Treatment of Cracked Heels
Apply emollient creams or lubricating oils regularly to dry, cracked heels, combined with proper footwear and daily foot hygiene, and refer to a podiatrist if severe cracking persists beyond 2-4 weeks of appropriate treatment. 1, 2
Initial Conservative Management
Topical Therapy
- Use emollient creams or lubricating oils daily to alleviate pain, dryness, and improve the appearance of heel cracks. 1, 2
- For hyperkeratotic (thickened skin) cracked heels, topical salicylic acid 6% cream applied twice daily can provide rapid resolution of both hyperkeratosis and pain within 1-2 weeks. 3
- Never apply lubricating products between the toes, as this can promote fungal infections. 1
Foot Hygiene Practices
- Wash feet regularly with water below 37°C (98.6°F), ensuring careful drying especially between toes. 1
- Inspect feet daily to monitor healing progress and identify any worsening. 1
- Avoid walking barefoot both indoors and outdoors; always wear shoes with socks. 1
Footwear Modifications
- Select proper footwear with adequate cushioning and support to reduce pressure on cracked areas. 1, 4
- Avoid tight shoes or those with rough edges and uneven seams that can worsen cracking. 1
- Consider using heel cups or orthotic inserts to redistribute contact forces and relieve pressure. 4
What NOT to Do
Critical Warnings
- Never use chemical agents or plasters to remove calluses on your own, as this can cause injury or worsen the condition. 1
- Never attempt aggressive self-debridement, as overdebridement can make underlying skin more tender and susceptible to further damage. 5
When to Refer for Professional Care
Indications for Specialist Referral
- If severe cracking persists despite 2-4 weeks of appropriate conservative treatment, refer to a trained foot care specialist or podiatric surgeon. 1
- Professional debridement of hyperkeratotic tissue may be necessary for thick, painful calluses that don't respond to topical therapy. 1
- Evaluation for underlying conditions (such as diabetes, neuropathy, or fungal infections) should be performed if healing is delayed. 1
High-Risk Patients Requiring Regular Professional Care
- Patients with diabetes or peripheral neuropathy should have callus and skin pathology treated regularly by a trained specialist, as they are at higher risk for complications. 1
- These patients require more aggressive monitoring due to impaired sensation and healing. 1