Cracked Heels (Heel Fissures)

Several factors contribute to the development of cracked heels:

• Dry Skin (Xerosis): Naturally dry skin or conditions that cause dry skin are primary culprits. Singapore’s climate, while humid, can be offset by air-conditioning, which dries the air and skin.
• Prolonged Pressure: Standing or walking for long hours, especially on hard surfaces, puts stress on the heel pads, causing the skin to expand sideways. If the skin lacks flexibility, it cracks.
• Excess Weight: Increased weight puts more pressure on the fat pad under the heel, contributing to cracking if the skin is dry.
• Improper Footwear: Open-backed shoes (like sandals or flip-flops) allow the fat under the heel to expand sideways, increasing the possibility of cracks. Poorly fitting shoes can also contribute.
• Water Exposure: Prolonged exposure to water, especially hot water during showers or baths, can strip the skin of its natural oils, leading to dryness.
• Ageing: Skin naturally loses moisture and elasticity with age, making it more prone to dryness and cracking.
• Underlying Health Conditions: Certain medical conditions increase the risk, including:
  • Diabetes (which can cause nerve damage and poor circulation, impairing skin health and healing)
  • Eczema and Psoriasis
  • Thyroid disorders
  • Athlete’s foot (fungal infection)

• Deep, Painful Fissures: Cracks can deepen, making walking extremely painful.
• Bleeding: Open fissures can bleed easily.
• Infection: Cracks provide an entry point for bacteria, potentially leading to skin infections (cellulitis). This is a significant risk for individuals with diabetes or compromised immune systems.
• Difficulty Walking: Severe pain can limit mobility and affect daily activities.

Diagnosing cracked heels typically involves:

• Visual Examination: A podiatrist will examine your heels and feet, assessing the severity of the dryness, calluses, and fissures.
• Medical History Review: Discussing your symptoms, lifestyle (e.g., occupation, footwear), hygiene practices, and any underlying health conditions (like diabetes) helps identify contributing factors.

Further Tests (If Needed): If an infection is suspected, a swab might be taken. If an underlying skin condition like psoriasis or athlete’s foot is considered, skin scrapings might be analysed

Effective management often involves addressing the underlying causes and providing symptomatic relief. While self-care is important, professional podiatric treatment ensures safe and effective management, especially for deep or persistent cracks.

• Professional Debridement: A podiatrist can safely remove the thick, hard skin (callus) surrounding the fissures. This reduces pressure on the cracks and allows them to heal more effectively. Do not attempt to cut away hard skin yourself, as this can lead to injury or infection.
• Specialised Moisturisers & Dressings: We may recommend or prescribe stronger emollients (moisturisers) to hydrate the skin effectively. In some cases, special dressings or heel sleeves might be used to lock in moisture and protect the area.
• Addressing Underlying Causes: If a fungal infection (Athlete’s foot) or another skin condition is contributing, specific treatments will be provided.
• Footwear & Orthotic Advice: Guidance on appropriate footwear and potentially custom orthotics can help redistribute pressure away from the heels.

Important Note: While various treatments exist, a consultation at Fine Podiatry Clinic allows us to assess your specific condition and recommend the most suitable, personalised management plan. We focus on safe, effective solutions tailored to your needs.

You can help prevent cracked heels or manage mild cases with consistent self-care:

• Moisturise Daily: Apply a thick, oil-based moisturiser or heel balm to your heels twice daily, especially after bathing and before bed. Consider wearing cotton socks overnight after moisturising to enhance absorption.
• Gentle Exfoliation: Use a pumice stone or foot file gently on damp skin 2-3 times a week to reduce callus build-up. Avoid harsh scrubbing.
• Stay Hydrated: Drink plenty of water to keep your skin hydrated from the inside out.
• Choose Appropriate Footwear: Wear supportive, closed-heel shoes whenever possible. Ensure shoes fit well and provide adequate cushioning.
• Avoid Harsh Soaps & Long Hot Baths: These can strip natural oils from your skin. Use lukewarm water and mild cleansers. Pat feet dry gently after washing.
• Regular Foot Checks: Especially important if you have diabetes or poor circulation. Check daily for any cracks, redness, or signs of infection.