Posted by Jenn F. on Friday, August 17th, 2012
Cracks are everywhere. There are cracks in walls, cracks in the sidewalk, cracks in your argument, cracks in the financial system, cracks in the shiny crust of a nice batch of brownies (mmm…brownies…). Unfortunately, there can also be cracks in or on you. As we’ve discussed here many times, you can have cracks in your foot bones. However, those aren’t the only cracks that can affect your foot–you can also have cracks on the outside of your foot. Let’s talk about these.
Cracks on the outside of my foot? Are you sure you don’t mean cracks on my shoes? I’ve worn some bad shoes on occasion. No, I do mean cracks in the skin of your foot, specifically heel fissures. These are deep cracks that occur at the rim of the heel where what’s known as the hairy skin, the skin that covers the upper part of the foot, and the glabrous skin that covers the sole of your foot.
The skin on top of my feet is not hairy. Why is it called “hairy skin?” Maybe the term came from a Hobbit doctor. That’s a whole different issude, so let’s just move on.
Okay. How do these fissures happen? For most people, the area where the two skins meet is barely noticeable. However, some people will tend to form heavy calluses there. For example, there may be a hereditary link, or it may happen to people with an overall tendency to dry skin; heel fissures are more likely to occur during the winter. Some relate it to a deficiency in Vitamin A, and it can also be a problem for diabetics.
The most common culprit, though, is just being overweight. Somewhat like an overfilled balloon, the skin down at that part of the foot is constantly being pushed to its limit at every step. The constant pressure on the skin there causes the skin to react by forming calluses. In time, it can become too much for these calluses, and they crack, revealing the middle layer of skin, the dermis.
That’s surely ugly, but if this most often happens in the winter, it’s no big deal, right? I can just put on some socks. No, you should pay attention to heel fissures because they can become infected. This is an especially dangerous problem for diabetics.
So how do you cure them? You can’t actually cure heel fissures; rather, you have to just manage them and take care of them. If you have severe, deep cracks, you may need your foot taped or strapped to hold them together and let them heal a bit. Then it’s important to keep the skin in that area soft, with regular use of a thick, rich moisturizer. There are even types specifically made for calluses. A podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) can make recommendations if you’re not sure what to use. You can also periodically gently–very gently–rub off dry skin with a pumice stone. Do this when your skin is soft, like after a shower, or after soaking your feet. If you’re diabetic, don’t do this at all–talk to your podiatrist about the best course of action. Finally, a podiatrist may recommend heel cups or heel pads for your shoes to help take pressure off our heels.
The best way to deal with heel fissures is to avoid them. If you notice you have calluses forming around the rim of your heel or you know you have dry skin, start a moisturizing program for your feet and keep an eye out for any cracks. If you’re overweight, try your best to lose weight to help your feet out. We know it’s hard, but it’s important to you and your feet, and we want your feet to be healthy, happy, and uncracked!
If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.