Painful split heel

Dry, thickened skin loses flexibility and can open when the heel spreads during standing. Open footwear, friction, long periods on hard floors, and frequent hot washing can worsen cracking. Heel pain may also come from deeper structures: plantar fasciitis tends to hurt beneath the heel, while Achilles tendinitis affects the back of the heel. In a growing child, activity-related heel pain can have a different cause. A clinician should distinguish a surface fissure from a deeper injury such as a stress fracture or nerve irritation from tarsal tunnel syndrome.

Look for the depth of the crack, bleeding, discharge, surrounding redness, and whether pain is limited to the skin or felt deeper with weight-bearing.

Wash gently, pat dry, and apply a plain emollient regularly, especially after bathing. Cover an open fissure with a clean dressing and wear supportive closed shoes with soft socks. Avoid picking, shaving, or applying harsh antiseptics inside the crack. Reduce walking that stretches the heel until the skin settles. Custom Orthotics may reduce heel loading for some people when foot mechanics are involved, but they do not replace care of the open skin. Do not share foot files or towels if there is peeling or possible infection.

Seek prompt care for spreading redness, warmth, swelling, pus, fever, worsening pain, or a crack that does not begin to improve. Urgent assessment is needed if the heel is deeply open, bleeding will not stop with pressure, you cannot bear weight, or the foot becomes numb or cold. People with diabetes, reduced circulation, or reduced sensation should have a low threshold for professional review of any open heel wound.

Ask whether the fissure is superficial or infected, whether a skin condition is contributing, how to dress it, and whether your heel loading or footwear needs changing. Ask when exercise and swimming are safe again.