What lotion is recommended for treating cracked heels (plantar xerosis)?

From the Guidelines

For treating cracked heels (plantar xerosis), I strongly recommend using a urea-based moisturizer like Eucerin Advanced Repair Foot Cream or CeraVe SA Cream, which contain 10-40% urea, as they have been shown to effectively penetrate the thick skin of the feet and lock in moisture. The provided evidence does not directly address the treatment of cracked heels, but based on general medical knowledge, urea-based moisturizers are effective in treating dry skin conditions, including plantar xerosis 1. Some key points to consider when using these moisturizers include:

• Apply the lotion twice daily, especially after bathing when skin is slightly damp, to lock in moisture
• Before bed, apply a thicker layer and wear cotton socks overnight for deeper penetration
• For severely cracked heels, products containing salicylic acid or lactic acid can help exfoliate dead skin
• Soak your feet in warm water for 10-15 minutes before gently using a pumice stone to remove calluses, then apply the moisturizer It is essential to note that while the evidence provided does not directly address the treatment of cracked heels, the recommended treatment is based on the principles of managing dry skin conditions and preventing further dryness and cracking 1. Additionally, drinking adequate water and using a humidifier in dry environments can also help maintain skin hydration from within, which is crucial in preventing and treating cracked heels 1. If cracks are painful or show signs of infection, it is essential to consult a healthcare provider as prescription-strength treatments may be necessary.

From the FDA Drug Label

The medication is washed off in the morning and if excessive drying and/or irritation is observed, a bland cream or lotion may be applied.

• The FDA drug label recommends using a bland cream or lotion to treat excessive drying and/or irritation associated with salicylic acid treatment.
• No specific lotion is recommended for treating cracked heels (plantar xerosis), but a bland cream or lotion may be applied to alleviate drying and irritation caused by the treatment 2.

From the Research

Treatment Options for Cracked Heels (Plantar Xerosis)

• Cracked heels, also known as plantar xerosis, can be treated with various lotions and creams, with urea being a key ingredient in many of these products 3, 4, 5, 6
• Urea concentrations can vary, with studies examining the effects of 5% urea cream 3, 20% urea cream 3, 4, and 40% urea cream 5 on skin hydration and dryness

Efficacy of Urea Creams

• A study found that 20% urea cream was more effective in hydrating the foot compared to a placebo cream, but there were no significant differences between the 5% urea cream and the placebo cream 3
• Another study demonstrated that a 20% urea cream was well-tolerated and effective in treating keratosis pilaris, a condition characterized by dry, rough skin 4
• A 40% urea cream was used in conjunction with a topical antifungal to treat moccasin tinea pedis, a fungal infection of the foot, with a 100% cure rate achieved in 12 patients 5

Vehicle Choice for Urea-Containing Products

• A study compared the efficacy of cream and foam vehicles for urea-containing products, finding that cream vehicles may be more effective in reducing skin thickness and improving skin moisture 6
• The study also found that urea-containing cream formulations appeared to be equal or slightly superior to foam formulations in terms of skin moisture 6