What causes cracked heels?

Cracked heels is a frustrating condition that manifests as thick callus around the heels. When combined with dryness, this can crack into a fissure, often splitting into the skin causing bleeding, and pain.

Cracked heels exist firstly because there is callus formation on the heels, but fissures do not necessarily occur just because of callus. If the skin is dry, or has a fungal infection, the skin loses its suppleness and may then fissure.

The cause of cracked heels is often blamed on footwear like sandals, as women tend to get it more than men, but there are a number of factors that lead to cracked heels.

  • Age
  • Psoriasis or other skin-related conditions
  • Diabetes
  • Kidney disease
  • Thyroid disease
  • Vitamin deficiency
  • Excess weight

Hard skin on heels

Hard skin, leading to cracked heels, starts by the formation of a rim of thick skin around the heel. This can form on the outside, inside or all around the heel.

The formation of callus is caused by high arches, or dropped arches. High arches are generally poor shock absorbers, and, because of poor shock absorption, they thump the heel on contact as you walk or run, leading to callus formation.

Dropped arches have calluses forming on the inside or medial side of the heel because of the amount of time the foot spends rolling in. If you are carrying a bit too much weight, this may be a factor as well – increased weight places the feet under a lot of stress.

High arched feet tend to be poor shock absorbers. Improving  shock absorption and calf flexibility will help reduce impact on the heels.

Dropped arches or excessive pronation can be assisted with supports, orthotics and correct footwear, this could assist reduction of medial heel pressure, thereby reducing callus build up.

Callus formation itself, however, does not justify cracking. There would have to be a loss of suppleness of the skin that would be more common in dry feet. In the section an Anhidrosis, I have dealt with the approach to dry skin. Athletes Foot may lead to dry skin that is less supple, and this may be the cause.

Cracked heels

Cracked heels photo by James Helman MD (creative commons).

Cracked heels treatment

When treating cracked heels, you can encourage skin suppleness with emollients or moisturising creams, or by improving your nutrition. Podiatrists can remove most of the hard skin with skilled scalpel technique that is painless, and will make the feet feel good again, but the hard skin will build again and one may need maintenance treatment.

  • Marigold Therapy is a cracked heels treatment that proposes to restore normal skin through blocking the process of excess skin production.
  • This involves the application of a paste derived from marigold flowers.
  • Three to four applications over a few weeks.
  • Then additional self-treatment at home with a tincture and oil to maintain the skin.

Appreciating the mechanical cause of cracked heels and hard skin and improving foot function can help as well.