Even at the best of times, heels take a lot of abuse. When we are standing, they bear more of our weight than any other part of the body. With us moving, including walking and running they are exposed to all sorts of elements including rough, hard, and uneven surfaces both on the ground we walk and in our footwear. Environmental humidity levels can also contribute to problems, whether there is excess moisture or dryness.
Hyperkeratosis – Scaling of Heels
The best Omaha dermatologists know that heels respond to many of these insults by thickening—a phenomenon we call hyperkeratosis. In the real world, hyperkeratosis means scaling and thickening of the skin. In its mildest form, this can cause roughness in the heels. That roughness causes annoying feelings where the heels tend to rub against our socks or the bed linens at nighttime. As this hyperkeratosis worsens, skin becomes thicker and more uncomfortable. This may cause pain with walking. It also can lead up to splitting of the skin resulting in fissures that are often extremely painful due to the exposed nerve endings. If those fissures are severe enough, they can even cause infection in the skin as they create a portal for bacteria to enter the deeper tissues.
So, what do we do now? How do we get our cracked heels to heal?
This article shares with you our standard approach and secret recommendation to improve this common problem.
Cracked Heels Treatment
Offload the pressure – mind your footwear
You should baby your heels with your footwear. Naturally, you would think that we would see problems with the heels mostly in the winter due to dry weather, but surprisingly we often see them in the summer as well. This has to do with many of us going barefoot or wearing sandals and flip-flops. This means less cushioning for our heels. They will naturally respond by thickening. Think of it like the heel putting on a suit of armor for protection.
Look for footwear that is soft on the inside and has plenty of cushions. Thicker plush socks can help as part of the equation. Tennis shoes tend to have better insoles with more cushioning. Consider buying special insoles for your shoes to help even more.
Minimize the friction
Despite our best intentions, there are other things that we do that may worsen the thickening due to increased friction. In some cases, with very thick heels some people use an emery board, pumice stone, nail file, or magic egg to scrape down the heel. However, when exposed to this type of friction the heel naturally responds by trying to further thicken. This becomes a vicious cycle in some cases. For this reason, we generally advise against doing these things or having them done as part of your foot and nail care.
Find the Right Softening Agent for Cracked Heels Treatment
We live in a world of vast moisturizer options and most of them are useless, especially when it comes to our heels. For moisturizer, thicker is better—much better.
Light soupy lotions in some cases may dry out the heels even more. Thicker moisturizer creams tend to work better and can soften the skin. Generally, the brands we recommend most at Advanced Dermatology of the Midlands are:
- CeraVe cream
- Eucerin cream
It may be common sense, but we always recommend caution when using these on the bottom of the feet because if we aren’t careful, they can lead up to us slipping, sliding, and falling.
Along with that, one of the biggest challenges in applying these to the feet and getting them to do their trick before they’re smeared away by our socks and shoes when walking. We recommend that the best time to apply moisturizer for cracked heels treatment is in the evening, especially when we are sitting and can relax and apply the moisturizer, letting it soak in before putting socks on and walking around. It is always important to put your socks and shoes (or slippers) on before getting up and walking so that you are less likely to slip and slide.
Additional over-the-counter moisturizers with special active ingredients can also be used and may be helpful. Sometimes it helps to use moisturizers that contain urea or lactic acid. Both active ingredients are humectants, which are known to help increase the ability of the skin to carry water. Also, they have keratolytic properties, meaning they chemically soften thickened skin. Amlactin is the most readily available brand of over-the-counter moisturizer with lactic acid. Urea is available in several different over the counter and prescription formulations.
Secret Rescue Tip
If you remain frustrated with the progress in improvement, we have a secret for you. Our secret approach is to have patients soak their feet in a basin of water in the evening, then apply a thick layer of plain petroleum jelly vaseline and then white cotton socks. The same pair of socks should be worn night after night for least a few weeks. This approach can super soften thickened skin.
Advanced Dermatology of the Midlands | Best Dermatologist Omaha & Council Bluffs, IA | Board Certified Dermatologists
Please remember that even with the best of care, problems in heels can take a long time to improve. Also know that certain underlying skin diseases can make this problem worse if they are not appropriately treated. If you are struggling, we are here to help. Please contact us to schedule a consultation. in any of our clinics in Omaha, Council Bluffs or the surrounding communities.