Essentially, a heel fissure is a callus crack that forms in the bottom of the heel, usually near the bottom of the back of the heel. So, what exactly causes heel fissures? Most of the time, this type of crack appears in the winter for people who lived in colder climates, but it can also be seen in the summer when people wear a lot of sandals and other types of shoes that allow for open exposure to the air while simultaneously causing rubbing against the bottom of the heel. What usually happens in this condition is that there is a loss of moisturization to the heel tissue. In the wintertime, this occurs because people sweat less because they are not trying to reduce or get rid of excess body heat so most of that heat stays towards the core of the body and there’s less sweating in the extremities. This allows for decreased production not only of actually sweat moisture, but also the natural oils and allowed the skin to become lubricated.
In the summertime, the same phenomenon occurs not necessarily because there’s a loss of sweating because the sweating is normal. The production of oil glands is normal. There’s a combination of evaporation that occurs with air exposure and wind exposure onto the heel tissue and cells such as when you are wearing sandals. As well as the fact that while wearing sandals, there’s a certain looseness of the heel across this material and allow these essential oils will get rubbed off of the heel tissue and will essentially either soak into the leather or the lining of the shoe itself or just simply be removed. The end result of this loss of moisturization to the heel is a thickening of the heel tissue. Within that thickening, linear cracks can form which are essentially lines that can deepen. In severe cases, as the callus around these lines thickened up, the cracks can go all the way down to the base of the skin. As pressures applied with walking, these cracks will split open and that causes a bit of a tearing effect in its space which can lead to pretty significant amount of pain as one is walking with these cracks and these fissures.
How to treat heel fissures
Treatment for this condition is very difficult to say the least. This is a chronic condition for a lot of people in the wintertime and it’s hard to keep under control. It requires daily vigilance to keep the heel tissue well moisturized. You need to use a good moisturizer at least once if not twice a day. The nighttime application of the moisturizer will typically need to be done under the cover of a sock because that will allow a lot of the moisture to be retained when you place them underneath a cover. In extreme cases, you can use something like saran wrap to keep that moisturization in place, but for the vast majority of people, just simply wearing socks when you go to bed will do. Certainly, in the wintertime, that feels more comfortable. That helps to keep the tissue better moisturized. The thicker the cream, usually the better it is as far as whether it can fill those cracks and those crevices and help to moisturize the space in between there. Creams with urea or lactic acid are usually superior to more the water glycerin-based moisturizing creams. Some of those creams are also more available in prescription preparations rather than over-the-counter preparations.
In addition to moisturizing the heel, controlling some of the pressure and the forces that go across the heel are also very helpful in reducing some of the splitting and some of the callus production in the first place. The use of a gel heel pad one that simply is a pad sort of a U-shape without an opening that fits underneath the heel can help displace some of that pressure and they reduce some of the production of strain that goes through the heel and the skin tissue itself to allow to split. In some cases, the use of a prescription orthotic which actually stabilizes the heel tissue and supports it and lateralizes the pressure and the strain of walking away from the heel tissue itself. Sometimes it’s also be an answer to reducing this pressure. Now, the combination of reducing the pressure and increasing the moisturization is often effective for a lot of people, but you have to be very vigilant about this each and every single day. Otherwise, these heel cracks will continue to form. Sometimes it gets thick enough that they need to be trimmed down. I don’t generally tend to recommend that most people do this on their own because it’s very easy to cut into good skin tissue and create a bigger problem or even start an infection, especially if one is diabetic which is a big no-no.
If they become that painful, that thickened, it’s probably best just to simply go see a podiatrist and they will be able to take care of that and reduce that. Also offer further solutions including possible prescription moisturizers to reduce the production of this callus or this crack in order to get it to feel better. They have come up with a number of other novel treatments. Currently available is sort of a sleeve or a sock that has medicated base to it that basically fits around the heel and the ankle and this medicated base sits right where the heel tissue is at in order to reduce some of the cracking and some of the callus production overnight. I currently have this condition myself so I’m trying these products out and if I find one that I think is particularly effective, I will certainly make my recommendations to everybody. As I said, this is a tough condition to treat. It’s very common and just requires daily vigilance and skin care in order to reduce it.