From the Guidelines
For the treatment of fissures on feet, especially in individuals with diabetes, I strongly recommend providing appropriate treatment for any pre-ulcerative lesion, including fissures, to help prevent foot ulceration, as suggested by the International Working Group on the Diabetic Foot (IWGDF) 2023 update 1.
Treatment Approach
The treatment approach should involve removing excess callus, protecting blisters, and draining them when necessary, as well as treating fissures, ingrown or thickened toenails, and fungal infections.
- Over-the-counter urea-based creams, such as those containing 10-40% urea, can be used to soften hardened skin and promote healing, as seen in the example of Eucerin Advanced Repair or AmLactin.
- For deeper, painful fissures, liquid bandage products like New-Skin can create a protective seal while healing occurs.
- Salicylic acid products (2-6% concentration) can help remove excess dead skin.
- If infection is present, use an antibiotic ointment like Neosporin or Polysporin.
- Maintaining treatment consistency is crucial, as is preventing future fissures by regularly moisturizing feet, wearing proper footwear, and staying hydrated.
Importance of Professional Care
It is essential that these treatments be performed by an appropriately trained healthcare professional to avoid potential harm from improper treatment, as emphasized in the IWGDF guidelines 1. The benefit-harm ratio of treatment of pre-ulcerative lesions by a trained professional will likely be positive and come at relatively low costs.
Prevention and Maintenance
Preventing future fissures and foot ulcers involves a combination of regular foot care, proper footwear, and staying hydrated. Education on the dangers of pre-ulcerative lesions and the importance of their treatment is also crucial, as people educated on these dangers are more likely to prefer treatment, thereby potentially reducing the risk of foot ulceration 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Medication for Fissures on Feet
There are no research papers directly related to medication for fissures on feet. However, the provided studies discuss the treatment of tinea pedis, a fungal infection of the feet, which can sometimes cause fissures.
Treatment Options for Tinea Pedis
- Topical antifungal agents such as terbinafine cream or butenafine cream are effective in treating tinea pedis 2, 3.
- Oral antifungal agents like terbinafine may be indicated for extensive disease, failed topical treatment, immunocompromised patients, or severe moccasin-type tinea pedis 3.
- Combination treatment of oral terbinafine with topical terbinafine and 10% urea ointment has been shown to be effective in treating hyperkeratotic type tinea pedis 4.
Specific Medications
- Terbinafine 1% cream applied twice daily for 1 week has been shown to be significantly superior to a 4-week course of clotrimazole 1% cream for treating tinea pedis 5.
- Clotrimazole is a new antifungal agent which is effective topically in dermatophytosis, cutaneous candidiasis, and tinea vesicolor 6.