Dry and cracked feet

Corns and Calluses Ingrown Toenails Arthritis What is a Podiatrist?
Hammertoes Bunions Nail Fungus Links and Websites
Wart Diabetic Foot Problems Athlete’s Foot Patient Education Links
Heel and Arch Pain Pain in the Ball of the Foot Sports Injuries Common Disorder Videos
Children’s Heel Pain Hallux Limitus-Rigidus More Information

Corns and Calluses
Definition: These are areas of hard, dense skin. Calluses are wider and flatter and found on the soles of the feet. Corns are smaller and usually found on the tops of toes, or between them.
Cause: Too much pressure upon the skin causes Corns and calluses. The skin’s response to this pressure is to grow thick and hard, creating the corn. Most corns are seen on the tops of contracted, hammered toes or frequently between toes. Here the knuckle is causing too much pressure, or sometimes, a spur between the toes projects out and creates the corn.
Treatment: There are a number of treatment options. Trimming the corn or callus and applying a felt or moleskin pad will give temporary relief. Purchasing wider shoes to decrease the pressure will help. An orthotic support with a depression to relieve the pressure on the ball of the foot will help a callus. Corns can be eliminated permanently if the toe is straightened and the pressure from the bone beneath the corn is eliminated.

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Hammertoes
Definition: Toes that are contracted are called hammertoes.
Cause: Toes are meant to be straight. However, with time and wearing of shoes that are frequently too tight, toes can become contracted so that the knuckles become very prominent. These are painful in themselves or can cause painful corns and occasionally ulcers that cause even more pain.
Treatment: Buying wider shoes can relieve pressure and make the toes more comfortable. Hammertoes can be corrected with a minor procedure to straighten the toes.

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Warts

Definition:

These are small, hard painful areas of skin, usually found on the balls of the feet, but can be anywhere on the skin of the feet. They may be solitary or found in clusters, called “mosaic warts”.

Cause:This is a viral infection of the outer layout of the skin and they are quite contagious. If picked at, they can be easily spread to your hands, friends or family.

Treatment: There are many treatments for warts, but they are usually grouped as topical or surgical. Topical treatments include application of acid preparations or freezing the wart. Warts on the bottoms of the feet are often best treated by removal under local anesthesia and cauterizing the bases of the wart so that the viruses are killed. There is usually little discomfort with this procedure and patients are able to walk immediately afterwards.

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Heel and Arch Pain – Visit our Heel Pain Center
Definition: pain in the bottoms of the heels, extending into the arch is most often defined as “plantar fasciitis” or “plantar fasciosis” – inflammation or disease of the plantar fascia ligament, which runs from the ball of the foot to the heel.

This is an ultrasound image of plantar fasciitis on the right window. The image is looking at the bottom of the heel (the sole of the foot is up). The thick white lines are the bottom of the heel bones and the outline of tissue entering from the right side is the plantar fascia. If there is inflammation, the tissue becomes thicker and darker at the insertion into the heel bone. The thickness can be measured on the ultrasound screen.

This is an X-ray of the bottom of the heel bone, the calcaneus, showing a heel spur.

Think of the arch being like a bow and this ligament being like a bowstring. When the foot bears weight, the arch elongates and puts tremendous tension on the ligament. The ligament pulls off on the bottom of the heel and this causes the pain. This can also cause heel spurs. The spurs, by themselves, are frequently not the cause of the pain, but are often more a result of the pulling of the ligament, which becomes inflamed. The ligament inflammation can be viewed directly using an imaging ultrasound machine. The thickness of the ligament is proportional to the inflammation. Pain is frequently seen in people whose feet pronate, or flatten out, too much. If the pain and inflammation is present for a prolonged period of time, there can be degeneration or disease of the ligament which is termed “Plantar Fasciosis” which is more chronic in nature.

Treatment: People often begin treatment before they come to the office by using anti-inflammatory medications, over-the-counter supports and exercises to stretch the Achilles tendon and the plantar fascia ligament.

There are many treatment options for heel pain. The good news is that open surgery is rarely necessary. These conditions are often successfully treated with orthotic supports that prevent the foot from pronating. These supports are easily transferred from shoe to shoe. Occasionally a cortisone injection is beneficial to relieve acute symptoms. If a spur is present, occasionally it may require surgical removal.

In recent years, a number of new techniques have become available that allow for definitive pain relief without having to proceed to open surgical release of the ligament or removal of the heel spur.

CRYOSURGERY can eliminate plantar fascial pain with a procedure that lasts only about 7 minutes. This is done under local anesthesia. EXTRACORPOREAL SHOCK WAVE THERAPY can also give good relief for heel pain. For more information visit:

  • For more information, go to http://www.curamedix.com

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Heel Pain in Children
Definition: This is frequently referred to as “Sever’s Disease” or “Calcaneal Appophysitis”. This is an inflammation of the growth plate at the back of heels.
Cause: A boney growth plate is present at the back of the heels between the ages of 8 to 14. It is attached by soft cartilage to the main portion of the heel. The Achilles tendon inserts into the back of it, coming from the calf muscle, and a strong ligament inserts into it from the bottom. Pulling of these structures on the growth plate causes pain and inflammation. This is especially true in people whose feet pronate (arches flatten out) excessively. Common sports associated with this condition include tennis, soccer, football, basketball, baseball, and skateboarding.
Treatment: Stretching the Achilles tendon prior to running and wearing a cushioned heel lift can help prevent this condition. Sever’s disease usually responds very nicely to an orthotic support to control the pronation and cushion the foot.

