Dry skin over the heels is common. Sometimes this skin will crack. The result can be a heel fissure. These cracks may be quite painful. Sometimes, the pain is worse with pressure like walking. But sometimes the pain actually becomes worse when you stop putting pressure on the heels, like when you raise your legs in bed at night. That is why a heel fissure can be a cause of night leg pain.
Heel Fissure Causes
The main cause of a heel fissure is dry skin. Of course, dry skin is common. But it is more common in some people. For instance, people who work outside, especially in the cold in dry cold weather. It is also more common in older people. So a heel fissure can be a cause for night leg pain in elderly.
The second important cause is pressure. Heel fissures are a common problem for runners. But it can also be a complication for people who do not have good sensation in their feet. Neuropathy can cause neuropathy leg pain, but it is more common a cause for lack of sensation. And diabetes is probably the most common cause of neuropathy. In fact, some people with diabetes will have dry skin and poor sensation of their feet. Practically, these two problems make them prone to heel cracks.
Treatment
There are two parts to treating cracked skin over the heels:
- Moisturizing the skin with a heavy emollient. It is important to apply the moisturizing cream over the heels. But you should avoid placing it between the toes. If you moisturize between your toes, you might promote athlete’s foot. This is because athlete’s foot is caused by fungi, and fungi love dark, humid areas. Like in between our toes.
- Reducing pressure until the skin heals.
Some recommend soaking your feet in warm soapy water to help the skin heal. The idea is that the water will soften the skin. Then, the dead skin will fall off, and healthy skin will grow in to close the crack.
Special Situations
Not all heel fissures are simple. In fact, some people will need special care. For instance, sometimes, the skin is dry because of inflammation. This is called dermatitis. The treatment of dermatitis might include topical steroids. Another cause is actually athlete’s foot. Then, the treatment is with an anti-fungal cream. It is important to get the diagnosis right, because steroids might make a fungal infection worse.
Finally, remember that sometimes skin cracks over the feet might be part of a bigger problem. I already mentioned diabetes. But there are other options. For instance, hypothyroidism might also cause dry skin.
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