Cracked Heels: Causes, Prevention, and Treatment

Heel fissures result from dry, thickened skin losing elasticity. Common causes:

• Dry Skin (Xerosis): Low humidity, aging, hot showers, harsh soaps.
• Mechanical Stress: Prolonged standing, obesity, open-back shoes, gait abnormalities.
• Skin Conditions: Eczema, psoriasis, athlete’s foot (tinea pedis), palmoplantar keratoderma.
• Nutritional Deficiencies: Vitamins A, C, E; zinc; omega-3s.
• Systemic Diseases: Diabetes (autonomic neuropathy → anhidrosis), hypothyroidism, Sjogren’s.

Treatment

1. Debride: Gently file thick calluses after soaking (pumice/foot file). Don’t cut.
2. Moisturize: Urea 10–20%, salicylic acid 3–6%, ammonium lactate, or ceramide creams 2× daily. Occlude with socks at night.
3. Protect: Closed-back shoes, cushioned insoles.
4. Treat Underlying Cause: Antifungals for tinea; glucose control for diabetes; thyroid replacement.

Prevention

• Daily moisturizing, supportive shoes, manage comorbidities, humidifier in winter.

See a Podiatrist If: fissures bleed, show infection (redness, pus, warmth), or you have diabetes/neuropathy/peripheral arterial disease.