Cracked heels

Also known as fissured or split heel

A cracked heel is a common foot problem. In most cases it's just a nuisance and unattractive to look at. But when the cracks or fissures become deep, it can be painful to stand, walk or put any pressure on your heel.

Key points about cracked heels

  1. The first sign of getting a cracked heel is dry, hard, thickened skin around the edge of your heel.
  2. Cracked heels are of particular concern if you have diabetes, as the fissures may lead to diabetic foot ulcers.
  3. In severe cases, cracked heels can become infected and lead to cellulitis. This needs urgent medical attention.
  4. To help prevent cracked heels, rub them with a moisturising cream regularly to keep your skin soft and hydrated.
  5. See your doctor if you have severely cracked heels or if no improvement is seen after a week of self-treatment.

Who gets cracked heels and why?

Anyone can get a cracked heel. You may be more likely to get them if you have:

  • dry skin
  • allergic dermatitis
  • psoriasis – especially on the sole of your foot
  • thickened skin on the soles of your feet
  • certain conditions including diabetes and hypothyroidism.

Some factors that contribute to cracking or splitting include:

  • being overweight
  • standing for long periods of time, especially on hard floors
  • open-back shoes and sandals, as they provide no support to hold the fat pad under your foot
  • playing sport requiring long periods standing, eg, bowls.

What are the signs of a cracked heel?

The first sign of getting a cracked heel is the development of dry, hard, thickened skin around the edge of your heel. This is called a callus. It may be a yellow or dark brown colour.

At first, small cracks over the callus are visible. If left untreated, and as more pressure is placed on your heel, these cracks become deeper. Eventually, walking and standing become painful. The cracks can get so deep that they begin to bleed.

In severe cases, cracked heels can become infected and lead to cellulitis. This is an infection in the deeper layers of your skin and needs urgent medical attention.

Cracked heels and diabetes

Cracked heels are of particular concern if you have diabetes, as the fissures may lead to diabetic foot ulcers. Foot problems can be avoided if you take care of your feet and act quickly if you have a problem.

Read more about diabetes and foot ulcers.

What is the treatment for cracked heels?

The best form of treatment for cracked heels is to prevent cracks from occurring in the first place. You can do this by simply rubbing your heels with a moisturising cream on a regular basis to keep your skin soft and hydrated.

Special heel balms are available from your pharmacist to help your skin retain moisture, or break down the outer layers and decrease the skin thickness.

  • Urea-based products
    • These products work mainly by preventing water loss through your skin. 
    • They may cause a stinging sensation if applied to fissures or other broken skin. 
    • Read more about urea cream. 
  • Salicylic acid-based products
    • These products work by breaking down the outer layers of your skin and can decrease the thickness of skin.
    • They are best applied to thickened, dry heel skin.
    • They may cause a stinging sensation if applied to fissures or other broken skin.
    • An example is HealthE cream.
  • Alpha-hydroxy acids
    • An example is QV Heel Balm.
  • Saccharide isomerate 
    • An example is Ellgy Heel Balm.
    • This product is not easily washed off and moisturises for a long time.
  • Petroleum jelly  
    • An oil-based product, eg, Vaseline.

Check your feet every day. On the first sign of any cracking, a moisturising routine 2–3 times a day may be all that is needed to heal the heel. A pumice stone can be rubbed gently against the callus to take away some of the thick hard skin. Soak your feet in warm soapy water (not detergent) for about 10 minutes before applying moisturiser.

See your doctor or a podiatrist (a non-medical foot specialist) if you have severely cracked heels or if you have no improvement after a week of self-treatment. They may treat fissures with a liquid, gel or spray bandage to reduce pain, protect your heel and allow more rapid healing.

You can also try a heel-raise (eg, Scholl’s) into shoes or boots you wear often. These are available from your pharmacist.            

References

  1. Cracked heels: stop them in their tracks BPAC, NZ, 2014
  2. Cracked heel Dermnet, NZ

Reviewed by 

After 45 years of GP experience, and 8 years as an examiner and practice assessor, Dr Bryan Frost has completed a Diploma in Editing and is pursuing a new career. He also has a Diploma in Health Administration, with honours in management, and has also completed a paper in Health Care Law.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Bryan Frost, FRNZCGP, Morrinsville Last reviewed: 07 Dec 2020