The dry, cracked skin on the feet, known as xerosis, is a common and serious complication for individuals managing diabetes. This dryness occurs because diabetes can damage the autonomic nerves responsible for regulating sweat and oil production in the feet, leading to a loss of the skin’s natural moisture barrier. Reduced blood circulation—a condition called peripheral artery disease—slows healing and makes the skin less elastic, which causes it to crack easily. These cracks serve as entry points for bacteria, posing a high risk of infection, ulcers, and potentially severe limb-threatening complications. Proactive and consistent foot care is necessary to prevent minor dryness from escalating into a major health concern.
Daily Moisturizing Techniques
Applying a proper moisturizer is the most direct way to treat dryness and prevent skin cracks on the feet. The best products are thick creams, ointments, or petroleum jelly, which offer superior barrier protection compared to thin lotions. These products should be fragrance-free and hypoallergenic to avoid irritation, and ingredients like urea and glycerin are particularly effective at helping the skin retain moisture.
The technique of application is as important as the product itself, and it should be performed at least twice daily. The ideal time to moisturize is immediately after bathing or washing the feet when the skin is still slightly damp, which helps lock in the absorbed water. It is imperative to apply the moisturizer only to the tops and soles of the feet and never between the toes.
Placing moisturizer between the toes traps moisture, creating an environment that encourages the growth of fungal infections, such as athlete’s foot. When applying, gently rub the product into the skin, which can also help stimulate circulation. Consistency in this routine protects the skin’s integrity, minimizing the risk of fissures.
Essential Hygiene and Inspection Practices
A daily routine of cleaning and inspection is necessary to ensure the skin remains healthy and any developing issues are caught early. Feet should be washed every day using a mild soap and water that is lukewarm, never hot, as elevated temperatures can cause burns due to reduced sensation from neuropathy. Soaking the feet is not recommended because it can paradoxically increase skin dryness.
After washing, the feet must be dried thoroughly by gently patting the skin with a soft towel, paying extra attention to the spaces between the toes to prevent fungal growth. Nail care should be managed carefully by trimming toenails straight across to avoid ingrown nails, and edges should be smoothed with a file; avoid cutting cuticles. Never attempt to remove corns or calluses yourself, as this can easily lead to a break in the skin.
The most important part of the daily routine is a thorough visual inspection of the entire foot. You must check the soles, heels, tops, and all spaces between the toes for any cuts, scrapes, blisters, redness, or swelling. If you have difficulty seeing the bottom of your feet, use a small mirror or ask a family member for assistance. This daily check allows for immediate action on minor injuries that might otherwise go unnoticed due to nerve damage.
Choosing Protective Footwear and Socks
You should never walk barefoot, even inside your home, to prevent accidental injuries. Footwear should have a wide, deep toe box to prevent pressure and friction, and it is best to avoid pointed shoes or high heels. Look for shoes made from breathable materials like leather or canvas, which allow air to circulate and help keep the feet dry.
Shoes should fit well and have a smooth, seamless interior lining to reduce the risk of rubbing, which can cause blisters and sores. It is generally recommended to buy new shoes in the late afternoon or evening when feet are slightly swollen, ensuring a comfortable fit throughout the day. Before putting on any shoe, you should always check the inside to ensure no foreign objects, like small pebbles, are present, as nerve damage may prevent you from feeling them.
Socks provide an important layer of soft cushioning and protection between the foot and the shoe. The best options are seamless socks, which eliminate the friction points caused by typical toe seams. They should be made from moisture-wicking materials to draw sweat away from the skin, keeping the foot dry. Look for socks with non-binding tops that do not restrict circulation, and they should be changed daily to maintain hygiene.
Recognizing When to Seek Professional Help
Certain signs indicate that a foot problem has progressed beyond simple dryness and requires prompt medical attention from a healthcare provider or podiatrist. Any cut, blister, or crack that does not show signs of healing within a few days is a serious warning sign. Because of reduced circulation and impaired immunity, even minor wounds can quickly escalate into severe infections.
Signs of infection include increased redness, persistent swelling, warmth in one foot compared to the other, or localized pain that may be felt even with neuropathy. The presence of foul odor, any discharge or drainage from a wound, or an accompanying fever are also immediate red flags. Loss of sensation, or new tingling and numbness, indicates advancing neuropathy and warrants a professional evaluation of nerve function. Regular check-ups with a podiatrist are necessary for early detection and management of issues before they become severe.