What are cracked heels?

Cracked heels are splits in the skin around the heel.

The medical term for a deeper skin crack is a fissure.

Fissures can vary from:

• Fine superficial lines
• Dry scaling
• Thickened skin with shallow cracks
• Deep painful splits
• Bleeding fissures

The deeper the crack, the more uncomfortable it may become.

Why do heels crack?

Cracked heels usually develop because of a combination of dry skin, thickened skin and mechanical pressure.

Common contributing factors include:

• Dry skin
• Thick callus
• Open-backed footwear
• Barefoot walking
• Prolonged standing
• Increased pressure around the heel
• Hot or dry weather
• Reduced skin elasticity
• Inadequate moisturising
• Certain skin conditions
• Age-related skin change

More than one factor is often involved.

Why does hard skin form around the heel?

The skin responds to repeated pressure and friction by becoming thicker.

This can be protective initially.

However, excessively thick skin becomes less flexible.

When the heel spreads under body weight, thickened dry skin may not stretch adequately and can begin to split.

This is why simply applying moisturiser without reducing significant callus may sometimes be insufficient.

What do cracked heels feel like?

Symptoms may include:

• Dryness
• Rough skin
• Thickened yellowish skin
• Pain
• Tenderness
• Burning
• Splitting
• Bleeding
• Pain when standing
• Pain when walking barefoot

Some cracks are mainly cosmetic.

Others can become painful enough to affect walking.

What makes cracked heels worse?

Factors that may increase symptoms include:

• Barefoot walking
• Thongs or open-backed sandals
• Shoes that provide little heel support
• Prolonged standing
• Dry weather
• Hot showers
• Harsh soaps
• Repeated friction
• Failure to moisturise
• Excessive callus
• Certain medical or skin conditions

Footwear and skin care often both need to be considered.

Can sandals cause cracked heels?

Open-backed footwear can contribute in some people.

Without support around the heel, the heel pad may spread more during walking.

This can place greater tension across already dry or thickened skin.

This does not mean sandals must always be avoided, but recurrent fissures may improve when supportive enclosed footwear is used more regularly.

How our podiatrists assess cracked heels

Assessment may include:

• Depth of the cracks
• Amount of hard skin
• Pain
• Bleeding
• Redness
• Signs of infection
• Skin condition
• Footwear
• Walking and standing demands
• Previous treatment
• Diabetes
• Circulation
• Sensation
• Relevant dermatological history

The objective is to determine whether the problem can be managed with routine podiatry and skin care or whether additional medical assessment is appropriate.

Professional hard-skin reduction

Where excessive callus surrounds the heel, our podiatrists can carefully reduce thickened skin using professional instruments.

This is often referred to as debridement.

Reducing excessive hard skin can:

• Decrease pressure around fissures
• Improve skin flexibility
• Reduce discomfort
• Help moisturising products reach healthier skin
• Make ongoing home care easier

The skin should not be aggressively removed.

The aim is controlled reduction rather than attempting to remove every layer of protective skin.

Should I cut hard skin off my heels myself?

This is generally not recommended.

Using:

• Blades
• Razors
• Scissors
• Sharp instruments

can cause skin injury, bleeding and infection.

The risk is greater in people with diabetes, reduced circulation or reduced sensation.

Professional treatment is safer when there is significant callus or deep fissuring.

Do moisturisers help cracked heels?

Yes.

Regular moisturising is one of the most important parts of managing dry, cracked heels.

A good heel-care routine may help:

• Improve skin hydration
• Increase flexibility
• Reduce dryness
• Reduce superficial cracking
• Reduce recurrence after professional treatment

Consistency is important.

What type of cream is best for cracked heels?

Products designed specifically for dry or thickened skin are often more useful than light cosmetic moisturisers.

Ingredients may include:

• Urea
• Lactic acid
• Other humectants and emollients

These help draw water into the skin and soften excessive keratin.

The appropriate product depends on how dry and thick the skin is.

What is urea cream?

Urea is commonly used in foot-care creams.

At lower concentrations, it primarily helps hydrate the skin.

At higher concentrations, it also helps soften thickened keratin.

Urea-based creams can therefore be useful for:

• Dry heels
• Thick callus
• Recurrent fissures

The strength of the product should be appropriate for the condition of the skin.

Can I put heel balm into an open crack?

Products designed for intact dry skin may not always be appropriate inside a deep open fissure.

