thickened skin around the heel rim, called a callus. Pressure makes the fat pad underneath the heel spread sideways, splitting the hard skin above it. Standing for long periods, especially on hard floors, and wearing sandals without heel support contribute to this. Small surface cracks can deepen until standing or walking hurts, and deeper cracks can bleed. The problem is not always dryness alone: eczema, psoriasis, diabetes and an underactive thyroid can also contribute.2

What should you do each day?

1. 1Wash your feet daily with lukewarm water and a gentle, fragrance free cleanser. Avoid scrubbing. Keep any separate foot soak brief rather than leaving your feet in water for a long session.
2. 2Blot your feet gently with a towel. Dry between the toes carefully, but leave the heels slightly damp for moisturizing.
3. 3Apply heel cream within five minutes of bathing. Look for 10% to 25% urea, or a cream containing alpha hydroxy acid or salicylic acid.
4. 4Reapply moisturizer whenever your heels feel dry. At the first signs of cracking, moisturizing two to three times daily can be enough to help the skin heal.
5. 5Before bed, apply plain petroleum jelly to the heels. Wear cotton socks overnight to help retain moisture and keep the ointment off your bedding.

Long, hot showers can worsen dryness, so limit baths and showers to five to ten minutes. Prolonged soaking can weaken the skin barrier, the outer layer that helps keep moisture inside. A long soak is not a shortcut to softer heels, however convincing the bowl of water looks.15

Which cream should you choose?

Heel balms can contain ingredients that hold water in the skin or help remove thick, dead skin. Urea, salicylic acid and alpha hydroxy acids are common options. A cream containing ceramides helps trap water and restore the skin's natural barrier. Petroleum jelly goes over moisturizer to seal in moisture rather than taking the place of the whole routine. A heel balm's useful qualification is its formula, not how many times the packaging mentions feet.25

For dry, cracked heels, choose urea in the 10% to 25% range. Once the heels are healthy, an exfoliating moisturizer can help keep dead skin from building up; options include 20% or 40% urea creams. Keep that distinction clear: a stronger maintenance product is not automatically the starting point for cracked skin.15

Should you file the hard skin?

For ordinary hard skin, gentle filing once or twice weekly can help. Use a foot file on dry skin, or gently rub a pumice stone against the callus before moisturizing. Sit on a chair and bring your foot back toward the file if reaching your heel is awkward. Do not file inflamed, itchy or sensitive areas. Never cut hard skin away with scissors or a razor blade: removing too much skin can cause injury and infection. If you have diabetes or poor circulation, leave callus removal to a professional.23456

Foot peels remove outer layers of skin, but avoid them on broken skin, sores or wounds. They are also unsuitable if you have or are prone to eczema, psoriasis, contact dermatitis or athlete's foot. An exfoliating treatment is not a substitute for protecting an open crack.5

How do you protect cracks while they heal?

A liquid bandage applied during the day creates a protective barrier over heel cracks. It can reduce pain, help healing and keep germs out. Deep, bleeding or infected cracks need medical assessment rather than relying on a cosmetic foot treatment.12

Choose properly fitting shoes with enclosed heels. Avoid flip flops, slingbacks, worn down shoes and pairs that rub or fit poorly. Socks or stockings can help when open footwear makes dryness worse. Open backed shoes leave the heel without support, which is an ambitious amount of responsibility to give a sandal. Continue applying cream daily after the skin improves to help prevent cracks returning.126

How long does healing take?

Exfoliating moisturizers used regularly can take about two weeks to show a response. That is not a fixed healing time for a deep crack. If your heels show no improvement after one week of home care, arrange a podiatry appointment rather than simply increasing the strength or filing harder.25

When should you see a doctor or podiatrist?

Seek help for severe cracks, bleeding or pain with walking. Infection can develop in cracked heels and sometimes causes cellulitis, a skin infection requiring medical treatment. A podiatrist can safely remove thick skin, use dressings to reduce movement around a crack, or recommend stronger softening treatments. Heel pads, cups or insoles can redistribute pressure and support the heel.2

What changes if you have diabetes?

Diabetes can make skin extremely dry, easily irritated and slower to heal. Reduced feeling in the feet can make injuries harder to notice, and heel cracks can lead to ulcers. Check your feet daily, including the soles and between the toes. For dry heels, apply 10% to 25% urea cream at bedtime, add petroleum jelly and wear white cotton socks. Repeat daily until the skin heals. Choose fragrance free creams or ointments; products labeled "unscented" can still contain masked fragrance.23

Get professional care for foot calluses rather than removing them yourself. Seek immediate medical care for suspected infection, including swelling, discoloration, tenderness or fluid leaking from a wound. Clean a minor cut with soap and water and cover it with an adhesive bandage; use antibiotic ointment only if your doctor recommends it. Get immediate care if a wound worsens or fails to heal, and for wounds other than minor ones.3

What if you have poor circulation?

Peripheral arterial disease reduces blood flow to the legs, so even small foot wounds take longer to heal. Inspect your feet daily for cracks, bleeding, redness, swelling or discharge; use a mirror to see the soles. Wash with mild soap, keep soaking to no more than five minutes and dry between the toes. Apply a simple moisturizer daily, but not between the toes. Do not remove hard skin or use acid corn plasters. Avoid walking barefoot and check inside shoes for anything sharp or rough. Contact your GP, podiatrist or nurse immediately for unusual swelling, color changes, blisters or discharge.4