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Ingrown Toenails
Definition: An ingrown nail is present when the side of the nail curves down into the flesh and causes pain, and frequently infection.
Cause: Ingrown nails often run in families or can be the result of an injury to the root cells at the base of the nail. Nail fungal infections make the nails more thick and curved and can also contribute to this condition.
Treatment: These can be treated temporarily or permanently. A wedge of nail can be removed from the ingrown portion to relieve the pressure and this usually makes the toe comfortable for a few months. However the ingrown nail frequently returns. For permanent relief, the toe is anesthetized with local anesthesia. The ingrown portion of the nail is removed, leaving the top, flat part alone. Once the root cells are exposed, they are cauterized with a chemical so that the ingrown part will no longer grow back. People are usually able to return to normal activities immediately.

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Bunions
Definition: Bunions are a boney bump on the first metatarsal bone, at the base of the big toe.
Cause: This portion of the foot bone becomes prominent when the first metatarsal and big toe shift out of alignment, most often as a result of tight shoes or excessive pronation.
Treatment: Purchasing wide shoes can relieve pressure on the bump. Bunions can be corrected with a minor surgical procedure where the bump is removed and the bones are shifted back into alignment. This is done on an outpatient basis and usually people are able to walk on the foot that day and return to an athletic shoe within a few weeks.

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Diabetic Foot Problems
Definition: Diabetes is a medical condition that effects many areas of the body including the feet, eyes, kidneys, nerves and arteries. Some of the more dangerous problems involve the feet. Problems that might be considered minor in non-diabetics, like thick nails, corns or callouses, are dangerous with diabetics. Some diabetics lose sensation in their feet so they can’t feel if they have a problem. Diabetics are more prone to infections and ulcerations (forming holes through the skin). How significant is this? Approximately 86,000 amputations are performed each year on diabetics in the United States (American Public Health Association). Comprehensive podiatric care and good control of the diabetes is the best treatment for prevention of diabetic foot problems.
Cause: Diabetes causes heightened levels of sugar in the blood which goes on to effects many areas and tissues of the body. Nerves begin to lose their function, beginning in the toe tips. The arteries can become occluded so that inadequate blood flow to the feet. Skin becomes dry, cracked and brittle. Corns, calluses and ingrown nails that put pressure on the skin can go on to cause infection and ulceration.
Treatment: Regular foot care is essential for prevention of diabetic complications, including testing for loss of sensation and ongoing education for home care. Debridement of corns, calluses, ingrown nails that could cause skin breakdown at regular intervals is essential. A prescription for protective shoes is given if necessary.

The Medicare Therapeutic Shoe Program: Medicare will provide a pair of therapeutic shoes and protective innersoles each year to qualified diabetic patients.

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Pain in the Ball of the Foot

Definition: Pain in the ball of the foot is caused by excessive pressure on the bones, joints and adjacent nerves. These include a number of different conditions. Pain beneath the joints is called “Capsulitis” or inflammation of the ligamentous capsule that surrounds the joint. Nerves that are located between the metatarsal bones where they join the toes can become pinched, swollen and inflamed. This is called a “Morton’s Neuroma”. Neuroma means tumor, but this is not a cancer-type tumor, but rather just a swollen, inflamed nerve. Pain beneath the base of the big toe may be from irritation to two small bones called “sesamoid bones”. This is referred to as “Sesamoiditis”. These are floating bones that everyone has that are similar to miniature knee caps. They can become bruised, crushed or fractured.

Cause: Any of the above conditions can become painful with injury. Some people just have a foot structure where the bones are too long, too low or out of alignment creating abnormal pressure at a specific location. Additional stress is caused by abnormal foot function during gait: excess pronation or supination (flattening of the arch or an unusual high arch). Sports that require being on the balls of the feet, like tennis, volleyball or basketball can contribute to these conditions.

Treatment: Often, these problems respond to conservative treatment with shoe changes, orthotic supports. Cortisone injection may give relief to a neuroma condition or joint inflammation. For neuromas that do not respond to orthotics or injections, cryosurgery (see cryosurgery section) has been found to be effective. Occasionally, open surgery will be necessary to correct these problems. This is done on an out patient basis.

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Arthritis

Definition: Joint pain, inflammation and deteriorization, as well as deformity can be caused by many types of arthritis.

Cause: Each type of arthritis attacks the joints in a different way and at different locations. Osteoarthritis most often attacks the big toe joint (“Hallux limitus-rigidus”) and midfoot joint of the arch. Rheumatoid arthritis attacks the joints across the ball of the foot, often causing dislocations. Psoriatic arthritis attacks the joints of the ball of the feet as well as the toe joints. Gout usually attacks the big toe joint, but occasionally can attack any other foot or ankle joint. Gout has some special characteristics that will lead your doctor to this diagnosis. Gout rarely attacks women.

