Cracked Heels or Heel Fissures

Cracked heels are a common foot problem that are often referred to as heel fissures. Cracked heels are commonly caused by dry skin (xerosis), 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 – in severe cases this can become infected.

• prolonged standing (at work or home, especially on hard floors)
• being overweight (this increases the pressure on the normal fat pad under the heel, causing it to expand sideways – if the skin is not supple and flexible, the pressures to ‘crack’ are high)
• open back on the shoes (this allows the fat under the heel to expand sideways and increases the pressure to ‘crack’)
• some medical conditions predispose to a drying skin (eg autonomic neuropathy in those with diabetes leads to less sweating; 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 (eg psoriasis and eczema)

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