Why do I have cracked heels?

Why does the skin split?

The first sign is often a callus: dry, hard, thickened skin around the heel's rim. When you put weight on your heel, the fat pad underneath spreads sideways and the callus can crack. Standing for long periods, especially on hard floors, and greater body weight add pressure. Open backed sandals leave that fat pad unsupported, so their contribution to heel care is mostly an unobstructed view. Repeated rubbing from shoes, a dry climate and age related changes in the skin can also contribute to dryness.14

Why are my heels cracked even though I moisturize?

Moisturizer addresses dryness, but not every cause of cracking. Athlete's foot is a fungal infection that can spread to the heels and cause painful splits. Itching, scaling or redness on the soles or between the toes are useful clues, not a diagnosis. Ask a pharmacist about treatment and follow the packet's full course, even if the rash clears earlier. Eczema, psoriasis, diabetes and an underactive thyroid can also contribute. Persistent cracking despite regular care deserves an assessment rather than another, richer cream.13456

How to care for dry, cracked heels

For ordinary dry heels, use this daily routine:

1. 1Wash gently with lukewarm water and a fragrance free cleanser. Keep baths and showers to 5 to 10 minutes, avoid scrubbing and blot dry gently.
2. 2Apply moisturizer within five minutes of bathing, while the heels are still damp. A thick cream is useful; options include creams containing 10 to 25% urea, alpha hydroxy acid or salicylic acid. Moisturize again whenever the heels feel dry. Keep cream out of the spaces between your toes.
3. 3Before bed, apply plain petroleum jelly to your heels. Cotton socks help retain moisture and keep grease off your bedding.
4. 4During the day, a liquid bandage can protect cracks, reduce pain and help healing. Wear well fitting shoes that support and cover the heel rather than worn down shoes or open backed sandals.

A simple moisturizer can be enough for dry heels; the tub does not need a separate foot department. Creams containing ceramides help retain water and support the skin's protective barrier.46

Should I file the hard skin?

Gentle filing can remove some thick callus. Use a foot file on dry hard skin once or twice weekly, or gently use a pumice stone before moisturizing. Do not file inflamed, itchy or sensitive areas, and never cut calluses with scissors or a razor. Avoid foot peels on broken skin or if you have or are prone to eczema, psoriasis or athlete's foot.145

How long should improvement take?

Regular use of exfoliating moisturizers can take about two weeks to show a response. However, see a podiatrist if cracks are severe or you see no improvement after a week of home care. Deeper cracks can become painful, bleed or become infected. Once the skin improves, keep moisturizing daily to prevent recurrence; the cream has a maintenance job, not a retirement date.145

When do cracked heels need medical help?

If you have diabetes, reduced feeling or poor circulation, get help early rather than relying on home treatment. Diabetes can reduce sensation and blood flow, so a serious problem is not always painful. Check your feet daily, including the heels, soles and between the toes; use a mirror if needed. Contact your doctor, podiatrist or diabetic foot team straight away for a wound, redness, swelling, warmth or signs of infection such as discharge or a bad smell. Sudden colour changes, severe pain or a foot that becomes cold or numb also need urgent medical attention.7