Treatment:The good news is that almost all the conditions can be relieved or improved upon. Treatment depends upon the type of arthritis and degree of involvement. Treatments may involve oral medication, injection, orthotic supports or surgery depending upon the need. Obtaining relief of painful arthritic conditions is particularly gratifying for both the doctor and the patient.

Hallux Limitus-Rigidus: : (Stiff Big Toe Joint)

Definition: This is a condition where the big toe joint becomes arthritic, stiff and painful. The “hallux” is the Latin word for the big toe. As the joint becomes stiffer, it is referred to as “hallux limitus” and when motion stops it becomes “hallux rigidus”.

Cause: This is either caused by an injury to the joint which with time causes erosion of the joint cartilage and bone spur formation or by poor foot structure and mechanics so that the joint wears out from abnormal stresses, just like the knee or hip joints do. People who pronate excessively have a higher tendency for this condition.

Treatment: If this is caught early, much of the progression of the arthritis can be halted with a proper orthotic to eliminate the pronation and relieve the stress from the joint. Anti-inflammatory medications and cortisone injections can give good temporary relief. For chronic conditions there are a number of surgical procedures that can give permanent relief.

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Nail Fungus

Definition: This is an infection of the nail plate by a fungus, the same types that cause athlete’s foot. This is seen when the nail becomes thick, discolored and sometimes flaky.

Cause: The nail plate is not live tissue and is susceptible to infection. In fact, it is normal for people to get fungal infections after age 60. Some patients are at greater risk – particularly diabetics, immunosuppressed individuals and people who live or work in moist environments.

Treatment: Most of the over-the-counter medications found at sores are not effective. Nail fungus can be treated with oral or topical medications. The oral medications are the most successful and are generally quite safe, though it is necessary to inquire about the medical history and perform liver function tests during the course of the oral medication. Topical medications can be effective and minimize the side effects. No nail fungus treatment works all the time.

**Not Fungal Nails: Just because your nail may be discolored, thick or loose does not mean it is fungal. There are a number of other conditions that can cause similar appearance to a nail fungal infection. These conditions, of course, will not respond to nail fungus treatments, since they aren’t fungal in the first place. Your doctor can help determine what the cause of your nail condition and advise the best course.

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Athlete’s Foot
Definition: This is a fungal infection of the skin, causing either inflammation, blisters, flaking, redness, oozing and/or itching.
Cause: Fungus is everywhere and can be acquired by anyone, infecting the skin of the feet. Some of the people are more susceptible including diabetics, individuals whose feet perspire more, and those who work in greenhouses or are from moist environments.
Treatment: Most athlete’s feet infections will respond to the over-the-counter medicated powders and creams. The more severe infections will be treated with prescription medications.

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Sports Injuries
There are many kinds of sports related injuries, some more prevalent due to the stresses of specific sports. Many injuries are caused by faulty foot structure and function and aggravated by improper shoes.
Treatment: The goal when treating athletes is to get them safely back to participating in their sports as soon as possible. If the condition is severe enough that they cannot participate in their sport for a period of time, an alternative exercise can usually be found to allow the athlete to stay in shape during the rehabilitation period. Once the painful condition has resolved, steps must be taken to prevent recurrence. If poor foot structure or function is to blame, we can often correct this with a support worn in the shoe. We offer both experience an d the latest technology in the fabrication of orthotic support.

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More Information – Other Common Foot Problems
besides the information given on this section of our website, the American College of Foot and Ankle Surgeons has a very good website with in-depth information on a wide range of foot problems at:

    Tobacco Cessation: Weight Managment: Diabetic Foot Care

    DISCLAIMER: *MATERIAL ON THIS SITE IS BEING PROVIDED FOR EDUCATIONAL AND INFORMATION PURPOSES AND IS NOT MEANT TO REPLACE THE DIAGNOSIS OR CARE PROVIDED BY YOUR OWN MEDICAL PROFESSIONAL. This information should not be used for diagnosing or treating a health problem or disease or prescribing any medication. Visit a health care professional to proceed with any treatment for a health problem.

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    “There’s no pain that should be ignored,” says Jane Andersen, D.P.M., a podiatrist in Chapel Hill, North Carolina and a member of the American Podiatric Medical Association. Any type of pain—new or prolonged—warrants a visit to your primary care doctor or podiatrist. Pain in the feet can signal a host of conditions, from fractures to plantar fasciitis (inflammation in the tissue that connects your heel bone to toes), to arthritis. Noting the time of day when the pain occurs can give you a hint as to the cause.

    • Pain in the morning, when you first get up, can point to arthritis or plantar fasciitis. With both conditions, pain will recede as the foot loosens up throughout the day. A common cause of heel pain, plantar fasciitis often affects runners, and people who are overweight. Wearing high heels, or shoes that don’t have enough arch support also raises the risk. Dr. Andersen often sees people in her practice whose plantar fasciitis is caused by exercising in worn out shoes. “Athletic shoes don’t last very long,” she says. If you can estimate the mileage you put on shoes, then a good rule of thumb is replacing shoes every 350-500 miles, or anything over a year old, she says.

