I Think I’m Cracking Up!

Cracked heels are a common foot problem that is often referred to as heel fissures. Cracked heels are commonly caused by dry very skin and made more complicated if the skin around the rim of the heel is thick (callus). For most people this is a nuisance and a cosmetic problem but when the fissures or cracks are deep, they are painful to stand on and the skin can bleed and in severe cases this can become infected. If you are diabetic, this can lead to devastating issues!

Some people tend to have a naturally dry skin that predisposes them to the cracks. The thickened dry skin (callus) around the heel that is more likely to crack is often due to mechanical factors that increase pressures in that area (for example, the way that you walk).

Other factors that can be involved in the cause of cracked heels include:

• Prolonged standing, especially on hard floors
• Open back on the shoes (this allows the normal fat pad under the heel to expand sideways and increases the pressure leading to the cracking)
• Some medical conditions predispose to a drying skin (for example, diabetic neuropathy where diabetes leads to less sweating or an underactive thyroid lowers the body's metabolic rate and there is a reduction in sweating, leading to a dryness of the skin)
• Skin conditions  such as psoriasis, fungus and eczema)