Question: My husband gets deep, painful cracks in his heels in the winter. I say it is because he doesn’t use moisturizing cream on his feet. He says it is from wearing black socks. Either way, they are very painful, and he won’t go to the doctor. What really does cause these, and can they be prevented? I never get foot problems like this, so I can’t offer many suggestions.
Answer: Heel cracks or fissures, are a very common foot problem usually caused by dry skin. They are worse when the skin around the heel is thick. Sometimes the fissures can become so deep that they bleed. When this occurs, the fissures can become infected, requiring treatment with an antibiotic. Foot pain, especially while standing or walking, is the most common complaint from people with heel fissures.
As noted above, dry skin is the main cause, but there are contributing factors that predispose some people to heel fissures. People at greater risk include those who are overweight, those who stand for long periods of time (especially on hard floors) and those who wear non-supportive, open-back shoes like sandals. This last factor is very important, as many people with cracked heels tend to wear sandals in an attempt to keep pressure off the painful cracks. This actually makes them worse since there is no support around the heel to prevent the heel tissue from pressing outward when under pressure from standing.
There are also some medical conditions that make you more likely to have heel fissures. Hypothyroidism and diabetes can be medical factors in the development of heel cracks.
First, make sure your footwear is closed and supportive, and try to reduce your daily standing time. Next, sanding down the heels to get rid of the excess dry skin (callus) can help to heal existing cracks and prevent new ones from forming. Taping the crack together with bandages or tape from a first-aid kit can help reduce the pain and speed up the healing process. You may also want to look for heel cups to insert into your shoe to help the heel tissue from expanding and causing more cracks. You can find these at most general pharmacies.
Finally, your instinct is right about moisturizers and emollients. I prefer ointments rather than creams. I would recommend that your husband apply an ointment like Vaseline to the entire heel, then wear socks to bed at night to help heal fissures and prevent new ones. By the way – the socks can be of any color.