    • Pain that gets worse throughout the day may indicate a fracture, Dr. Philbin says. Pain caused by a fracture will recede when resting and worsen when bearing weight. Fractures, or small cracks in the bone, can be caused by overactivity or changes in activity, like trying a new exercise, according to the AAOS. Osteoporosis or other conditions that weaken bones can up the risk of a fracture. Healing fractures requires immobilizing the foot with a boot, and possibly even surgery.

    2. Discoloration

    You know to check your body and face for skin cancer, but you probably overlook your feet. However, skin cancer is the most common cancer seen in the foot, says Dr. Andersen. If you see “an unusual mole on the top or bottom of your foot or between toes, it should be checked out,” she says. “If you notice anything – a lump or bump – you should see a podiatrist.” Don’t forget to check your toenails, too. Melanoma, the most deadly type of skin cancer, can occur as dark spots underneath the nails. If you’re not sure whether dark spots are serious or something benign, like dried blood from an injury under your toenail, see your doctor—and know that blood under the nail will grow out, while skin cancer will not, Dr. Andersen says.

    3. Numbness

    Numb feet can indicate a host of serious health problems, from poor circulation to alcoholism. Causes of numbness may include:

    • Peripheral artery disease (PAD), a narrowing of the arteries that reduces blood flow, can result in numbness. PAD is also usually accompanied by leg pain and cold lower legs.

    • Diabetes affects circulation and blood supply, and numbness is a complication of the disease. “Diabetes is a big thing we worry about,” Dr. Andersen says. Neuropathy, a complication of nerves most often caused by diabetes, damages the skin and causes diabetics to lose sensation in their feet. Loss of sensation might mean the person can’t feel their skin breaking down, which can cause ulcerations, infections, and sometimes severe infections that require amputations, Dr. Andersen says. For many undiagnosed diabetics, neuropathy is often the first sign that they have diabetes, Dr. Philbin says.

    • Numbness can also be related to neurological problems, arthritis, or long-standing alcoholism, says Dr. Philbin. Although unknown why severe alcoholism over time can numb arms and legs, it’s possible that poisoning of the nerves and poor nutrition associated with heavy alcohol use are to blame, according to MedlinePlus, the web site of the U.S. National Library of Medicine.

    4. Swelling

    While swollen feet can commonly occur after standing for long periods of time, they’re also “indicative of some injuries like stress fractures and tendon tears,” Dr. Philbin says. It’s also possible that “something is wrong with the veins or arteries, and they’re not working well enough to control swelling,” he says. If you experience excessive swelling in the feet with no history of injury, your podiatrist can check your circulation by feeling your pulses, and doing tests to rule out thyroid problems or other issues. Swelling may also be a reaction to a medication or a sign of congestive heart failure, Dr. Andersen points out.

    5. Cold feet

    Constantly cold feet may be a result of insufficient blood flow. Poor circulation is a complication of diseases such as PAD, which most often affects men over 50. Risk factors include smoking, high blood pressure, heart disease, and history of stroke. Your podiatrist can check your circulation by feeling for pulses in the feet. Coldness along with toes that turn colors – from white or blue to red – may be due to Raynaud’s disease, a common condition in which the blood vessels spasm and constrict in response to cold temperatures.

    6. Itching

    Itchy, scaly feet may signal athlete’s foot – a fungal infection that usually affects areas in the “mocassin distribution,” Dr. Andersen says, meaning on the sides and bottoms of the foot and in between toes. Look for a white, scaly or flaky rash, sometimes accompanied by cracks between the toes that itches and stings or burns. Athlete’s foot mostly happens when sweaty feet are confined in tight shoes, but is contagious and can also be spread through contaminated surfaces like towels, floors, and other shoes, according to theMayo Clinic. The condition can lead to fungal toenails, which can get worse and harder to treat as we age since the body can’t fight infections as well, says Dr. Andersen. About 50 percent of people in their 70’s have fungal toenails, she says. Visit a podiatrist for a proper diagnosis. Most cases can be treated by over-the-counter antifungals, though some may need prescription medications.

    7. Gait

    If you’ve had a sudden change in your gait, consult your doctor right away. Neurological problems may be the cause – ranging from serious issues like stroke and multiple sclerosis, to more minor problems like a herniated disk in your back. Changes in the way you walk can affect your health in other ways – “if there’s instability in your gait and you’re not walking appropriately because of numbness where you can’t feel the ground, it’s dangerous because it’s a fall risk,” says Dr. Andersen. Sometimes gait change occurs after joint replacements in which slightly more bone is removed in one leg than the other, she says. This can lead to pain in one foot or leg. “Any time you have a painful gait it’s a problem,” Dr. Philbin says, and you should see a podiatrist.

    Also from Grandparents.com:

    Reasons and treatments for white spots on the nails

    Leukonychia can be caused by a variety of different factors, depending on the type.

