Causes and risk factors
The most common cause of cracked heels is dry skin. Skin which is less hydrated is more prone for cracks. Cracked heels can occur in a variety of skin infections like atopic dermatitis, psoriasis, or palmoplantar keratoderma. Certain systemic conditions can also lead to development of fissures on heels. The most common causing diseases are diabetes and thyroid complaints like hypothyroidism. Corns and calluses seen on the heels are the major contributing factors for development of cracked heels. Excessive weight, prolonged standing, and use of shoes and sandals which are open at the back are some of the other risk factors for developing cracks. These factors lead to increased pressure on the fat pad which is present under the heel.
Clinical presentation
The complaints are usually mild. An individual suffering from cracked heels complains of development of fissures on the rim of the heels. These cracks are shallow initially. Gradually, they tend to become deep. Presence of cracks on the heels can lead to pain which is aggravated while walking, standing, or activities which induce pressure on the heel. The skin on the heel becomes thick and hard. Discoloration of the surrounding skin can be seen. The skin becomes yellow or brown in color. Pressure on heels causes the cracks to become deeper. At times, bleeding from cracks can be seen. Apart from all these complaints, cracked heels are also a matter of worry from a cosmetic point of view. Cracked heels can be a matter of worry in diabetic people as it can lead to diabetic foot ulcers.
Investigations
Diagnosis is done on the basis of symptoms narrated by the patient and the examination carried out by the dermatologist. Clinical examination itself is diagnostic. No investigations are needed for diagnosis.
Treatment:
Usually the complaints are mild and do not need any medical intervention. Certain topical ointments are easily available over the counter. Softening agents can be advised. Use of liquid gels and spray or bandages is advised to reduce pain. A pumice stone can be rubbed to remove the hard and dead skin on the heel. Heel balms or heel moisturizers can be used for adequately hydrating the skin over the heels. In severe cases where conservative method is not effective, debridement of the dead skin can be done. Use of insoles or heel pad or heel cups can be advised to reduce the pressure on the heel.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptom. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.
