From the Guidelines
To effectively treat dry, cracked heels, it is essential to prioritize a comprehensive approach that addresses both the causes and symptoms of heel fissures, focusing on moisturizing, protecting, and preventing further irritation. The causes of dry, cracked heels, also known as heel fissures, can be attributed to a combination of factors including pressure from standing, walking, or ill-fitting shoes, as well as insufficient moisture in the skin. When considering treatment options, it's crucial to note that while the study by the American College of Foot and Ankle Surgeons 1 focuses on heel pain, its recommendations for reducing pressure on the area and using orthoses can indirectly benefit individuals with heel fissures by alleviating some of the pressure that contributes to the condition.
Key treatment strategies include:
- Soaking feet in warm water for 10-15 minutes to soften the skin
- Gently exfoliating with a pumice stone or foot file to remove dead skin
- Applying a thick moisturizer containing urea, salicylic acid, or lactic acid, such as CeraVe SA Cream, Eucerin Advanced Repair, or AmLactin, twice daily
- Wearing supportive, properly fitting shoes with closed heels to prevent further damage
- Staying hydrated to maintain skin moisture and elasticity
For severely cracked heels, additional measures such as using liquid bandage products to seal cracks and promote healing, or applying petroleum jelly (Vaseline) as an overnight treatment, can be beneficial. It's also important to recognize when to seek professional care, such as if the heels are severely cracked, painful, bleeding, or show signs of infection, or if the individual has diabetes, as these conditions may require prescription-strength treatments or specialized care.
From the Research
Causes of Dry, Cracked Heels
- Dryness-related heel skin problems are common, and heel skin is prone to dryness 2
- Xerosis is defined as dehydration of skin characterized by redness, dry scaling, and fine crackling that may resemble the crackling of porcelain 3
- Hyperkeratosis of the heels can be caused by dry skin with winter exacerbation and can be painful 4
Treatments for Dry, Cracked Heels
- Emollient cream may alleviate pain and dryness and improve the appearance of heel cracks 5
- Salicylic acid and urea ointment, as well as ammonium lactate lotion, can be used to treat xerosis and reduce its severity 3, 4
- Urea-containing cosmetic preparations, such as creams and foams, can be used to moisturize and improve the skin barrier function of dry skin 6
- Topical multivesicular cream formulation of 6% salicylic acid can be effective in reducing dryness, scaling, and hyperkeratosis of the heels 4
- Cream vehicles may be preferred over foam vehicles in the formulation of skin care preparations for dry skin, including pedal skin care 6
Effectiveness of Treatments
- Daily repetitive application of moisturizer may be helpful for hydrating dry heel skin and preventing complications 2
- Salicylic acid 6% multivesicular cream can provide rapid resolution of hyperkeratosis and pain in the heels 4
- Urea 10% cream can reduce the thickness of the horny layer and improve skin moisture 6