    Trauma

    Injury to the nail plate or the area where the nail grows from, known as the matrix, can cause damage to the nail. This type of injury is common in children and is usually the cause of white spots on the nail.

    The types of injury that can cause this include:

    • nail biting
    • manicures
    • day-to-day nail injuries
    • footwear that is too small, causing abnormal pressure on the nails

    As a result of these injuries, the spot will grow out with the nail.

    Poisoning and drugs

    Some forms of poisoning or medication can also cause leukonychia. This cause is relatively rare and often results in transverse leukonychia.

    Poisoning and medication that can lead to white areas on or under the nails include:

    • heavy metal poisoning from metals, such as lead and arsenic
    • chemotherapy treatment for cancer, which is either given by mouth, injection, or infusion through the skin to try and kill cancer cells or stop them from dividing
    • sulphonamides, a medication used for bacterial infections, such as skin infections, septicemia, and infections of the urinary tract

    Systemic illness

    Share on PinterestOne or more horizontal white lines across the nail is known as striate or transverse leukonychia, also known as Mees lines.
    Image credit: Yannick Trottier, 2012

    Systemic diseases can also cause white nails. If so, they are a signal that there is a problem elsewhere in the body. Again, this is rarely the cause of white spots.

    Illnesses that can lead to white nails include:

    • iron deficiency anemia, a lack of iron in the body
    • liver cirrhosis, which is scarring of the liver
    • kidney disease
    • heart failure
    • diabetes
    • problems with the digestion of proteins
    • an excessive loss of proteins in the intestines
    • zinc deficiency
    • hyperthyroidism, an overactive thyroid resulting in abnormal levels of the thyroid hormone in the body
    • psoriasis
    • eczema

    Fungal disease or infection of the nail or skin disease around the nail can also cause white spots to appear.

    Nails grow slowly. Complete regrowth for a fingernail takes between 6-9 months, while a toenail takes between 12-18 months. As a result, the presence of white spots or nails could be the sign of an injury or condition that occurred, or began, several months before.

    Hereditary causes

    In very rare cases, white nails can be a genetic condition. However, this is usually only because of the presence of rare, complex syndromes, such as:

    • Bart-Pumphrey syndrome, which involves nail problems, knuckle issues, and deafness
    • Buschkell-Gorlin syndrome, which involves nail problems, skin cysts and kidney stones
    • Bauer syndrome, which involves nail problems and skin cysts
    • Darier disease, which involves wart-like blemishes on various parts of the body

    Six fixes for cracked heels

    Share on PinterestCracked heels or heel fissures are a common foot condition that may affect one fifth of adults in the U.S.

    Moisturizing treatments in the form of creams, lotions, and ointments can help retain moisture in the skin. This may prevent the skin from drying out and cracking. Moisturizing treatments can also help fix skin that is already cracked.

    In mild cases of cracked heels, moisturizing two or three times per day may fix the problem. Rubbing any calluses gently with a pumice stone and applying a moisturizer can also help. However, be careful not to overuse the pumice stone, which can make cracked heels worse.

    The following steps may help treat cracked heels:

    1. Using an emollient or humectant moisturizer

    Emollients penetrate the skin and reduce water loss. They fill the gaps between skin flakes, which makes the skin feel smooth, soft, and flexible. They help to reduce water loss in the skin.

    Humectants penetrate the outer skin layer, attract water from the air, and maintain moisture. They also help to increase the water capacity of the skin.

    In dry conditions, humectants may draw moisture from the lower skin layers instead of from the atmosphere. This may result in more dehydrated skin overall. Combining a humectant with an occlusive may help seal in moisture.

    If you want to buy humectant moisturizers, then there is an excellent selection online with thousands of customer reviews.

    2. Applying an occlusive moisturizer over the top

    Once the emollient or humectant is absorbed, people can apply a thick layer of an occlusive moisturizer over the top just before bed to seal the moisture in.

    Occlusive moisturizers coat the skin in a thin film that prevents moisture evaporating from the outermost layer of the skin.

    Examples of occlusive moisturizers include:

    • petroleum jelly
    • lanolin
    • mineral oil
    • silicones, such as dimethicone

    Petroleum jelly is considered to be the most effective occlusive moisturizer, reducing water loss from the outer skin by more than 98 percent.

    Although occlusives work well to lock in moisture, they can be greasy, sticky, and messy.

    3. Wearing 100 percent cotton socks to bed

    Wearing 100 percent cotton socks to bed after applying petroleum jelly to the heel may help to:

    • keep the moisture in
    • allow the heel skin to breathe
    • prevent the bed sheets from becoming stained

    The skin on the heels should soften after this routine is repeated for a few days.

    100 percent cotton socks are available online.

    4. Applying a keratolytic to thickened skin

    When the heel skin is thick, applying a keratolytic may help thin it, as well as the other treatments.

    Keratolytics are agents that thin thickened skin, cause the outer skin layer to loosen, and help with removal of dead skin cells. This process allows the skin to keep in more moisture.

