As the weather turns cold, many people notice the skin on their heels getting rough, thick and dry. Sometimes it splits into cracks that catch on socks or sting when you walk. Doctors call these cracks heel fissures.1

For most people, cracked heels are a skin-care problem that responds to simple home care. But for some people, especially those with diabetes, a crack in the skin can become a doorway for infection. Here's why heels crack, what you can do about it, and when to have them checked.

Have diabetes or reduced feeling in your feet? Don't wait on a crack or sore that doesn't start to heal after a few days, or skin that becomes red, warm or painful or has drainage. These can be signs of infection. Call us instead of using the web form: Butte & Anaconda (406) 782-2278, Bozeman, Ennis & Harlowton (406) 587-8478. For severe symptoms, seek emergency care.

Why Do My Heels Crack?

The most common cause is dry skin. The American College of Foot and Ankle Surgeons (ACFAS) notes that dry skin on the heels can be made worse by:1

  • Open-back shoes
  • Extra body weight
  • Friction from the back of your shoes

The American Academy of Dermatology (AAD) also suggests avoiding open-heeled, worn-down or poorly fitting shoes, such as flip-flops and slingbacks.2 Cold, dry winter air is hard on skin in general,3 and so are long, hot baths and showers.2,3

Sometimes cracked heels point to something else going on:

  • Diabetes or nerve damage. ACFAS notes that dry, cracked skin can be an early sign of larger problems, including diabetes or autonomic neuropathy (a loss of nerve function).1 The AAD also says cracked heels are sometimes caused by a medical condition such as diabetes.2
  • Athlete's foot. A type of fungal infection called moccasin-type athlete's foot affects the bottoms of the feet, the heels and the edges of the feet. The skin there can become dry, itchy and scaly, then thicken and crack.4 Read more in our article on athlete's foot.

What Can I Do at Home?

Home care is the first step for most cracked heels.1 Sources recommend:

  • Moisturize often. ACFAS suggests moisturizing the heels twice a day.1 Look for a cream with 10 to 25 percent urea, alpha hydroxy acids or salicylic acid.1,2 These ingredients help soften thick, dry skin. ACFAS suggests switching to creams with ceramides, petroleum or natural oils once the thick skin has thinned.1
  • Moisturize while skin is damp. Apply moisturizer soon after bathing, while your skin is still damp, and again whenever your heels feel dry.2,3 Ointments and creams tend to work better than lotions for dry skin.3
  • Try petroleum jelly at bedtime. The AAD suggests plain petroleum jelly at night, with socks on to keep it off your sheets.2
  • Keep baths short and gentle. Limit baths and showers to about 5 to 10 minutes, use a gentle fragrance-free cleanser, and pat your skin dry.2
  • Exfoliate gently. ACFAS suggests soaking your feet in warm (not hot) water for 10 minutes a day and gently scrubbing with a scrub brush or pumice stone.1 If you have diabetes, read the next section first.
  • Protect cracks during the day. A liquid bandage can help reduce pain, speed healing and keep germs out of a crack.2
  • Add moisture to the air. A humidifier can raise indoor humidity. If you use one, clean it regularly to prevent mold.3
  • Choose closed-back shoes that fit well.1,2 For tips, see our article on proper footwear.

Never cut or shave thick skin yourself with a blade. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) warns that cutting corns and calluses, or using medicated pads and liquid removers, can damage the skin and cause an infection.7 Our article on corns and calluses covers thick skin in more detail.

I Have Diabetes. What Should I Do Differently?

Cracked skin matters more when you have diabetes. People with diabetes are more likely to have dry, itchy skin.5 And nerve damage can make it hard to feel a blister or sore, so a small problem can turn into an infection before you notice it.7

Diabetes foot-care guidance differs from general skin-care advice in a few ways:

  • Don't soak your feet. NIDDK advises people with diabetes not to soak their feet, because soaking can make the skin too dry.7
  • Ask before using a pumice stone. NIDDK says to use a pumice stone on corns and calluses only if your doctor advises it.7
  • Skip the spaces between your toes. Put lotion on the tops and bottoms of your feet, but not between your toes, where extra moisture could lead to infection.6,7
  • Check your feet every day. Look for cuts, redness, swelling, sores, blisters and other skin changes. Use a mirror or ask a family member if you can't see the bottoms of your feet.6

The Centers for Disease Control and Prevention (CDC) lists dry, cracked skin on your feet among the problems people with diabetes should not wait to bring up. It advises seeing your doctor or foot doctor right away rather than waiting for your next appointment.6 Learn more on our diabetic foot care page.

When Should I See a Podiatrist?

Consider having your heels checked if:

  • Your cracks are severe, or they don't get better with home care1,2
  • You have diabetes and notice dry, cracked skin on your feet6
  • Your skin becomes red, warm or painful, which can be a sign of infection7
  • You notice redness, pain or drainage5
  • A cut or crack doesn't start to heal after a few days7

A foot and ankle specialist can usually tell what's going on with an exam. They may also ask about your health history or look at lab work to find out why your skin is so dry. They can check for a fungal or bacterial infection, carefully trim away thick callus, and prescribe medicated creams when needed.1 ACFAS notes that surgery is rarely needed for heel fissures that are treated early. But a fissure that becomes an open wound can get infected.1 That's one more reason not to ignore deep or painful cracks.

The Bottom Line

Cracked heels are usually caused by dry skin, and cold, dry weather doesn't help. Regular moisturizing with the right cream, short warm showers, gentle care of thick skin and closed-back shoes are the first steps for most people. If home care isn't working, or if you have diabetes, have your feet checked rather than waiting. And if a crack looks infected, call right away.

If dry, cracked heels are bothering you, our podiatrists can help. Request an appointment and our team will follow up within one business day. You can also find your nearest office on our locations page.

This article is for general education and isn't a substitute for medical advice. Talk with a podiatrist or your doctor about your own symptoms.

Sources

  1. Cracked Heels (Fissures). American College of Foot and Ankle Surgeons (FootHealthFacts.org). www.foothealthfacts.org
  2. How to Care for Dry, Cracked Heels. American Academy of Dermatology. www.aad.org
  3. Dry Skin: Tips for Managing. American Academy of Dermatology. www.aad.org
  4. Athlete’s Foot (Tinea Pedis). Cleveland Clinic. my.clevelandclinic.org
  5. Diabetes and Your Skin. Cleveland Clinic. my.clevelandclinic.org
  6. Diabetes and Your Feet. Centers for Disease Control and Prevention. www.cdc.gov
  7. Diabetes & Foot Problems. National Institute of Diabetes and Digestive and Kidney Diseases. www.niddk.nih.gov