Cracked heel treatment in Esperance
Cracked heels (heel fissures) are one of the more common foot problems we see. For some people they're just rough and unsightly. For others, the cracks become deep, painful and can even bleed, making every step uncomfortable.
The good news is that cracked heels usually respond well to the right care, and once they've healed, a simple routine can keep them that way.
Why heels crack
Under your heel bone is a thick, springy fat pad that cushions you every time your heel hits the ground. Each time you stand on it, the fat pad squashes down and spreads out sideways, then springs back when you lift your foot. The skin around your heel has to stretch and bend with that change in shape thousands of times a day. Healthy, supple skin copes easily. But when the skin is dry, inelastic, thick or hard, it can't bend far enough. Instead of bending, it splits. That's why cracks usually appear around the rim of the heel, where the skin is stretched the most.
Some heel cracks sit within a band of very thick, hard, yellowish callus. Others appear in skin that has no callus at all, just skin that's too dry to stretch. Treatment depends on which type you have.
What makes it more likely
Anything that dries the skin out, thickens it, or makes the fat pad spread further:
Dry skin, which is more common as we get older and in dry or windy weather
Open-backed shoes, thongs and going barefoot
Standing for long periods, especially on hard floors
Carrying extra body weight, which increases how much the fat pad spreads
Skin conditions, such as tinea (athlete's foot), eczema or psoriasis
Health conditions, such as diabetes or an underactive thyroid, which can affect the skin's moisture
Crack or pressure sore?
Not every sore heel is a crack. In people who spend a lot of time in bed, like when recovering from illness or surgery, a painful on the heel may be a pressure sore (bed sore) instead. A pressure sore is usually more painful in bed at night, when the heel is resting on the mattress. Pressure sores need a different approach called pressure relief: taking the weight off the heel with pillows, heel protectors or a pressure-relieving mattress. Creams alone won't fix them. If you think you or someone you care for has a pressure sore, book in promptly.
Why it's worth treating
Deep cracks can be painful to walk on.
Cracks that reach the living skin can bleed, and become an entry point for infection.
For people with diabetes, poor circulation or reduced feeling in their feet, an infected heel crack can become serious quickly, so cracks should be treated early.
How to heal cracked heels
The aim is to make the heel skin thinner and more flexible, so it bends rather than splits.
1. Remove the hard skin
Thick, hard skin around the heel can't bend, so it has to go. Rebecca can safely remove the hard skin and smooth the edges of the cracks in one appointment. This is painless, and many people notice their heels feel more comfortable straight away.
2. Tape painful cracks
For deep, painful cracks, a strip of tape applied across the crack at a right angle (90 degrees) holds the edges together. This stops the crack opening up with every step, which reduces pain and gives it a chance to heal. Rebecca can apply the best tape (a rigid sports tape in between Fixomull Stretch tape) and show you how to do it at home.
3. Moisturise every day
A urea-based cream or heel balm is the best choice for cracked heels. Urea draws water into the skin and softens hard skin, helping it become flexible again. The right strength depends on your heels:
Cracks within thick callus: Walkers 25% Urea Cream, which softens and thins the hard skin as well as moisturising.
Cracks with no callus around them: a 10% urea cream, which moisturises without removing skin you need.
We stock Walkers 25% urea cream in the clinic.
Apply it once or twice a day, especially after a shower or bath.
Rub it in well around the rim and back of the heel.
Creams only work for a short period, which is why you need to be persistent. Make it part of your daily routine rather than something you do when cracks appear.
4. Gently file between visits
After a shower, while the skin is soft, use a pumice stone to gently smooth the heel a few times a week. Or use an emery board while the skin is dry and hard. Go lightly: a little often works better than a lot at once.
5. Enclose the heel
Shoes with a closed, firm heel cup hold the fat pad in place so it doesn't spread as far, reducing the stretch on the skin. Try to cut back on thongs, scuffs and bare feet while your heels heal. Wearing socks holds a bit of moisture near your skin, preventing it from drying out. A gel heel cup can also help by cupping the fat pad and cushioning the heel. We stock Tuli's Heavy Duty Gel Heel Cups in the clinic.
6. Treat any underlying skin condition
If tinea, eczema or psoriasis is part of the problem, treating it is essential. Otherwise the cracks are likely to keep coming back. Read more about tinea (athlete's foot).
Avoid razors and avoid picking
Please don't use razors, blades or scissors on your heels. It's very easy to cut too deep, which can cause bleeding and infection. The same goes for picking at the skin - it’s too easy to peel back too much skin and making the problem worse. This is especially important if you have diabetes, poor circulation or reduced feeling in your feet.
When to see a podiatrist
Book in if:
your cracks are deep, painful or bleeding
they haven't improved after a few weeks of daily moisturising and frequent exfoliating
you just want to get them off to a good start to summer footwear season, or get them back to square one after a long summer/autumn of open shoes
you have diabetes, poor circulation or reduced feeling in your feet
Book an appointment
If your heels are cracked, sore or just won't stay soft, book in with Rebecca at Esperance Podiatry. No referral is needed.
Call (08) 9072 1514 or visit us at Suite B, 116 Dempster Street, Esperance.