    Examples of keratolytics include:

    • alpha hydroxy acids, such as lactic acid and glycolic acid
    • salicylic acid
    • urea

    Products that contain both keratolytics and humectants may be the most useful. For example, urea is both a keratolytic and humectant that moisturizes and removes dry, cracked, and thickened skin.

    5. Gently rubbing thickened skin with a pumice stone

    Gently rubbing a pumice stone against the heel, once the skin is moisturized, may help reduce the thickness of the hard skin and calluses. Pumice stones are available here.

    Razors and scissors should be avoided for scraping back and cutting skin. People with diabetes or neuropathy should not use pumice stones and should instead visit a dermatologist or podiatrist.

    6. Using a liquid bandage

    Liquid, gel, or spray bandages can be used to cover the cracked skin. These may provide a protective layer over the cracks, help reduce pain, stop dirt and germs entering the wounds, and aid faster healing.

    People should see a podiatrist or dermatologist if their heels are severely cracked, or if self-treatment does not improve cracked heels after a week.

    Medical treatments

    In severe cases of cracked heels, or if medical care is required, a doctor may:

    • remove dead skin
    • prescribe stronger softening or removal agents
    • apply medical glue to seal cracks
    • prescribe an antibiotic if there is an infection
    • strap the heel with dressings or bandages
    • recommend shoe inserts, heel pads, or heel cups
    • help the patient change how they walk

    Cracked Heels Information and Treatment

    Dry Cracked Heels? Try Our Doctor-Recommended Footcare Creams
    Cracked heels are a common problem and affect people of all ages and demographics – though they become even more common as we age. Moisture, or the lack of it, is a huge contributing factor to the prevalence of cracked heels. Chronic dehydration and the depletion of moisture in your body can lead to dry skin as the water reserves are dedicated to other, more vital areas like your internal organs. When it impacts the feet, dry skin eventually turns into cracked heels. Below, our foot care professionals at HealthyFeetStore.com have put together a list of care recommendations to help individuals find the best treatment for cracked heels possible. Read on for our recommendations, and shop high-quality foot care products on right here on our site.
    RECOMMENDATIONS: Searching for the treatment for dry cracked heels? You’ll find that this search is often a process of trial and error in finding what works best for you. Dry, cracked heels are best treated with quality therapeutic ointments and creams, avoiding lotions that may contain drying alcohol. Use doctor recommended foot care creams that are especially formulated for dry, cracked heels and calluses, especially at night. We also recommend wearing specially designed socks that help absorption. Wear comfortable shoes with doctor-recommended insoles or other corrective devices that reduce the risk of friction and rubbing against the injured heel. Do your research to find the best treatment for cracked heels according to what others have said, and see if it works for you. If you have any questions about a potential treatment, please contact our team or schedule an appointment with your doctor.

    Risks Posed by Cracked Heels
    On occasion, dry skin and cracked heels on their own are not particularly damaging or concerning. However, if left untreated, these symptoms can lead to bleeding if the cracking and dryness progresses. Bleeding caused by the cracks will lead to infection. Should bleeding lead to an infection in those with diabetes and the elderly, it could have serious consequences.
    Cracked heels typically appear in with age, but people of any age, including younger generations can also develop dry skin that leads to cracked heels. Common causes include wearing shoes that don’t fit correctly, diabetes, and exposure to dry or stale air from spending several hours indoors. No matter how cracked heels form, there are several treatment options available.
    Products to Sooth Cracked and Hardened Skin
    Healthy Feet Store carries doctor recommended products that target cracked heels. Browse our inventory to find therapeutic ointments and creams. These are specially designed formulas that treat dry skin, calluses, and cracked heels. The products we carry do not contain alcohol, an ingredient known to dry out the skin. Avoid lotions and creams that contain drying ingredients like alcohol.
    Another product that should be on your radar is moleskin adhesives with gel cushioning. They are used to treated blisters and corns. They provide constant moisturizing and sooth irritated and sensitive skin. If you have issues caused by shoes that don’t fit correctly you may find gel cushions to be very helpful.
    The Importance of Removing Dead Skin
    People with cracked heels are also likely to have calluses and corns. To treat these issues we offer the Personal Pumi Bar, which is a pumice bar that gently removes harden skin and smooths out calluses and corns. Removing dried out, dead skin layers are also a part of caring for heels that are prone to cracking. Pumice bars can help keep your skin exfoliated and supple.
    Preventing Infections and Fungal Growth
    If your cracked heels begin to bleed, infection is a risk. Take preventative measures to stop the growth of bacteria and fungus that can lead to infection. Products like PediFix Tea Tree Oil Antifungal Foot Soap can help prevent the growth of foot fungus and keep your feet clean. Tea tree oil is a well-known natural disinfectant that can gently clean the skin in small doses. This soap in particular also has moisturizing properties.
    Corrective Footwear
    Wearing comfortable shoes can be extremely helpful when dealing with cracked heels. Insoles and similar corrective products can help ease the stress on your feet. Avoid shoes that cause friction or irritation through rubbing and chaffing.

