Heel fissures, commonly known as cracked heels, are a frequent skin condition ranging from a cosmetic concern to a source of pain and potential infection. This condition occurs when the skin on the heel becomes excessively dry, thickens into a callus, and then splits under the pressure of body weight. The skin loses its natural elasticity, making it unable to stretch when the foot’s fat pad expands during walking or standing. Understanding the factors that contribute to this dryness and splitting is important for effective prevention and treatment.
The Role of Inherited Traits
Cracked heels often appear to be a simple matter of dry skin, but a person’s genetic makeup can predispose them to the condition. Inherited factors influence the fundamental structure and function of the skin barrier. Genetic variations affect how well the skin retains moisture, making some individuals more susceptible to developing dry, rigid skin on their feet.
One significant genetic factor involves the filaggrin (\(FLG\)) gene, which produces a protein that helps maintain the skin’s outer layer and hydration. Loss-of-function mutations in the \(FLG\) gene are associated with conditions like Ichthyosis Vulgaris, characterized by dry, scaly skin. Individuals carrying these mutations have a compromised skin barrier that loses water more easily, leading to chronic dryness pronounced on the thick skin of the soles and heels.
Inherited structural differences in the foot also increase mechanical stress on the heel. The way a person walks or the natural cushioning provided by the heel’s fat pad is often an inherited trait. If the foot structure causes abnormal pressure distribution, it accelerates the development of thick calluses prone to fissuring.
Environmental and Lifestyle Influences
Non-genetic factors frequently act as immediate triggers that cause a genetic predisposition to manifest as cracked heels. Mechanical stress is a primary culprit, as prolonged standing places sustained pressure on the heel pad, forcing the skin to expand sideways. Wearing open-backed footwear, such as sandals or flip-flops, allows the heel fat pad to expand without support, increasing shearing forces that cause the rigid skin to split.
The surrounding environment significantly impacts skin hydration. Cold, dry weather or low-humidity climates strip the skin of its moisture. Harsh soaps and long, hot showers also contribute to dehydration by dissolving the skin’s natural protective oils, and insufficient internal hydration further reduces the skin’s ability to remain pliable and elastic.
Underlying health issues can severely compromise the skin’s integrity. Conditions like diabetes can cause neuropathy, reducing the skin’s natural moisture and making it vulnerable to breakdown. Hypothyroidism, eczema, and psoriasis are acquired diseases that disrupt the skin’s metabolism and barrier function, leading to chronic dryness and an increased likelihood of fissuring.
Practical Steps for Healing and Prevention
Healing existing cracked heels involves a dual approach: exfoliation to remove hardened skin and intense moisturization to restore elasticity. After a brief soak in lukewarm water, gently scrub the thickened skin with a pumice stone or foot file to reduce callus buildup. Following exfoliation, immediately apply a thick, emollient moisturizer to trap water in the skin.
Look for products containing active ingredients like urea, salicylic acid, or alpha hydroxy acids, which function as chemical exfoliants and humectants to soften and hydrate the skin. For severe cracks, apply a thick occlusive agent, such as petroleum jelly, and cover the foot with cotton socks overnight to create a highly moisturizing environment. A liquid bandage on deep fissures helps seal the crack, reduce pain, and prevent bacteria from entering the wound.
To prevent recurrence, switch to supportive, closed-back footwear that limits the sideways expansion of the heel pad during walking. Maintain internal hydration by drinking adequate fluids. Daily moisturizing, ideally within five minutes of bathing, is the most effective preventative measure to keep the skin supple and resistant to cracking.