Foot fissures: common causes and next steps

Heels and weight-bearing areas are exposed to stretching with every step. Dry skin, hard callus, open footwear and prolonged standing can make the surface less supple. Atopic dermatitis or psoriasis may create inflamed, scaly skin that cracks. Athlete-related irritation or another rash can also disrupt the barrier. Fissures can be shallow and uncomfortable or deeper enough to bleed, especially when the skin is pulled by walking.

Use lukewarm water and a mild cleanser, pat dry, and apply a rich moisturiser while the skin is slightly damp. Emollient therapy can help restore flexibility; cover a painful heel with a clean dressing to reduce rubbing. Wear supportive, well-fitting shoes and socks, and avoid cutting calluses with blades or aggressively filing an open crack. Keep feet clean and dry, particularly around the toes.

See a clinician if fissures are deep, bleeding, recurrent, infected-looking, or not improving with regular moisturising. Prompt assessment is needed for spreading redness, warmth, swelling, pus, fever or increasing pain. A clinician may check for dermatitis, psoriasis, infection or another contributor and recommend targeted treatment rather than treating the split alone.

Is the cracking mainly dryness and callus, or does a skin condition explain it? Would a specific emollient or dressing help? Could my shoes, work routine or foot products be contributing? How should I care for a fissure that bleeds?