What should you know about scaly heel skin?

Heel skin bears pressure and can thicken when it is dry, exposed to friction, or repeatedly pressed by footwear. This may create rough scale and painful fissures. A fungal infection can cause peeling or scale that extends along the sole or sides of the foot, sometimes with itch or changes between the toes. Psoriasis can affect the soles with well-defined thick scale, and dermatitis can make the skin inflamed and cracked.

Look at both feet and note whether the scale is on one side, both sides, between the toes, or elsewhere on the body. Bleeding, drainage, tenderness, and difficulty walking are more concerning than mild roughness alone.

Apply a bland emollient to clean, dry heels every day, especially after bathing. Choose comfortable shoes and breathable socks, and change damp socks promptly. Do not cut thick skin with blades or aggressively file cracked areas. Keep feet dry and avoid sharing towels or footwear if fungal infection is possible. A clinician may recommend a topical antifungal treatment or another plan after examining the sole and nails.

Arrange a review when scaling lasts despite moisturising, spreads to the sole or nails, repeatedly cracks, or makes walking uncomfortable. Seek prompt care for increasing warmth, swelling, pus, severe pain, fever, or a wound that is not closing. People with reduced sensation or circulation should have foot breaks assessed early.

Ask whether the scale is from dryness, dermatitis, psoriasis, or fungus; whether the nails need checking; which moisturiser is suitable; and how to protect fissures while they heal.