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Heel Cracks 

Introduction
Cracked heels (heel fissures) are a common foot condition.  The condition develops in dry skin or calluses on the heel if there is too much pressure on the skin.  Moisturizing creams, clinical skin treatments, heel cups, or insoles can help.  People with certain medical conditions, signs of infection, or significant cracked heels should contact a podiatrist for professional treatment. 

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Anatomy
Your skin is the largest organ of your body and covers your body to protect it from the environment.  Your skin has three layers.  The epidermis is the skin’s outermost layer.  It protects the inner layers.  Basal cells at the bottom of the epidermis move upward to replace the outermost cells that wear off. 

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Causes
A combination of dry skin and heel pressure can lead to cracked heels.  Mechanical factors, such as the way you stand or walk, can contribute to pressure imbalances that affect the heels.

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Symptoms
Heel cracks occur in dry skin, calluses, or thick skin around the edge of the heel.  The cracks are usually visible.  The heel skin may appear flakey, discolored, brown, or yellow.  Your skin may feel painful when you put weight on your foot.

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Diagnosis
Your doctor can diagnose cracked heels by reviewing your medical history and examining your feet.  The doctor may brush your skin with a swab to collect cell samples for examination to rule out an infection.

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Treatment
Over-the-counter moisturizing cream and gentle use of a pumice stone can help mild heel cracks.  For persistent heel cracks, a podiatrist or dermatologist can professionally remove hardened thick skin to allow the cracks to heal.  You should not try to remove heel cracks or calluses at home.  On rare occasions, special glue is used to hold the skin together to promote healing.  Your doctor may prescribe prescription moisturizers.

Your doctor may recommend that you wear heel cups or custom insoles in your shoes to help relieve pressure.  You should avoid wearing open back shoes.  Regular professional foot care can help maintain healthy heel skin. 

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Prevention

You can help prevent heel cracks by following your doctor’s instructions for wearing heel cups or insoles.  Lose weight and maintain a healthy weight. 

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Am I at Risk

Risk factors for heel cracks include:

• Dry Skin
• Skin conditions such as eczema or psoriasis
• Certain medical conditions, such as diabetic neuropathy, hypothyroidism, or inactive sweat glands
• Wearing open back shoes or sandals or wearing shoes with thin soles
• Walking barefoot
• Obesity or overweight
• Standing for long periods of time

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Complications
Severe heel cracks may bleed or become infected.  People with diabetes or vascular conditions should contact their doctor if they develop persistent heel cracks.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.