Cracked heels can range from annoying tags of dry skin that catch your bed linen and socks, to deep fissures that expose underlying capillaries and nerves. Needless to say, the latter often bleed and can be extremely painful. Whilst some people are afflicted year-round, for the majority it’s a seasonal problem that presents when the thongs come out for summer. Newcomers to our country will often say that they have never experienced the problem before coming here, for cracked heels are about as Australian as vegemite and meat pies.
Cracked heels first begin with a build-up of callus around the heel. The callus is hard skin that forms in response to forces between the skin and ground. A lot of weight is transferred through the heel as it strikes the ground with each step, making it common to see callus here. The second phase is cracking of that hard and dry skin. Whilst it’s intuitive to think that thongs or bare feet allow the callus to dry out and crack, there is another reason in play.
Positioned underneath the heel bone is a cushion of fat. This fat pad, acts like a water balloon expanding as weight pushes down on it. In this way the heel bone is protected from the body’s weight as it comes into ground contact. This works well on grassy savannahs on which humans evolved, but it is overwhelmed in today’s concrete jungle. The forces are higher and fat pad expansion is greater. When the skin loses its elasticity due to being callused, the internal force of the expanding fat pad push outward causing it to crack.
Enclosed footwear somewhat contains the heel’s fat pad, and provides an opposing force that helps prevent excessive expansion and cracking of the skin. Thongs and bare feet offer no such support. In fact, in the case of the former, the situation is made worse as the heel is allowed to hang over the edge of the thong thereby increasing problem.
A podiatrist is a health professional proficient in the management of callused and cracked heels. The podiatrist will expertly debride the callus and cracked edges with a sterile blade, without pain. For most people, relief from open cracks will be immediate. Moreover, contributing factors will be addressed and the best advice regarding choice of skin creams and footwear will be provided.