From the Guidelines
To treat heel fissures, the most effective approach is to reduce pressure on the area and promote healing through a combination of lifestyle modifications and topical treatments. The initial step involves reducing pressure on the heel by wearing open-backed shoes, using heel lifts or orthoses, and decreasing activity [ 1 ]. Additionally, stretching exercises and weight loss (if indicated) can help alleviate pressure on the heel. In terms of topical treatments, there is no specific recommendation for heel fissures in the provided evidence, but based on general medical knowledge, applying a thick moisturizer and wearing cotton socks overnight can help lock in moisture and promote healing. It is essential to note that local injections of corticosteroids are not recommended for treating heel fissures [ 1 ]. Key aspects of the treatment plan include:
- Reducing pressure on the heel through lifestyle modifications
- Promoting healing through topical treatments and moisturizers
- Avoiding certain treatments, such as local injections of corticosteroids By following this approach, patients can effectively manage their heel fissures and promote healing.
From the Research
Treatment for Heel Fissures (Cracked Heels)
- The treatment for heel fissures, also known as cracked heels, typically involves the use of moisturizers to help soften and heal the skin 2, 3, 4.
- Studies have shown that moisturizers containing urea, such as 10% urea cream, can be effective in treating xerosis (dry skin) and cracks on the feet, including heel fissures 2, 5, 4.
- A study published in 2002 found that a moisturizer containing 10% urea and 4% lactic acid was more effective than a vehicle cream in treating moderate-to-severe xerosis of the feet in patients with diabetes 2.
- Another study published in 2011 found that a 10% urea-based lotion was more effective than a glycerol-based emollient cream in reducing scaling, roughness, redness, and cracking in patients with ichthyosis vulgaris 3.
- A 2024 study found that a moisturizing cream with 20% urea was well-tolerated and effective in treating keratosis pilaris, a condition characterized by dry, rough skin 6.
- A 2017 study found that a moisturizer containing urea, glycerine, and petrolatum was effective in healing deep open fissures on the feet of people with diabetes, and resulted in greater xerosis improvement compared to a placebo 4.
- The choice of vehicle for urea-containing moisturizers, such as cream or foam, may also play a role in the treatment of heel fissures, with cream vehicles potentially being more effective in reducing skin thickness and improving barrier function 5.