Heel fissures are splits in dry skin around the back of a person’s heel. They typically form in a vertical line, and there will often be more than one. In most cases, heel fissures may only be a cosmetic concern, but they can also be painful, and for some people, they might even become dangerous because of infections. A variety of conditions and factors can work together to increase the chances of developing heel fissures, including weight, the type of shoes a person wears, and various conditions that result in dry skin. Treatment can be a lengthy process, and for some people, heel fissures are a recurring problem.
One of the main causes of heel fissures is wearing shoes with open backs, such as sandals, or some kinds of high-heels. These shoes allow the skin to bulge outwards, which can stress the tissue and cause cracks. This is especially problematic when people also have particularly dry skin and thick calluses on the backs of their feet. Heavy people are also generally at a greater risk because the increased body weight causes the flesh to bulge out further at the back part of the foot, and these individuals generally put more stress on their feet when walking. Any person who has a condition that leads to less sweating is also at a greater risk of developing heel fissures.
Heel fissuring generally happens in the calluses on the feet. Some level of callusing is normal. Calluses happen naturally in response to abrasive action against the skin, and they toughen up tender areas, dulling them to pain. The feet are a prime area for this because they have to support a person’s weight, and they need to withstand a lot of friction. When calluses get too thick and too dry, heel fissures become a possibility.
For many people, cracked heels are simply something that they endure. The fact that they happen inside of calluses means that most of them aren’t particularly painful, and sometimes they aren’t especially obvious from a cosmetic perspective. For other people, they may be a serious cosmetic concern, and they can even become very painful if they get deep enough to damage non-callused tissue.
Individuals with poor immune systems and those whose bodies don’t heal properly may have significantly greater problems with cracked heels. For example, some people may get severe infections that make it necessary to amputate limbs. Bacteria tends to get trapped inside of heel fissures, and this makes infection a likely possibility.
Once fissures are diagnosed, doctors will usually take steps to reduce calluses and possibly moisturize the skin around the area. People are also usually advised to use footwear that better supports the skin on the outside of the heel. After people develop heel fissures for the first time, they may have to take special precautions to avoid them for the rest of their lives.