relief for cracked heels

A patient of mine shared that he struggles with thick skin on his heels all year long.  But in the winter, they crack and get quite painful. Why does that happen and what can he do to prevent this?

Calluses are especially common on the heels, because they take a lot of pressure as we walk. That pressure, combined with skin that’s often dry, makes us susceptible to a common and potentially debilitating condition called cracked heels.

Calluses form as a result of friction. Sometimes it’s caused by the way your foot strikes the floor, and sometimes it’s due to loose shoes, which cause your feet to move around and rub against the shoe. With all of that friction, the body protects itself by forming thicker skin on the heels.

When callused skin is very dry, it tends to crack. If you picture a piece of dry, brittle bread, you can imagine that it would crack open if you stepped on it.
Winter is a common time to develop cracked heels. Here are steps to take now to protect your heels:

-Keep your feet covered. Wear socks and cushioned shoes when you’re up and about.
-Moisturize feet regularly. Use thick moisturizers with emollients — a mixture of water and oil, the kind that’s so thick you have to scoop it out of a jar.
-Cover your feet after moisturizing, so you don’t slip and fall.
-Treat calluses immediately. Use a cream that contains the ingredient urea twice a day, and only on the calluses. Urea helps thin them and break them down.
-Use a pumice stone. If urea cream isn’t helping, soak your feet and afterward rub callused heels with a pumice stone to sand off the calluses.
-Check feet for calluses regularly. They pose higher risk if you have diabetes (which can cause nerve damage that keeps you from feeling an injury) or peripheral artery disease (which can impair the circulation in your feet).

Cracked heels can usually be treated at home, with similar measures as you do for prevention. But you need to be sure that the affected areas are calluses and not plantar warts or psoriasis, which would require different treatment.

If there is any pain, redness, pus, or swelling, contact your doctor or podiatrist. It could indicate an infection — an urgent health matter for anyone, especially if you have diabetes or PAD. To treat the infection, your doctor will prescribe a topical or oral antibiotic. Then you have to return two weeks later, to make sure you’re healing correctly and the pain is going away.

The doctor may also remove the callus with special tools such as scalpels and power sanders made for the feet.

Article provided by Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.) ©2023 Harvard University. For terms of use, please see https://www.health.harvard.edu/terms-of-use. Distributed by Tribune Content Agency, LLC.

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