Why do you get cracked heels?

Typical cracked heels

It is normal to develop a mild thickening of the skin around the rim of the heel.  This area experiences a lot of pressure and the skin would suffer if it was too fragile.  You can imagine that a walk on a bitumen road would end badly if the skin on your feet was the same as the skin on your face.

Sometimes, though, this skin becomes excessively thick which can cause it to split through to the good skin below.  The thickness of the skin can cause it to lose its flexibility.  It is a bit like the difference between trying to bend a piece of bread or bend a piece of toast. When this happens, the splits will bleed and be very painful. Several things can cause this problem to occur. Most often it is a simple matter of skin type and often runs in families. Abnormal pressure distribution or neurological conditions can contribute. Whatever other factors are involved, we know that walking barefoot or in backless shoes / thongs makes things worse.  Shoes and socks protect the skin from drying out excessively.

What is the problem with having cracked heels?

The number one problem with having cracked heels is the pain that this issue can cause.

Depending on your general health,  infections  can arise from cracked heels. Because the deeper flesh is exposed, bacteria can track in further that it can with just a superficial scratch. This is especially true for people with compromised immune systems, those on chemotherapy, Rheumatoid Arthritis drugs and those with diabetes.

More minor issues include the cosmetic outcome. Split heels can also be unsightly as dirt and blood gets imbedded in the grooves and can be impossible to wash out.

Also, spouses often complain that their own shins get brutalised during the night.  Often, it is the spouse who insists that cracked heels must be treated.

Why don’t Cracked Heels heal?

The thickened top layer of the skin is not alive.  Therefore, it has no potential to heal any cuts or splits etc. Once it is damaged it cannot repair itself. Inside the heel, there is a big blob of fibrous tissue that sits under the heel bone. When you are not standing on it, it is mostly under the bone. When you bear weight, this tissue bulges out to the side. As you walk, the heel pad changes shape with each step. This leads to the cracks constantly opening and closing. Where the skin has a fault line (i.e. the split), the good skin below it is under a lot of stress from this motion.  It can split open and bleed which is very painful. When the deeper living flesh heals, the pain goes for a time. The crack in the dead top surface of the skin persists though and the cycle repeats.

What can be done about Cracked Heels?

Fortunately, the treatment is simple, effective and painless. Now that you know that the skin around the heel is dead, you can appreciate that this also means that it doesn’t have any nerves.  This means it can be removed by the podiatrist painlessly, kind of like a hair cut. If the problem is mild, that may be all that is required. If the cracks go too deep, you might need a ‘two part’ cure.  A second appointment can be needed around 3 weeks after the first. If you haven’t already bought heel ointment, hold off until seeing the podiatrist. Many commercial preparations are very greasy and pose a slip hazard as well as being annoying to apply. The podiatrist may also teach you a taping method that will stop pain straight away if another split should occur.