    With warmer weather around the corner, we soon will be casting our boots aside in favour of sandals and flip-flops. However, switching to this type of footwear can also reveal our cracked heels – but how can we get rid of them?

    Podiatrist Richard Hanford says, “In the summer, many of us like to wear sandals, and this is where the problems lie. The combination of the skin being physically unsupported and exposed to the elements increases the risk of dry, cracked heels.”

    And dry feet can worsen every time you walk or run.

    What causes cracked heels?

    Richard adds, “Our heel is a shock absorber and, as such, is designed to deform when the heel strikes the floor as we walk or run. To do this effectively, the skin around our heels needs to be supple and able to move and stretch.

    “If the skin on the heel becomes dry (skin dries out the more it is exposed to the elements) or has grown hard skin or callouses (calloused skin is caused by pressure) it is much less supple. When the heel strikes the ground, instead of deforming it is more likely to crack and split.”

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    As a result, your foot’s condition can worsen, and white cracked skin will show at the back of your heels.

    How to get rid of cracked heels

    So how do we get rid of this issue? We asked Richard to share his top tips…

  1. Pressure will be reduced if the heel is physically supported and preferably cushioned; this is best achieved by wearing shoes with a heel cup. Flip-flops have no heel cup, so the heel is subject to greater mechanical stresses, producing more callouses.
  2. Skin will dry out when exposed to the elements. In the Summer, this also includes the sun and dust. Again, wearing shoes with a heel cup will help, as will wearing socks – to stop skin from rubbing against the leather of a shoe, for example.
  3. The best weapon for treating dry, cracked heels is to use a good-quality cream. In recent years, ‘heel balms’ have become available specifically to target dry, cracked skin. Look for a cream with 25% urea to rehydrate feet. Regular use of this really makes a difference, but remember that cracks will keep returning if the underlying cause is not addressed.

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Cracked heel

Introduction

A cracked heel is a common foot problem. In most cases the problem is merely a nuisance and unattractive to look at, however, when the cracks or fissures become deep, standing, walking or any pressure placed on the heel can be painful.

Cracked heels

Who gets a cracked heel and why?

Anyone can get a cracked heel. Predisposition may be due to:

  • Dry skin
  • Atopic dermatitis
  • Juvenile plantar dermatosis
  • Psoriasis, especially palmoplantar psoriasis
  • Palmoplantar keratoderma
  • Systemic conditions, including diabetes and hypothyroidism

Dry thickened skin (corn and callus) around the rim of the heel is the very first step towards cracking. Increased pressure on the fat pad under the heel causes it to expand sideways, leading to splitting or cracking of the callus. Some factors that contribute to cracking or splitting include:

  • Excessive weight or obesity
  • Prolonged standing, especially on hard floors
  • Open-back shoes and sandals, as they provide no support to hold the fat pad under the foot

What are the signs of symptoms of cracked heel?

The first sign of getting cracked heel is the development of dry, hard, thickened skin around the rim of the heel. This is called a callus and may be a yellow or dark brown discoloured area of skin. Initially, small cracks over the callus are visible. If left untreated and as more pressure is placed on the heel, these cracks become deeper and eventually walking and standing will be painful. The cracks may be so deep that they begin to bleed.

In severe cases, cracked heels can become infected, and lead to cellulitis. This must be treated with the elevation of the area, debridement of dead tissue, and antibiotics.

Cracked heels are of particular concern for diabetic patients, who may suffer neuropathic damage (loss of feeling, particularly of the feet), as the fissures may lead to diabetic foot ulcers.

Complications of a cracked heel

What is the treatment for a cracked heel?

The best form of treatment for cracked heel is to prevent cracks from occurring in the first place. This can be achieved by simply rubbing the heels with a moisturising cream on a regular basis to keep the skin supple and hydrated. Special heel balms are available that contain descaling (keratolytic) or water-retaining (humectant) agents, such as:

  • Urea
  • Salicylic acid
  • Alpha-hydroxy acids
  • Saccharide isomerate

Feet should be inspected daily and on the first sign of any cracking, a moisturising routine 2–3 times a day may be all that is needed to heal the heel. A pumice stone can be rubbed gently against the callus to take away some of the thick hard skin before applying moisturiser.

The fissures may be treated with a liquid, gel or spray bandage to reduce pain, protect and allow more rapid healing.

For severely cracked heels or if no improvement is seen after a week of self-treatment a visit to a podiatrist may be required. Treatments may involve the following.

  • Debridement – cutting away hard thick skin (this should not be attempted at home using scissors or razor blade as there is a risk of removing too much skin and infection occurring)
  • Strapping – bandage/dressings around the heel to reduce skin movement
  • Prescription for stronger softening or debriding agents, usually containing urea or salicylic acid
  • Insoles, heel pad or heel cups to redistribute the weight of the heel and provide better support (prevent the fat pad from expanding sideways)
  • Special tissue glue to hold the edges of the cracked skin together so it can heal.

