Cracked Heels: Causes

Cracked heels almost always start as dry skin. The American Academy of Dermatology (AAD) lists cold, dry air, long hot showers, deodorant soaps and harsh cleaning products, and shoes that leave the heel unsupported among the things that pull water out of the skin — and heel skin has an anatomical disadvantage on top of all that.

Why the heel dries out more easily

Sebaceous glands — the ones that make sebum, the oil that keeps skin supple — are found in skin all over the body except the palms, the soles, the lips, and the tops of the feet. The heel therefore has no oil supply of its own to slow water loss, which is why dryness shows up there first and hardest.

When dry skin gets severe, it develops what dermatology texts call plate-like scaling with deep fissures, and the lower legs, feet, and heels are where that happens most. At that point the skin can crack and bleed.

Factors that promote cracking

• Cold, dry air. When outdoor temperatures fall, the air holds less moisture, and research links that to excessively dry skin — see dry heels in winter: causes.
• Long, hot showers and baths, which strip the skin’s oils. The AAD’s limit is 5 to 10 minutes.
• Deodorant soaps and harsh cleaning products, which strip oils and fats from the skin.
• The wrong shoes. The AAD tells people with cracked heels to avoid open-heeled shoes such as flip flops and slingbacks, shoes that are worn down, and shoes that don’t fit properly.
• Age. Sebum production drops sharply by your 40s, and by 60 nearly everyone has dry skin.
• Medical conditions, including diabetes, thyroid disease, and kidney disease, and treatments such as dialysis and chemotherapy.

When the crack comes with pain

Fissures that go deep are painful to stand on and can bleed. See more in cracked heel pain: causes.

Not every crack is simple dryness

A fungal infection of the foot can scale and fissure the sole and heel in a way that looks like plain dryness, and it needs a different treatment. See how the two are told apart in cracked heel vs. fungal infection.

How to treat it

The AAD’s routine is short showers, a gentle fragrance-free cleanser, and a moisturizing cream with 10 to 25% urea, alpha hydroxy acid, or salicylic acid applied within 5 minutes of bathing. See the step-by-step guide in how to treat cracked heels.

When to see a dermatologist

The AAD’s threshold is simple: if your dry, cracked heels are severe or don’t improve after following the home-care tips, talk to a board-certified dermatologist. Cracked heels are sometimes caused by a medical condition such as diabetes, and broken skin is an entry point for infection.

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