How Do Heel Fissures Occur & What are its Symptoms, Treatment and Prevention

Heel fissures are the cracks in the skin on the heels. This can be an uncomfortable nuisance as there can be thick dead skin cells build-up.

Heel fissure can lead to painful, dangerous infection, and skin damage. If not treated, heel fissures can become deep and lead to serious medical problems, especially in those suffering from diabetes. It can also lead to amputations in people with diabetes.⁽¹⁾

Heel fissures are common in those suffering from diabetes, as the condition affects the peripheral nerves. Damaged nerves fail to sense the need to sweat which leads to moisture on the skin. These fissures can be dangerous in diabetic as they can lead to non-healing foot ulcers.

Dry skin is a common cause of heel fissure, but there are other factors as well that include:

• Eczema
• Hypothyroidism
• Psoriasis
• Living in a dry and cold environment
• Tinea pedis, a common fungal infection also known as athlete’s foot
• Rheumatoid arthritis
• Scleroderma

Any factor that leads to thickening of the tissue or affects the body’s ability to sweat can lead to heel fissures.

Heel fissures can lead to a range of symptoms, which can be mild as well as severe.

Mild symptoms of heel fissures are:

• Brownish and yellowish discoloration on the skin
• Thickening of the skin around the callus
• Visible cracking of the skin on the heels

These symptoms if not treated can lead to the development of the severe symptoms that include:

• Bleeding from the cracks in the heels
• Wounds present on the heels
• Pain on the heels on applying pressure while walking

Treating and preventing heel ulcers is important as they can further lead to deep ulcers that get infected and lead to cellulitis.

There are a few home treatments that can be considered if having mild symptoms of heel fissures.

• Apply thick moisturizers twice in a day. Look for the moisturizer with ingredients listing ceramides, petroleum, or natural oils like coconut oil, sunflower oil, or almond oil.
• You can also use products containing ingredients such as alpha hydroxyl acids (AHA), salicylic acids, and urea that can help get rid of the dead skin cells.
• Applying emollient creams containing 10-25% urea can also help deal with heel fissures.⁽¹⁾ The urea concentration can be decreased as the skin starts softening.
• You can try following 10 minutes of skin-softening routine for your feet every day.
• Start by soaking your feet in lukewarm water for 10 minutes. Add a moisturizing cleanser in the warm water.
• Pat the feet dry
• Exfoliate the excess dead skin with the help of a manual exfoliator such as loofah, pumice stone, or a brush.
• Apply a thick layer of petroleum jelly or any other ointment

Cover the feet with thin cotton socks. Applying the emollient to the skin can make the feet slippery. It is advised to wear anti-skid socks to prevent any falls.

If the home treatments are not being helpful you can look ahead to the medical treatments.

In case suffering from diabetes or any other circulation problem, consulting a podiatrist for thick dry skin at the bottom of the feet is advisable.

He would use special tools to remove the dead skin to prevent heel cracking. This procedure is known as debridement.

If over-the-counter medications do not help, antifungal and antibacterial medications would help treat the infection.

These medications kill the infectious organisms that increase the risk of heel fissures and help soften the heel skin.

If the heels fissures develop sores, consult a doctor immediately. Wound care treatments would help treat the area and restore healthy skin.

Certain lifestyle changes can prevent heel fissures.

• Avoid wearing open-heeled shoes. Exposing heels can dry them up.
• Avoid walking barefoot on the rough surface. Walking bare feet on stone pavements or floors at home can cause heel damage and dryness.
• Do not use harsh soaps or very hot water on feet. Scrubbing excessively can contribute to dryness and cracking.
• Moisturize the feet regularly. This would help keep the skin smooth and soft.
• While wearing shoes, wear protective heel cups. They help reduce stress on the heels.
• Exfoliate the skin of feet regularly with a loofah, pumice stone, or foot scrub. This prevents the excess dead skin build-up.

Heel fissure occurs due to a lack of moisture, which if not treated can turn into a serious condition. Keep your feet moisturized and examine them regularly to keep the condition from occurring or even worsening.