Temperatures are dropping and winter can make the skin on your feet, especially your heels, super dry — dry enough to crack like a fault line. Even though sock season gives them a place to hide in plain sight, cracks in your heels can fracture into deep cuts, or fissures, that can be pretty painful and even get infected. We asked board certified dermatologists Sheel Desai Solomon, MD, founder of Preston Dermatology & Skin Surgery in North Carolina and Samer Jaber, MD, founder of Washington Square Dermatology in New York City, what causes our heels to crack and what we can do to heal and protect them.

How heels crack

“Cracked heels occur when you have a disruption of your skin barrier,” explains Jaber. “It can be from a medical condition, like psoriasis or eczema, or can occur when you skin is very dry.”

Other variables that can dry out your heel skin enough to crack are age (your skin gets thinner, less elastic and some common medications can contribute) and, of course, winter itself is quite the culprit. “Heels are at their worst in winter,” says Solomon. “Indoors and outdoors there is less humidity in the air, and a lack of humidity causes the skin to become drier. Drier skin means more cracking and peeling.” This kind of cracking can cause wounds that can easily get infected if not treated, and if you happen to have a compromised immune system or diabetes, an infection can become a serious health risk, Solomon says.

4 tips for caring for dry, cracked heels

1. Keep your feet clean and moisturized

Solomon says diligence in keeping your feet clean and moisturized will keep you on the good foot. “Wash feet with non-foaming hydrating cleanser (typically in a cream or milk form), to keep foot skin from drying further and moisturize to still-damp feet after every bath or shower,” she recommends. “That’s when it’s time for to apply products with petrolatum, glycerin, shea butter, vitamin E or jojoba. These ingredients are very effective at preventing moisture loss.” She also recommends a kitchen cabinet remedy to try — honey. “Honey is full of antimicrobial and antibacterial properties great for cleansing and healing wounds, particularly Manuka honey,” she says, saying you can create your own honey foot mask by combining it with a drop of almond oil and slathering it on your heels.

2. Slough off dead skin

To prevent cracks, exfoliation is key. Both experts extol the virtues of moisturizers with exfoliants like urea (not urine, but a similar compound that has been shown to help moisture seep into skin), and salicylic acid, to help prevent heel cracks with regular use. Solomon also recommends using a “safe foot file that doesn’t look like a cheese grater” to remove dead skin. “Using a foot file on your feet after a shower or bath can be a great way to avoid thick calluses or cracks,” she says. “However, if the file has sharp teeth, it is putting you at risk for cuts or scrapes. The goal is to remove the old, dead skin but leave the healthy layer intact to protect infection.”

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3. Seal up deep cracks

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Cracked heels which have reached the point where they’ve started to bleed can be extremely painful, warns Solomon. Both experts say liquid bandages are an extremely effective way of sealing up cracks to ease the pain of walking on torn skin while keeping the wounds clean.

4. Wear socks made of natural materials

The damp, dark environment of wet socks in shoes and boots can bring on a fungal foot infection that resembles dry skin, warns Solomon. To prevent this from happening, she advises choosing winter socks made from natural materials, such as cotton or wool rather than synthetic blends, to keep your feet sweat and bacteria-free. “Materials like cotton and wool are naturally more absorbent and these moisture-wicking qualities are extremely important during the winter months. An added bonus is that your feet are less likely to smell, too,” she says. Jaber says his trick to beat cracks in severe dry and cold weather is to advise his patients to apply Vaseline onto the heels of their feet before bed and immediately put on white cotton socks to lock in the moisturizer while they sleep.

The best treatments for dry or cracked heels

1. Eucerin Roughness Relief Spot Treatment

Jaber recommends applying this spot treatment to your heels because its formula contains a high percentage of urea and exfoliating alpha hydroxy acid, which are great at removing dead skin cells so the moisturizing components of the formula, like sunflower oil rich in vitamins A and E, can seep in to heal skin.

2. Excipial Urea 20% Intensive Healing Cream

Though it’s on the pricier side, this fast-absorbing cream also contains a good amount of urea to help chemically exfoliate dead skin, leaving your feet soft and smooth, says Solomon. Plus, it’s good for dry cracked hands, knees and elbows, too.

3. CeraVe Healing Ointment

Dermatologists love this non-comedogenic, lanolin-free formula, because it doesn’t irritate the skin. As it’s almost half petrolatum (qualifying it as an ointment), is enriched with ceramides (to restore your skin’s barrier) and it also contains hyaluronic acid, an ingredient that helps skin retain moisture.

4. CeraVe SA Cream for Rough & Bumpy Skin

Jabar favors this multitasking moisturizer for its bounty of skin-loving ingredients. Lactic, salicylic and hyaluronic acids exfoliate and moisturize, niacinamide, a B vitamin that helps prevent moisture loss, ceramides 1, 3, and 6-II help restore your skin’s protective barrier, the formula is free of fragrances and dyes and it releases over time to keep your skin super soft.

5. NatraCure 5-Toe Gel Moisturizing Socks

Solomon recommends these socks because they have a liner that uses aloe vera, vitamin E, and shea butter to intensely hydrate your skin, she says. Plus, they are infused with medical-grade mineral oil for an added boost of moisture.