Dry skin on any part of the body can be annoying and can cause flaking and cracking, redness due to scratching, and unsightly patches of thick or hard skin. When dry skin occurs on the feet, the symptoms are magnified due to wearing shoes, the stretching of the skin on the feet with every step, and by certain synthetic materials in shoes or socks that may dry the skin out even more. Because of the confining nature of shoes and the lack of fresh air circulation, dry feet need special care.

Heels are the most prone to develop dry, hard, and painful cracks or fissures. For many people, cracks on the heels are only a cosmetic problem; however, when the fissures are deep they can be very painful and may bleed. Once bleeding occurs, the skin is prone to bacterial infections and athlete’s foot.

Causes of dry skin and cracked heels include:
• Inactive sweat glands. This is usually genetic.
• Obesity. Extra weight on the feet will destroy sweat glands.
• Years of prolonged standing will also destroy sweat glands.
• Using excessively hot water when bathing can reduce sweat gland activity.
• Certain chronic skin problems such as eczema and psoriasis cause dry skin.
• Biomechanical foot defects cause abnormalities in walking, which can cause certain areas of the feet to bear abnormal amounts of weight. This abnormal weight not only destroys sweat glands in these areas, but produces areas of thick, hard, and dry skin.

Cracked heels develop from conditions like psoriasis, where you make skin quicker in areas that receive friction or pressure. This also can be caused by friction, alone. People who wear flip-flops, sandals, slip on loafer-like shoes build up skin faster, from friction. This skin cracks or fissures when certain areas get thicker than the surrounding normal skin.

Treatment for cracks in the skin caused by conditions like psoriasis can be accomplished by applying strong steroid ointments to slow skin cell turnover. These steroids should only be used for short periods of time and usually in bursts (for example, apply twice a day for two weeks. Stop one week. Cycle, again.) Then, once under control, using prescription medications with urea or ammonium lactate can help keep things under control. However, if the problem is caused by friction, the cracks will not go away until you eliminate the cause of the friction. Wearing closed shoes that do not slip on the heel can slow the formation of and prevent the recurrence of cracked heels.

See your podiatrist, who will most likely shave down this thick, cracked skin and then prescribe a medication for you to keep it under control.

Contributed by Gene Mirkin, DPM

Checked 7/12/23