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Heel Cracks

Heel cracks are usually linked with dry thick skin.  Dry skin is more common in dry climates. Heels crack when the skin is dry and unable to stretch. As the heel strikes the ground when walking, the heel bulges and the pad of the heel gets wider. If the skin is too dry, it loses its stretch and the skin tears and rips. A heel crack or lots of cracks result.  If the skin is okay it has enough stretch to adapt to this movement and does not split.  People with diabetes need to protect their heels by wearing closed backed shoes like joggers, so that the skin does not dry out.
Gently use a sanding block, with soap and water, ‘look and feel’ to ensure you don’t damage the good skin, and smooth the heels and reduce thick skin. Moisturising cream should be applied after using the sanding block. Regular use of cream will help stop the dryness. If not cared for, the cracks can split deeply into the blood layers of the skin and infection canresult. Seek help from the Health
Team if you are unable to manage heel cracks.

What is it?
Callous around the heel, which has split and cracked. The depth of the crack can involve the epidermis only [superficial] or dermis [deeper, so blood can be seen to be involved]

Where is it found?
Around the rim of the heel, often including the medial, posterior and lateral surfaces of the heel.

What causes heel cracks?
Excessive and frequent pressure and friction causes the thickness of skin, Exposure to dry conditions dehydrates the skin. The thick dry skin is less elastic and less able to stretch. During walking, when the heel strikesthe ground, the heel pad expands. If the heel skin is thick and dry, it is more likely to split and tear and result in heel cracks.

How to look after heel cracks.

Apply moisturising cream regularly, to prevent the skin from becoming too dry and hard. Careful and regular use of a pumice stone or sanding block to reduce the thickness of the callous, cover the deep cracks with tape to hold the edges together and to reduce the chance of infection, see a podiatrist to have the heel cracks carefully reduced with a scalpel, and to obtain additional advice, wear closed­in shoes and socks to protect the skin.

What can happen if the heel cracks are not looked after?

All heel cracks have the risk of encouraging infection. Bacteria can enter the skin through an open split in the skin. Deep heel cracks can cause significant pain and discomfort.
For people with diabetes, if they have peripheral neuropathy [numbness of their feet], the person might not experience this pain of discomfort.
The splitting of the skin can result with infection.
For this reason – all heel cracks need care and attention.
If a heel crack becomes deeply split, see a Health Worker or Health Clinic to arrange an appointment.

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