What to do for cracked, painful heels

Why do heels split and hurt?

Dry, thickened skin around the heel forms a callus. Pressure pushes the fat pad beneath the heel sideways, splitting that hard skin. Deep cracks, also called fissures, can hurt when you stand or walk and can bleed. Prolonged standing on hard floors adds pressure. Open backed sandals leave the heel pad unsupported, which is a generous interpretation of the word shoe.2

What should I do each day?

1. 1Wash gently. Use lukewarm water and a gentle, fragrance free cleanser without scrubbing. Keep baths and showers to 5 to 10 minutes, and avoid long foot soaks.
2. 2Moisturize promptly. Blot dry gently and apply a thick foot or hand cream within five minutes of bathing, while the heel skin is still damp. Repeat whenever the heels feel dry; early cracks can benefit from moisturizing two to three times daily.
3. 3Protect the splits during the day. A liquid bandage creates a protective barrier over heel cracks and can reduce pain, help healing and keep germs out.
4. 4Seal in moisture before bed. Apply plain petroleum jelly and put on socks. Thin cotton socks help retain moisture.
5. 5Change the shoes. Choose properly fitting shoes with enclosed heels. Avoid worn out shoes and open heeled styles while your heels are cracked.

Dry carefully between your toes and keep cream out of those spaces, where extra moisture encourages athlete's foot. Socks help keep greasy foot treatments off your bedding, which has not volunteered for a heel treatment. Continue daily moisturizing after the cracks improve to help prevent them returning.17

Which cream should I choose?

A thick moisturizing cream is a useful starting point. Ceramides help hold water in the skin and restore its protective barrier. For dry, thickened heels, options include a cream containing 10% to 25% urea, or one containing alpha hydroxy acid or salicylic acid. These heel balm ingredients help retain water or remove built up hard skin. Stronger softening treatments are also available through a podiatrist.125

Should I file the hard skin?

For intact hard skin, gentle filing once or twice weekly on dry feet can help. Do not file inflamed, itchy or sensitive areas. Never cut hard skin away with scissors or a razor blade: removing too much skin risks infection. Avoid chemical foot peels on broken skin, sores or wounds, and if you have or are prone to eczema, psoriasis or athlete's foot.267

How long should I wait before getting help?

Exfoliating moisturizers can take about two weeks of regular use to show a response. However, arrange a podiatry appointment if painful cracks are severe or show no improvement after a week of home care. A podiatrist can remove thick skin safely, apply dressings that reduce movement, and offer heel cups or insoles to redistribute pressure. Persistent cracking also warrants assessment for an underlying skin or medical condition.25

If you have diabetes, check your heels, soles and between your toes daily; reduced feeling can hide damage. Contact your doctor, podiatrist or diabetic foot team straight away for a wound, redness, swelling, a hot foot, discharge or a bad smell. Seek urgent medical attention for sudden redness or swelling, colour changes or increasing pain, especially if you feel unwell. If you have peripheral artery disease, meaning narrowed arteries supplying your legs and feet, report any foot problem promptly rather than treating it yourself first.34