What causes cracked skin?

Cracks form when the outer skin barrier loses flexibility and cannot withstand movement, friction or stretching. Frequent handwashing, cleaning products, dry air and hot water can strip protective oils. Atopic dermatitis and hand eczema may cause itchy, inflamed skin that splits at the knuckles, fingertips or creases. Psoriasis can create thick, scaly plaques that fissure. On the feet, pressure and thick heel skin may lead to cracked heels.

Pain, bleeding, itch, scaling and the location of the fissures help distinguish simple dryness from an inflammatory condition. Deep cracks can allow germs to enter, particularly around the hands and feet.

Apply a thick, fragrance-free emollient after washing and whenever the skin feels tight. Use lukewarm water, a gentle cleanser and protective gloves for wet or chemical work; cotton liners can reduce sweating and friction. Do not pull at loose skin or file painful cracks aggressively. Cover a clean fissure with a suitable dressing and reduce pressure on cracked heels with well-fitting footwear.

See a clinician when cracks are deep, recurrent, bleeding, spreading or not improving with regular moisturising. Get prompt advice for increasing warmth, swelling, pus, red streaks or fever, which can signal infection. Painful hand fissures that prevent movement, or foot cracks in someone with reduced sensation, deserve early assessment.

Ask whether eczema, psoriasis, allergy or pressure is contributing; which emollient texture suits the area; and whether a prescription treatment or dressing is appropriate.