Cracked heels, which are also referred to as heel “fissures”, are a very common foot condition and can cause discomfort or even pain. They are especially prevalent in cold climates where the air is very dry.
According to the last National Foot Health Assessment, 20 percent of adults in the United States have experienced cracked skin on their feet. Women were 50 percent more likely to report the condition than men.
Cracked heels result from dry skin. In other words, a lack of moisture is the most common cause of cracked heels. Interestingly, the skin on the soles of our feet does not have any oil emitting (sebaceous) glands and instead has hundreds of thousands of eccrine sweat glands. Eccrine sweat glands regulate our temperature through evaporation. When the internal temperature of our feet rises, sweat glands release water to the skin surface. There, it quickly evaporates, subsequently cooling the skin and blood beneath. In dry air, that sweat evaporates even more rapidly! Unfortunately, that loss of moisture can dry out our heels. Even lying in bed, your heels are in contact with the bed linen all of the time, and the moisture is sucked out of them by the sheets.
Your skin is thickest on the bottom of your feet to help absorb shock. However, when the skin underneath your feet becomes dry, rough and chapped it lacks flexibility. So, when you apply pressure on your soles (e.g., standing for long periods, walking, running), the dry skin is not elastic and so it can split or crack, instead of stretching. Over time, the stress and friction imposed on our feet from everyday mileage can cause them to become parched, cracked and sore – and in some severe cases even to bleed.
In addition to exposure to cold, dry air (e.g., Canadian winters!), there are several other factors that can exacerbate dry, cracked heels, including:
- Medical or skin conditions (such as eczema and psoriasis)
- Fungus – e.g., athlete’s foot
- Diabetes (First, diabetics are more likely to experience cracked heels because nerves that control the moisture in your foot no longer work, due to nerve damage from uncontrolled blood sugars. Secondly, diabetes can reduce blood flow to your feet, depriving your feet of oxygen and nutrients, which makes it more difficult for the fissures to heal)
- Thyroid conditions. (People with hypothyroidism may develop extremely dry feet because their thyroid gland cannot regulate the sweat glands in the feet, which can lead them to become dry)
- Aging, since we naturally lose moisture in our skin as we age
- Obesity, because there is even more weight on the heel pad, which causes it to expand out further
- Certain medications, including diuretics, can cause dry skin on the feet
So, what do the foot specialists advise you to do to treat sore, dry cracked heels? In short - apply moisturizer then petroleum jelly (to keep the moisturizer in) then socks (to keep the creams off the sheets) and wear all night.
Let’s go over that again! Most podiatrists advise you to treat your dry heels at home by slathering on a thick coating of foot cream (to moisturize), then a layer of petroleum jelly (to lock in the moisturizer)…..and then by slipping on a pair of cotton socks (or a plastic bag) over the lotions, so that they won't soak into your sheets and to maximize penetration into your skin.
You can use our specialist Heal CupTM. See our post on How To Fix Dry Heels for instructions on how to use the Heal CupTM.
There are many brands of foot moisturizing creams on the market, so choose the one that you like the most. It is best to avoid lotions, creams, and moisturizers that contain alcohol, added fragrances, and artificial colors as these ingredients can worsen dry skin.
Instead, look for creams that contain:
- humectants, such as urea, aloe, and hyaluronic acid
- emollients, which include plant-based butter and oil
- occlusives, such as petrolatum, lanolin, and coconut oil (occlusives serve as a physical barrier to help prevent water loss from the skin’s surface)
 National Foot Health Assessment, 2012 available online at https://www.ipfh.org/resources/surveys/national-foot-health-assessment-2012
 American Diabetes Association. https://www.diabetes.org/diabetes/complications/foot-complications