Cracked dry heels, also called heel fissures, have many causes. The main sign of this problem is hard skin over the heel area that has noticeable cracks, and the skin color may be darkened or yellowed. Flaky or peeling skin may also be present and pain or itchiness is common. The causes include psoriasis, eczema, athlete's foot, diabetic neuropathy, air conditioning, open backed shoes, pressure from standing, and dry skin.
Dry skin, or xerosis, is the most common cause of cracked heels. Some people have naturally dry skin, and if it isn't moisturized so that it's soft and flexible, it becomes hard, tough, and easy to crack. The pressure created by standing only adds to the problem — especially if a person is overweight or spends a lot of time on his or her feet on hard floors.
Open-backed shoes can lead to heel problems because the heel pad of the foot is allowed to move around and spread out. Plus, if the foot is bare, the heel is exposed to drying environments such as those created by air conditioning systems. Excess heat in a home can also lead to drier skin and cracked heels.
Several medical conditions are also identified causes. Diabetic neuropathy, or nerve damage, is a complication of diabetes that may cause cracked heels if the nerves that control the sweat glands are affected. The feet don't sweat, so the skin becomes dry and hard. The fungus known as athlete's foot can also dry out the foot and cause fissures, or heel cracking. Chronic skin conditions such as eczema and psoriasis may also cause this problem.
Dry heels should be treated as they may bleed or become infected if the cracking is severe. It’s never a good idea to try to cut away the hardened skin on the heel without the advice of a medical professional as this may cause further injury and increase the possibility of infection. Using a pumice stone on the heels and applying moisturizing lotion to the area several times a day is usually recommended. Proper footwear with thick, supportive soles and a good fit that holds the heel in place may help reduce the problem. A foot specialist, or podiatrist, may suggest that a device to cup the heel be added to the patient's shoes.