Don’t let cracked heels ruin your sandal time
Calluses may be caused by ill-fitting shoes, excessive weight, going bare-foot or wearing opened-back shoes, or merely from constant pressure from repeated use!
At this time last year, I shared some information about unsightly toenails. And with sandal-wearing season upon us, I want to focus again on the feet. This time I will address the back of the feet, or the heels. Do you have dry or callused heels? Are there cracks around the rim of your heels? Because of constant use and, usually, lack of attention and care, the heel area of the foot can commonly become an area of concern. (It can also become unattractive in those sandals!)
The heel of the foot is the area that bears weight almost constantly. It is the “shock absorber” when we walk, and the “stabilizer” to help keep us upright when we stand. Let’s face it; the feet take a lot of stress. So we need to pay attention to them!
Within the foot, thick, connective tissue surrounds the calcaneus, or heel bone, and acts as a “cushion” when we walk, providing protection for the heel. These tissues are continually expanding within the confinement of the skin, placing pressure within the walls of our heels. Sling-back shoes, flip-flops, or any shoe that does not enclose the heel of the foot (even going bare foot), allows these connective tissues to expand and place even more pressure within the heel. The skin can expand only so far. When it cannot expand any longer, cracks may begin to develop. In addition to repetitive use, prolonged standing on hard floors, being overweight, advanced age (because of decreased sebum production), and fungal infections are some of the common causes of dry, cracked heels.
Of course, moisturizing and massaging can prevent dryness. But moisturizing and massaging must be done on a consistent basis to prevent the problem. In most cases of dry heels, hyperkeratosis (better known as a callus) has formed. This rough, sometimes discolored, hard skin around the rim of the heel may be caused by ill-fitting shoes, excessive weight, going bare-foot or wearing opened-back shoes, or merely from constant pressure from repeated use! Simply moisturizing may not be effective if a callus has formed because the moisturizer cannot penetrate the rough skin. The callus should be removed. This can be conveniently accomplished with a pumice stone, a callus remover product (which is specially designed to penetrate the thick skin), and some diligence. It is not recommended to remove the callus with a razor or any sharp object because of the risk of injury.
Simply moisturizing may not be effective if a callus has formed because the moisturizer cannot penetrate the rough skin. The callus should be removed.
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Using a pumice stone immediately after showering or bathing to exfoliate the heels will help reduce the dry skin and callus. The water will soften the skin and make the exfoliation process easier. It should be done a few times a week followed by the application of a callus removal product and/or a moisturizer.
Callus remover products may be purchased at a local drug store. Common remover products contain a kerotolyic agent combined with an emollient or humectant agent. Keratolytic agents help to remove or “slough off” the dead, tough skin, and the emollients and humectants moisturize the skin.
The most common kerotolyic agent is salicyclic acid. Because it is an acid, it should be applied only to the unopened, callused skin because as it will break down any skin that it is applied to. Salicylic acid is also the active ingredient in many over the counter corn and wart removers.
Emollients help moisturize the skin by creating a “film-like” barrier; trapping moisture, and preventing any water loss, thereby, softening the skin. Emollients are typically oil-based products. Some common emollients include shea butter, vitamin E, mineral oil and lanolin.
Humectants have the ability to penetrate dry, callused skin by attracting moisture into the skin cells. Common humectants include urea and lactic acid. The latter also has some exfoliating properties.
If your heels aren’t just callused and dry, but they are also cracked, it is necessary to ensure that there are no open areas. Pain is not typically involved with cracked heels unless the cracks have extended deep into the skin tissue, which may also result in bleeding. Open cracks or fissures on the heel (or anywhere on the foot) are very susceptible to infection and must be closely observed. It is especially important for people with chronic illnesses such as diabetes, the elderly, and those who are immunocompromised because they are prone to more serious complications.
Cracked heels may also be caused by Athlete’s Foot, or fungal infection of the feet. Fungal infections are usually contracted by sharing footwear or by exposure to the fungus in a shower or bathing area. In the case of fungal infections, the first signs may begin with scaling, flaking and/or itching of the feet. If diagnosed properly, the fungal infection can be treated with good hygiene and over the counter antifungal medications, found in the foot care section of your local drug store. Some of the treatments include Lamisil®, Lotrimin®, and Micatin®, but treatment may take several weeks. If left untreated, however, the fungal infection may spread to other parts of the body and become very serious. If these types of symptoms are noticed, contact your physician before self-treating.
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"Don’t let cracked heels ruin your sandal time"
authored by:
Tamara Dulin, R.Ph., is a registered pharmacist with Nightingale Home Health Care in Carmel, Indiana. A 1991 graduate of Butler University College of Pharmacy, she has spent the majority of her career in consulting. She is a past president of the Ind...
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