Cracked Heel Pain: Causes

A cracked heel hurts when the fissure stops being surface scaling and becomes a deep split in the skin. Severe dry skin develops plate-like scaling with deep fissures, and the lower legs, feet, and heels are exactly where that pattern shows up. Fissures that deep are painful to stand on, and they can bleed.

Why the pain appears as the condition progresses

Dry heel skin starts as roughness, scaling, and flaking, and at that stage it usually causes tightness or itching rather than pain. As water loss continues, the scaling thickens into plates and the splits between them go deeper — the “cracked porcelain” appearance dermatology calls eczema craquelé. Once the split reaches the vessels in the skin, it bleeds. See the general overview of causes in cracked heels: causes.

Signs that the crack is more advanced

• Pain when standing or walking on the heel.
• Visibly deeper and wider fissures, with thick plate-like scale around them.
• Bleeding, once the fissure damages the small vessels in the skin.
• Tenderness to touch even when you are off your feet.

Risk of infection

Broken skin lets microorganisms get past the surface, which is why dry, fissured skin carries a higher risk of skin infection. This is the reasoning behind the AAD’s advice to cover the cracks: a liquid bandage applied over them during the day creates a protective barrier that can reduce pain, speed up healing, and stop germs from entering the skin.

What helps relieve it

• Liquid bandage over the cracks during the day, for the barrier described above.
• A moisturizing cream with 10 to 25% urea, alpha hydroxy acid, or salicylic acid, applied within 5 minutes of bathing while the skin is still damp, and again whenever the heels feel dry.
• Plain petroleum jelly before bed, with socks over it to keep it off the bedding.
• Shoes that support the heel — the AAD says to avoid open-heeled shoes, worn-down shoes, and shoes that don’t fit.

See the full step-by-step guide in how to treat cracked heels.

When to see a dermatologist

The AAD’s threshold: if the cracked heels are severe or don’t improve after following the home-care tips, see a board-certified dermatologist. Cracked heels are sometimes caused by a medical condition such as diabetes. Signs of skin infection — pus or fluid leaking from the area, discoloration, swelling, and pain — also call for evaluation.

This content is informational and does not replace a medical consultation, diagnosis, or treatment.