What should you know about bad heel cracks?

Thick, dry skin around the heel can split when it is repeatedly stretched by standing, walking or open-backed footwear. Shallow cracks may improve with gentle skin care, while deep or inflamed fissures deserve clinical assessment.

The heel carries pressure and has relatively little oil production. When its outer skin becomes dry and thick, the heel pad can spread sideways under weight and pull that less-flexible rim apart. Walking barefoot, hot water, harsh cleansers, friction and footwear that leaves the heel unsupported can worsen the cycle.

Cracks may sting, itch or bleed. Athlete's foot often presents with itching, scaling and fissures, especially around or between the toes, and can sometimes involve the sole. Eczema, psoriasis and certain health conditions can also alter the skin barrier, so recurring or widespread changes may need diagnosis rather than repeated filing.

Wash with lukewarm water and a gentle, fragrance-free cleanser, then pat the feet dry, including between the toes. Apply a thick cream or ointment to the heel while the skin is slightly damp. A pharmacist or clinician can help select an emollient or a heel product that softens thick skin without irritating an open fissure.

Wear well-fitting, closed-back shoes that support the heel and reduce sideways spreading. Socks can limit rubbing and help keep an ointment in place. Do not cut thick skin with a blade, pick at the edges or aggressively file a painful, bleeding or inflamed area. A clean dressing can protect an open crack from friction; change it if it becomes wet or dirty.

Arrange prompt assessment if the heel becomes increasingly red, hot, swollen or painful, or if there is pus, an unpleasant smell, fever or redness spreading beyond the crack. Seek care for a deep wound, ongoing bleeding, dark or pale tissue, numbness, or difficulty putting weight on the foot.

Get professional advice early if you have diabetes, reduced feeling in your feet, poor circulation or a weakened immune system, because a small break may be harder to notice or heal. A clinician should also examine cracks that keep returning, fail to improve with careful home treatment, or occur with a persistent rash elsewhere on the feet.

Ask whether the pattern looks mainly pressure-related or whether fungal infection, eczema or psoriasis should be considered. Useful follow-up questions include which moisturiser suits intact skin, what is safe on an open fissure, whether a dressing is needed, and which footwear changes would reduce pressure. Mention itching, bleeding, numbness, discharge, other rashes, relevant health conditions and every product already tried.