If the heel is:

• Bleeding
• Open
• Weeping
• Very painful
• Inflamed

it is better to have the area assessed before applying strong keratolytic products directly into the wound.

Can cracked heels become infected?

Yes.

A deep fissure creates a break in the skin barrier.

This can allow bacteria to enter.

Signs that may indicate infection include:

• Increasing redness
• Warmth
• Swelling
• Pus or discharge
• Increasing pain
• Redness spreading away from the heel
• Fever or feeling unwell

These symptoms warrant prompt medical assessment.

What if my heel is bleeding?

A bleeding heel fissure should be cleaned and protected.

Persistent, recurrent or deep bleeding cracks should be professionally assessed.

This is particularly important in people with:

• Diabetes
• Poor circulation
• Reduced sensation
• Immune compromise

Can cracked heels be caused by fungal infection?

Sometimes.

Athlete’s foot can cause:

• Dryness
• Scaling
• Itching
• Cracking

particularly around the sole or sides of the foot.

However, not every dry or cracked heel is fungal.

Assessment can help distinguish mechanical dryness and callus from a skin infection.

What skin conditions can cause cracked heels?

Conditions associated with dry or thickened skin may include:

• Eczema
• Psoriasis
• Keratoderma
• Fungal skin infection

Persistent or unusual skin changes may require medical or dermatological assessment.

Can psoriasis affect the heels?

Yes.

Psoriasis can cause thickened, scaly or cracked skin on the feet.

When psoriasis is suspected, broader management may be required beyond routine debridement and moisturising.

Can diabetes make cracked heels more important?

Yes.

For a person with diabetes, a deep fissure may be more significant because of potential changes in:

• Sensation
• Circulation
• Healing
• Infection risk

People with diabetes should avoid cutting hard skin themselves.

Professional assessment is particularly important if a crack becomes deep, painful, open or infected.

Internal link:

Diabetic Foot Care

What about poor circulation?

Reduced circulation can affect skin quality and healing.

Patients with known circulation problems should seek assessment if heel cracks are:

• Deep
• Bleeding
• Painful
• Slow to heal
• Red
• Inflamed

Aggressive home treatment should be avoided.

Can body weight contribute to cracked heels?

Greater load through the heel can contribute to outward expansion of the heel pad and increased mechanical stress on the skin.

However, cracked heels have many causes.

Management should focus on all relevant contributing factors without reducing the problem to body weight alone.

Do heel cups help?

Heel cups or supportive footwear may help selected patients by supporting the heel pad and reducing outward expansion.

They may be particularly useful when mechanical pressure is contributing.

They are generally used alongside skin care rather than as a replacement for moisturising and callus management.

How can I prevent cracked heels from coming back?

Prevention may include:

• Moisturising regularly
• Using an appropriate heel balm
• Avoiding aggressive filing
• Wearing supportive footwear
• Reducing prolonged barefoot walking
• Managing excessive callus
• Treating fungal skin infection if present
• Reviewing recurrent fissures
• Seeking routine podiatry care where self-management is difficult

Regular care is often more effective than waiting until the heel becomes deeply cracked again.

Should I file my heels?

Gentle filing may be reasonable for mild superficial callus in otherwise healthy skin.

However, aggressive filing can:

• Irritate the skin
• Cause bleeding
• Create more trauma
• Be dangerous in people with diabetes or reduced sensation

Deep fissures and heavy callus are better assessed professionally.

Can cracked heels be permanently cured?

Not always.

Treatment can improve the existing fissures and reduce contributing factors.

However, cracked heels can recur if:

• Skin remains dry
• Thick callus reforms
• Mechanical pressure continues
• Footwear contributes
• An underlying skin condition remains

Ongoing prevention is therefore important.

How quickly do cracked heels improve?

This depends on severity.

Mild dryness may improve relatively quickly with consistent moisturising.

Deep fissures with substantial callus may require:

• Professional reduction
• Daily skin care
• Pressure management
• Repeated review

Healing can take longer if there is diabetes, reduced circulation or an underlying skin disorder.

When should I see a podiatrist?

Consider podiatry assessment if:

• Your heels are painful
• The cracks are deep
• Your heel is bleeding
• Thick hard skin keeps returning
• Home moisturising is not enough
• Walking is uncomfortable
• You are unsure whether the problem is fungal or another skin condition
• You have diabetes
• You have circulation problems
• You have reduced sensation
• You cannot safely manage the hard skin yourself
• The skin is red, inflamed or slow to heal