The pain of cracked heels, what causes them and what can I do.


crackedheels-w340h232Oh the pain, I think together with an ingrown toenail nothing compares to the pain of cracked heels. One of the most common problems our podiatrists at Dublin City Foot Clinic encounter (especially during the summer) is cracked heels. So, what causes our heels to crack open often so badly that they can bleed.

Well, to be honest there is no one answer to this question, as there are a number of possible causes. Undoubtedly having a tendency towards dry skin can be a problem, this can be simply age related (our feet loose moisture as we age) or related to other medical conditions such as an under active thyroid gland, vitamin A deficency and diabetes. Other conditions can also increase the hard skin production. These include Psoriasis which decreases the skin viability and some forms of Rheumatoid Arthritis which can impair the skins natural sweating mechanism. Our artificial heated environments such as under floor heating can also dry our feet causing our skin to be much more mechanically susceptible.

Unfortunately another major cause of cracked heels is obesity. The extra load on your feet is somewhat like an overfilled balloon, the skin down at that part of the foot is constantly being pushed to its limit at every step. This constant pressure on the skin there causes the skin to react by forming calluses. In time, it can become too much for these calluses, and they crack, revealing the middle layer of skin, the dermis. This can be made much worse if you wear a loose shoe such as a flip flop or sandal, or indeed shoes that have prominent edges or stitching. Many people attend our clinics say “oh but my shoes are very comfortable” or “ my shoes couldn’t be the problem as they were expensive”.

Firstly remember your feet will “always” have less problems if your shoes are supportive ( note comfort and support are not the same thing). Secondly, money is not a currency your feet understands, so cheaper shoes can often be a better shoe for you, as the style of shoe is more important than the cost. Shoes that have some padding are also very useful, as we age we also lose our natural foot fatty pads (unfortunately, not on our bum or belly though).

There are a few simple things we can do to reduce the problem of heel cracks. The application of a good water or oil based creams such aqueous cream or E45 twice daily can definitely help. Where possible use a pumice stone regularly to keep the hard skin (callus) to a minimum. Try not to use blades, knives or scissors to reduce the skin as this can lead to severe complications. Try to consider how your shoes are impacting on your feet especially around your heels and remember that the main cause of heel cracking is poor footwear.

If you attend our clinic our podiatrists will investigate t and address the underlying cause of the problem. Remove the hard skin by debriding using aseptic techniques, padding and strapping to reduce the stresses on the skin. Advice you regarding the most appropriate moisturiser or emollient for your feet. If necessary prescribe cushioned insoles or orthotics to improve your foot biomechanics which will thereby reduce the stress and load on your feet. Remember, our podiatrists are always available to assist, treat and advise you on the best options available to manage this extremely painful problem. Final words, enjoy the summer, and remember, comfort is “not” support so mind those flip flops…