From the Guidelines
To treat chronically cracked heels, a comprehensive approach is necessary, focusing on moisturizing, protecting, and relieving pressure on the heels. The most effective treatment plan involves daily foot soaking for 10-15 minutes in warm water, followed by gentle exfoliation with a pumice stone to remove dead skin 1. After drying thoroughly, apply a thick, urea-based heel cream such as Eucerin Advanced Repair (10% urea) or CeraVe SA Cream (containing salicylic acid) to soften calluses and moisturize the skin. For best results, apply the cream generously at night and wear cotton socks to enhance absorption while sleeping. During the day, wear supportive, cushioned shoes that don't put pressure on your heels. Some key considerations include:
- Staying hydrated and maintaining adequate nutrition, particularly with vitamins A and E, which support skin health.
- Using liquid bandage products like New-Skin to seal painful fissures while they heal for severe cracks.
- Avoiding walking barefoot or in socks only, and instead wearing properly fitting footwear to prevent further irritation and potential complications 1. If cracks are painful, bleeding, or show signs of infection (redness, warmth, swelling), it is crucial to consult a healthcare provider, as prescription-strength creams containing 20-40% urea or topical steroids may be necessary. Cracked heels typically result from excessive pressure combined with dry skin, causing the thick callused skin to split, so consistent treatment is essential for long-term improvement. Given the potential for complications, especially in at-risk patients such as those with diabetes, following guidelines like those from the IWGDF for foot care can help prevent and manage cracked heels effectively 1.
From the FDA Drug Label
Apply Urea 40% to affected skin twice per day, or as directed by your physician. Rub in until completely absorbed. To treat chronically cracked heels, apply Urea 40% to the affected skin twice per day, rubbing it in until completely absorbed, or as directed by your physician 2.
- Apply to affected areas
- Follow physician directions for use
- Use twice per day for best results
From the Research
Treatment Options for Chronically Cracked Heels
To treat chronically cracked heels, several options are available, including:
- Emollient cream to alleviate pain and dryness and improve the appearance of heel cracks 3
- Topical salicylic acid to reduce dryness, scaling, and hyperkeratosis, and to relieve pain 4
- Moisturizers to hydrate the skin and prevent dryness and fissures, with some moisturizers being more effective than others 5
- Combination treatment of oral and topical antifungal agents for hyperkeratotic type tinea pedis, which can be a cause of chronically cracked heels 6
Topical Treatments
Topical treatments are often the primary treatment for chronically cracked heels, and can include:
- Salicylic acid to break down thick skin and reduce hyperkeratosis 4
- Urea ointment to hydrate the skin and break down thick skin 6
- Moisturizers to hydrate the skin and prevent dryness and fissures 5
- Antifungal agents to treat fungal infections that can cause chronically cracked heels 7
Oral Treatments
Oral treatments may be necessary for more severe cases of chronically cracked heels, or for cases where topical treatments are not effective. These can include: